Gynecologic Cancer

What are the three cell types in the ovary?

1. germ cells
2. stromal cells
3. epithelial cells

Which type of ovarian cell tumor is derived from the oocyte and often occurs in women <20 yo?

germ cell tumors

Which type of ovarian cell tumor can occur at any age, but is more common in the postmenopausal group? (this type also secretes estradiol)

stromal cell tumors

What is the MOST COMMON type of ovarian cell tumor?

epithelial cell tumors

What catchphrase did Dr. Stohs teach us regarding the ovary?

Rest is Best

What catchphrase did Dr. Stohs teach us regarding the cervix?

flee HPV

What catchphrase did Dr. Stohs teach us regarding the endometrium?

thin is in

What catchphrase did Dr. Stohs teach us regarding the vulva?

white ain't right

What simple equation did Dr. Stohs teach us regarding hormones and endometrial thickness?

E/P = E.T. (where E=estrogen; P=progesterone; E.T.=endometrial thickeness)

When Dr. Stohs says "white ain't right," what disease is he referring to?

lichen sclerosis et atrophicus (LSA)

How do you confirm diagnosis of LSA?


What is the mean age of ovarian cancer?


What is the MOST LETHAL gynecological tract tumor?

ovarian cancer

What fertility drug increases a woman's risk of ovarian cancer?


What decreases risk of ovarian cancer?

suppression of menstrual function, oral contraceptive, pregnancy, and lactation

What is the MOST IMPORTANT risk factor for ovarian cancer?

family history

What gene is associated with a 16-40% risk of ovarian cancer as well as early onset breast cancer, and colorectal and prostate cancer?


What gene is associated with a 10% risk of ovarian cancer as well as breast and pancreatic cancer?


What familial predisposition for not only to colorectal cancer, but also ovarian and endometrial cancer?

Lynch syndrome II

What is the mutation in Lynch syndrome?

DNA mismatch repair genes

Your patient has been diagnosed with stage IV ovarian cancer. She has had a decreased appetite for several months, but she doesn't appear to have lost any weight. What gives?

actual weight loss might be offset by ascites

Cerebellar degeneration, migratory superficial thrombophlebitis and hypercoagulability, and sudden appearance of seborrheic keratoses are all examples of ______________ _________?

paraneoplastic syndromes

What is the best way to evaluate ovarian cancer?

transvaginal ultrasound

T/F: An ovarian mass that is composed both of solid and cystic areas is usually not malignant.


What two blood markers are most commonly used for monitoring response to therapy and tumor recurrence the progression of ovarian cancer?

CEA and CA125

What is removed in "debulking"?

ovaries, uterus, omentum, and lymph nodes

What are the 5 MOST COMMON cancer-causing types of HPV?

16, 18, 31, 33, and 35

What strains of HPV are prevented by Gardasil?

16, 18, 6, and 11

So does Gardasil prevent cervical cancer?

it doesn't protect against ALL cancer-causing strains

What's the point of being protected against 6 and 11 if they don't cause cancer anyway?

most responsible for genital warts

T/F: Gardasil can be used for post-exposure prophylaxis if administered within 24 hours.

False (must be given prior to exposure)

What ages is Gardasil approved for?


What's LEEP?

loop electric excision procedure

What is the most common type of cervical cancer? What is the second most common?

SCC; adenocarcinoma

How do you treat cervical cancer if caught in the early stages?

radical hysterectomy

What symptom of uterine cancer usually helps us catch it at an early stage?

postmenopausal bleeding

What layer is usually involved in 97% of uterine cancers?


What is the MOST COMMON tumor of the gynecological tract?

uterine cancer

What are the only two situations in a woman's life that she makes progesterone?

1. ovulation
2. pregnancy

Why is obesity one of the MOST COMMON risk factors for uterine cancer?

peripheral conversion of androstenedione to estrone

What drug is associated with an increased risk of uterine cancer?


Your postmenopausal patient postcoital bleeding and is terrified that she has uterine cancer. What else could it be d/t?

atrophy (or cervical cancer)

How do you diagnose uterine cancer?


What are you looking for on transvaginal US of a woman with suspected uterine cancer?

endometrial thickening

The treatment for uterine cancer is TAH/BSO. What is that?

total abdominal hysterectomy and bilateral salpingo-oophorectomy

What race of people have a worse prognosis with uterine cancer?

African Americans

T/F: The prognosis of uterine cancer is worse with over-expression of HER-2/neu.


What's VAIN? VIN?

VAginal Intra-epithelial Neoplasia; Vulvar