514 Obstetrics and Gynecology Board Review •••
❍ What are some of the risk factors for development of ovarian carcinoma?
Nulliparity, family history, early menarche and late menopause, white race, increasing age, and residence in North
America and Northern Europe.
❍ What do recent studies suggest to be the site of origin of high-grade serous epithelial ovarian cancers?
Fallopian tube mucosa.
❍ What are three syndromes that have been described related to ovarian cancer?
HNPCC (Lynch II syndrome) cancer of the ovary, endometrium, and colon, breast-ovary syndrome, and ovary-
specific syndrome.
❍ Where are the genes located that are responsible for the breast-ovary syndrome?
The genes are BRCA-1 that is found on chromosome 17q21 and BRCA-2 that is found on 13q12
❍ What serum marker is useful in determining the efficacy of therapy and recurrence of ovarian carcinoma?
CA-125.
❍ What is the most common cell of origin resulting in ovarian neoplasms (eg, germ cells, stromal cells, and
surface epithelium)?
By far, the surface epithelium gives rise to the most ovarian neoplasms (>60% overall and >90% of malignant
tumors).
❍ What is the most common malignant tumor of the ovary?
Serous cystadenocarcinoma, and it is frequently bilateral (more than half the time).
❍ What are the three general categories, which surface epithelial tumors of the ovary are divided into?
Benign, low malignant potential, and malignant.
❍ What are some of the histologic features that determine classification into the low malignant potential
category?
These are tumors that are composed of the same cell type but generally lack “high grade” nuclear features, complex
architecture, and destructive stromal invasion.
❍ Do ovarian low malignant potential tumors spread beyond the ovary?
Yes. The majority (60–70%) present confined to the ovary, while up to 40% will spread beyond the ovary,
particularly as peritoneal implants. Overall, the prognosis is markedly better than the malignant counterpart with
100% 5-year survival when confined to the ovary and 90% when spread to the peritoneum.
❍ What are the two histologic types of mucinous tumors of the ovary based on histologic appearance?
In addition to being divided into benign, borderline, and malignant varieties, the mucinous tumors may resemble
endocervical mucosa or intestinal epithelium. Thus, the tumors are divided into endocervical type and intestinal
type.