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Ovary (Tumors (Germ Cell Tumors (choriocarcinoma (malignant tumor composed…

- - - - serous
        
        benign
        
        cyst adenomas, a single cyst with a simple lat lining, most common in premenopausal women
        
        borderline
        
        features in between benign and malignant tumors
        
        better prognosis that malignant tumors, but still have metastatic potential
        
        malignant
        
        cystadenocarcinomas- complex cyst with a thick shaggy lining, most common in post-menopausal women
      - mucinous
        
        malignant
        
        borderline
        
        benign
      - endometroid
        
        usually malignant, endometroid like glands
        
        often associated with endometrial carcinoma (endometroid type) always check
      - Brenner
        
        bladder like epithelium, usually benign
      - prognosis is generally poor
  - - - composed of fetal tissue derived from two or three embryologic layers
      - most common ovarian tumor in females 10-30
      - benign, but presence of immature tissue or somatic malignancy (usually squamous cel carcinoma) indicates malignant potential
    - - malignant tumor composed of large primitive cells
      - aggressive with early metastasis
    - - large cells with clear cytoplasm and central nuclei; most common malignant germ cell tumor; fried egg
      - semimoma
      - LDH may be elevated
    - - malignant tumor that mimics the yolk sac; most common germ cell tumor in children
      - serum AFP often elevated
      - Schiller-Duval bodies are classically seen on histology
    - - malignant tumor composed of cytotrophoblasts and syncytiotrophoblasts
      - mimics placental tissue but villi are absent
      - high Bhcg
      - poor response to chemotherapy
  - - - Granulosa-Theca tumor
        
        neoplastic proliferation of granulose and theca cells
        
        often produces estrogen
        
        presents with signs of estrogen excess
        
        precocious puberty
        
        menorrhagia
        
        endometrial hyperplasia with post menopausal uterine bleeding
      - Sertoli-Leydig tumor
        
        Leydig cells with reinke crystals
        
        May produce androgen, associated with hirsutism and virilization
      - Fibroma
        
        Associated with pleural effusions and ascites
  - - - usually both ovaries
      - most commonly due to metastatic gastric carcinoma
      - bilaterally helps distinguish from primary mutinous carcinoma of the ovary which is usually unilateral
    - - Massive amounts of mucus in the peritoneum
      - due to a mutinous tumor of the appendix, usually with metastasis to the ovary
- - - - hirsutism
      - androgens are converted into estrone in adipose tissue
        
        Estrone feed back decreases FSH resulting in cystic degeneration of follicles
      - obese young woman with infertility, oligomenorrhea, and hirsutism
      - insulin resistance may occur, type 2 diabetes mellitus