DMS 212 Chapter 10 Workbook
Oral and intravenous contrast is given
A CT examination can demonstrate pelvic sidewall masses, lymph node enlargement in the retroperitoneum, liver metastases, and calcifications, especially when:
Ovary
A Krunkenberg tumor is a cancerous tumor of the:
The gastrointestinal tract
A Krunkenberg tumor usually metastasizes from:
Form cystic masses with multiple septa
A characteristic of most epithelial cancers is the tendency to:
Vaginal bleeding
A large number of patients with ovarian malignancy present with or develop:
Meigs syndrome - A combination of ascites, pleural effusion, and an ovarian neoplasm
A patient with known ovarian cancer complained of abdominal pressure and submitted to an abdominal ultrasound. View the four images. A and B demonstrate the right upper quadrant in transverse and longitudinal view. C displays the inferior abdomen/superior pelvis. D shows pleural space superior to the liver. Name a likely disgnosis.
Teratoma/Teratocarcinoma
A rare malignant form of a common germ cell tumor found in young adults containing fat, bone, hair, skin, and/or teeth
Alpha fetaprotein
AFP
Pseudomyxoma Peritonei
Accumulation of mucinous material in the peritoneal cavity
Pelvic cul-de-sac, and paracolic gutters, mostly on the right side
Ascites associated with ovarian malignancy collects in the:
Ovarian cancer
Benign processes, such as endometriosis, fibroids, and even pancreatitis, result in and increased CA 125, as does:
Carcinoembryonic antigen
CEA
Krunkenberg Tumor
Carcinoma of the ovary, usually metastatic from gastrointestinal cancer, marked by areas of mucoid degeneration and by the presence of signet-ring cells
Disorganized vascular patterns
Color Doppler of malignant lesions frequently demonstrates:
"Hands-on" maneuver
Compressibility of a mass while scanning can assist in differentiating from malignancy and is performed by:
Mucinous Cystadenoma
Cystic mass filled the thick gelatinous cystic fluid
Pre-predominatley solid mass with heterogeneous internal echotexture complete with spetations
Describe the appearance of this case of ovarian cancer
Epthelium covering the ovaries
Eighty percent of ovarian malignancies originate from the:
Lactate Dehydrogenase (LDH)
Enzyme involved in production of energy of the cells. Elevated levels in the blood indicate tissue damage, cancers, or other diseases
Solid papillary growths
Epithelial ovarian cancers typically form cystic masses and:
High risk
Extended ovulatory activity, over 40 years, places women in what risk category for developing ovarian cancer?
Struma Ovarii
Extremely rare neoplasm of the ovary containing thyroid tissue
Ovarian malignancies
Fallopian tube neoplasms are rare and frequently malignant and often confused with:
Pelvic pressure and bloating
Frequently, the only symptom of ovarian cancer is:
HER2/neu
Gene that produces a protein, which regulates normal cell growth found in breast and ovarian cancer cells. The identification of this protein enables determination of treatment options
BRCA1/BRCA2
Inherited gene mutation associated with a significant increase of breast and ovarian cancer risk
Lactate dehydrogenase
LDH
11. Liver edge ascites 12. Right lobe of liver 13. Left lobe of liver 14. Stomach 15. Transverse colon 16. Left paracolic gutter 17. Small bowel 18. Cul-de-sac 19. Rectum 20. Right paracolic gutter
Label this image:
1. Diaphragm 2. Liver 3. Serosal bowel implants 4. Colon 5. Nodes 6. Ovaries 7. Pleura 8. Omentum 9. Stomach 10. Pelvic peritoneal implant
Label this image::
Mucinous Cystadenocarcinoma
Large cystic ovarian mass with thick-walled septations; may have internal debris layering components
Serous Cystadenocarcinoma
Large multilocular ovarian neoplasm with papillary projections
Poor prognosis
Late stage diagnosis of ovarian malignancy leads to a:
10 cm^3 ; 20 cm^3
Malignancy suspicion increases with the amount of solid tissue in a complex mass and if the volume exceeds ____________ in postmenopausal woman and _____________ in premenopausal women
Dysgerminoma
Malignant tumor of the ovary arising from undifferentiated germ cells of the embryonic gonad. the tumor is historically identical to seminoma found in the testicle
Normal-sized ovaries
Menopausal females utilizing hormone replacement therapy (HRT) will demonstrate:
Common
Metastasis to the ovary is:
3-D multiplanar with surface rendering Image A demonstrated internal architecture of a simple cyst with smooth regular walls Image B shows internal wall projections into an ovarian cyst
Name the imaging technique used in these images. Describe image A and compare it to image B.
Image A - Ovary with mulitseptated cyst displaying internal projections (open arrows) Image B - Flow in the thick separating membrane (long arrows) The complex fluid and cystic septations suggest ovarian malignancy C8-4V transducer
Name the structure visualized in images A and B. Identify the struture the open arow is pointing to on image A and B. Describe what the long arrows are pointing to in image B. What transducer was used to obtain these images?
Transbadominal, transverse pelvis Small open arrow - Right ovary with simple cyst Thin arrow - Left adnexal dermoid Thick arrow - Uterus Large open arrow - Distended urinary bladder
Name the view and organs imaged. Describe what the small open arrow, thin arrow, thick arrow, and large open arrow are depicting.
Clear-cell adenocarcinoma
Neoplasm involving the surface epithelium of the female reproductive organs (ovary), which involves cells with a clear appearance on microscopic examination
Epithelial Ovarian Cancer
Neoplasm involving the surface epithelium of the ovary
Yolk cell tumor/endodermal sinus tumor
Neoplasm originating in the germ cells (ovum)
Menstruating
Nonneoplastic cystic foci of the ovary are commonly seen in ___________________ females and are difficult to differentiate from malignant lesions, so should be considered when determining the diagnosis.
Late stages of the condition
One of the most lethal forms of cancer is ovarian because it is frequently diagnosed in:
Perimenopausal and postmenopausal women
Ovarian cancer is mostly a disease of:
Dependent portion of the peritoneal cavity
Ovarian malignancy is often associated with ascites, which first accumulates in the:
Right side
Ovarian metastatic masses are usually bilateral and more common on the:
CA 125
Protein found in tumor cells that results in an elevation of blood levels
The accumulation of gelatinous material in the peritoneal cavity
Pseudomyxoma peritonei is defined as:
Sertoli-Leydig Cell Tumors/Androblastoma
Related to the sex-cord (cord-like masses of gonasal epithelial tissue) stromal tumors seen in ovaries, mostly in young adults
Sex Cord Stromal Tumors
Solid ovarian mass originating from the embryonic gonadal ridges and Sertoli cells
Laparotomy
Surgical incision in the abdomen usually performed to evaluate the organs
Salpingo-Oophorectomy
Surgical removal of the ovary and fallopian tube
False
T/F - Studies show that women who used oral contraceptives are at the greatest risk for developing ovarian cancer
Ovarian epithelium
The effect of ovulation is known to cause increased inflammation and wound healing because of repeated trauma to the:
Pelvic ultrasound, physical examination, and the tumor marker CA 125
The effective method to investigate for ovarian cancer includes:
Meigs Syndrome
The finding of pleural effusion, ascites, and an ovarian mass
HER2/neu
The gene that is related to errors in the replication process resulting in over expression:
MRI
The imaging modality providing the most accurate tissue characterization regarding adnexal masses is:
25%
The stage I ovarian cancer detection rate is:
CA 125, AFP, hCG, CEA
To increase specificity in diagnosing ovarian malignancy, laboratory values such as what are tested?
Carcinoembryonic Antigen (CEA)
Tumor marker for colon, stomach, breast, lung, some thyroid, and ovarian cancers
Endomertroid Tumor
Tumor of the ovary containing containing epithelial or stromal elements resembling endometrial tissue. typically arises form endometriosis, and a large percentage are malignant
BRCA1 and BRCA2
Two inherited gene mutations related to an increase of breast and ovarian cancer are:
Serous Carcinoma
Type of epithelial ovarian cancer, which presents as a partially cystic mass with solid components
Alpha Fetoprotein (AFP)
Used as a tumor marker for carcinomas of embryonic origin
Plain film radiography
What imaging method provides diagnostic value by presenting calcification, sometimes in a curvilinear fashion, soft tissue masses, and patterns suggesting abdominal distention?
Living in a developing country
What is the most unlikely risk factor for developing ovarian cancer?
Peristalsis
What must be identified to determine pelvic mass from possible bowel?
Endocrine studies
What technique is not directed at improving detection and outcome of ovarian cancer?
Human chorionic gonadotropin
hCG
Antegrade spread
If positive vaginal cytology is noted in association with ovarian cancer, it is most likely due to:
90%
If there is early detection of Stage I ovarian cancer, the cure rate is:
Peritoneal malignancy
In women, ovarian cancer is the most common tumor responsible for: