516 Obstetrics and Gynecology Board Review •••
❍ What is the term given to a benign ovarian teratoma where almost all of the tissues are composed of benign
thyroid elements?
Struma ovarii.
❍ Do mature teratoma undergo malignant change?
The vast majority (99%) do not; however, it can occur and has been well described and is most commonly a
squamous cell carcinoma.
❍ What is Meigs syndrome?
This is the presence of a large ovarian fibroma with associated ascites and pleural effusion both of which resolve
upon resection of the fibroma.
❍ What is produced by the majority of granulosa cell tumors that result in “feminizing” signs and symptoms?
Estrogenic hormones.
❍ What is the characteristic shape of the nuclei of granulosa cells?
They are round to oval, haphazardly arranged, and frequently contain a longitudinal groove imparting a
“coffee bean” appearance.
❍ What ovarian tumor is associated with the basal cell nevus syndrome?
Fibromas. These tumors are almost universally bilateral, multinodular, and at least focally calcified in these
patients.
❍ What is the typical age of presentation in patients with a thecoma?
They are almost always postmenopausal with a mean age of about 60.
❍ Although this can be true in several ovarian tumors, which sex cord-stromal tumor is associated with the
classic yellow gross tumor appearance?
Thecoma.
❍ In contrast to thecomas, what is the typical age of patients with Sertoli-Leydig cell tumors?
They occur during reproductive years with a mean of 25 years old.
❍ What syndrome is found in about a third of patients with the sex cord tumor called “sex cord tumor with
annular tubules”?
Peutz-Jeghers syndrome.
❍ What is a so-called Krukenberg tumor?
This is a gastric carcinoma that is metastatic to the ovary, although it can be of any site of gastrointestinal origin.
❍ What is the ovarian counterpart of the testicular seminoma?
Dysgerminoma.