Gonadal Tumors

What percent of fetuses have an ovarian cyst ?
1. Less than 1%
2. About 1/3rd
3. One-half
4. 75%
What are the indications for operation in newborns with an ovarian cyst ?
1. Larger than 5 cm
2. Signs of torsion
3. Echogenic debris
4. Persistence after 2 weeks
Ovarian cysts in prepubertal girls are rare or common ?
1. Common
2. Rare
T or F: Small asymptomatic unilocular cysts in the ovary of postmenarcheal girls can be treated with hormonal suppression and followed thru 1 -2 overian cycles?
1. True
2. False
Which type of ovarian cysts is most likely to be seen in the teenage years?
1. Follicular
2. Simple
3. Corpus Luteum
4. Paraovarian
Sixty percent of childhood ovarian tumors are what type ?
1. Sex-chord stromal
2. Epithelial
3. Germ cell
4. Gonadoblastoma
What percentage of ovarian teratomas are calcified ?
1. 10 percent
2. 25 percent
3. 50 percent
4. 75 percent
Overall, germ cell tumors account for 15 percent to 20 percent of ovarian tumors. However, if one specifically looks and women younger than 20 years of age, sixty percent of their tumors are germ cell; and 95 percent are cystic dermatoid/teratoma: true or false ?
1. True
2. False
What is the most common germ cell tumor found in children and adolescents ?
1. Teratoma
2. Dysgerminoma
3. Embryonal
4. Sex-chord stromal
What is the prefered treatment of a benign ovarian teratoma ?
1. Enucleation
2. Unilateral oopherectomy
3. Unilateral salpingoopherectomy (SPO)
4. Bilateral SPO
What is the treatment of immature teratoma ?
1. Enucleation
2. Unilateral oopherectomy
3. Unilateral salpingoopherectomy (SPO)
4. Bilateral SPO
What is the most common malignant tumor of the ovary in the female adolescents ?
1. Dysgerminoma
2. Serous adenocarcioma
3. Malignant teratoma
4. Embryonal carcinoma
What is the incidence of bilaterality in dysgerminomas ?
1. 5 percent
2. 10 - 20 percent
3. 30 - 40 percent
4. 50 percent
True or false: if the dysgerminoma is present in one ovary, even a normal appearing contralateral ovary should be biopsied ?
1. True
2. False
What is the overall survival for dysgerminoma ?
1. More than 75% 5 yr survival
2. More than 50% 5 yr survival
3. About 30 % 5 yr survival
4. 15% 5 yr survival
If recurrence occurs after surgical treatment of dysgerminoma, radiation therapy is often the treatment: T or F ?
1. True
2. False
What is the second most common germ cell tumor in the ovary of girls ?
1. Dysgerminoma
2. Endodermal sinus tumors
3. Malignant teratoma
4. Embryonal carcinoma
What ovarian teratomas receive chemotherapy ?
1. Grade 3 or above
2. All ovarian teratomas
3. Grade 2 or above and immature
4. Only immature
Which is the LEAST common malignant germ cell tumor to affect the ovary ?
1. Dysgerminoma
2. Endodermal sinus tumor
3. Embryonal carcinoma
4. Choriocarcinoma
Which germ cell tumor of the ovary is followed by AFP but not HcG?
1. Dysgerminoma
2. Endodermal sinus tumor
3. Embryonal carcinoma
4. Choriocarcinoma
Which is the MOST common malignant germ cell tumor to affect the ovary ?
1. Dysgerminoma
2. Endodermal sinus tumor
3. Embryonal carcinoma
4. Choriocarcinoma
T or F: Embryonal carcinoma (6 - 8% of malignant germ cell tumors) may have beta HCG and alpha-fetoprotein elevations, and beta - HCG has 60% incidence of hormonal symptoms such as vaginal bleeding, hirsuitism, precocious puberty?
1. True
2. False
What is the usual treatment of choriocarcinoma ?
1. Enucleation
2. Unilateral oopherectomy
3. Unilateral salpingoopherectomy (SPO)
4. Bilateral SPO
T or F: in mixed germ cell tumors (8% of malg GCT) of the ovary - 80% have dysgerminoma component ?
1. True
2. False
Gonadoblastomas arise in dysgenetic gonads. Children with mixed gonadal dysgenesis have what chance of developing a gonadoblastoma ?
1. 5 percent
2. 10 percent
3. 25 percent
4. 50 percent
What percent of pediatric ovarian tumors are sex cord stromal ?
1. 5 percent
2. 15 percent
3. 25 percent
4. 40 percent
Where the presenting symptoms of premenarchal girls with sex cord stromal tumors ?
1. Precocious puberty
2. Virilization
3. Mass and abdominal pain
What peptide hormone is elevated in patients with a granulosa cell tumor, and may be a marker for this condition ?
1. Inhibin
2. HcG
3. AFP
4. Ferritin
What is the treatment for sex cord stromal tumors ?
1. Enucleation
2. Unilateral oopherectomy
3. Unilateral salpingoopherectomy (SPO)
4. Bilateral SPO
Girls with ovarian Sertoli-Leydig cell tumors present HOW?
1. Precocious puberty
2. Virilization
3. Mass and abdominal pain
Epithelial ovarian tumors account for what percent of pediatric ovarian tumors ?
1. 5 percent
2. 15 percent
3. 25 percent
4. 50 percent
Most of ovarian carcinomas occur in women greater than 50 years of age. First-degree relatives have a ____ chance of ovarian cancer themselves (however, not in childhood) ?
1. 5 percent
2. 15 percent
3. 25 percent
4. 50 percent
Epithelial ovarian tumors in children tend to be large or small ?
1. Large
2. Small
What is the outcome for adult ovarian carcinoma ?
1. 35 percent
2. 50 percent
3. 75 percent
4. 90 percent
True or false: a second look operation is routine for stage 1 and 2 ovarian carcinoma ?
1. True
2. False
A poor prognosis is associated with an increase in all EXCEPT what in a child with ovarian cancer?
1. C-fms oncogene
2. Aneuploidy
3. Ferritin
What percent of pediatric testicular tumors are germ cell tumors, and are most malignant ?
1. 35 percent
2. 50 percent
3. 75 percent
4. 90 percent
The most common testicular germ cell tumor is what ?
1. Teratoma
2. Seminoma
3. Yolk sac tumor
4. Embryonal carcinoma
Most children with yolk sac testicular tumors are what stage?
1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 4
Stage 2 yolk sac tumor is microscopically positive retroperitoneal lymph nodes: Tor F?
1. True
2. False
Teratoma is always benign in prepubertal boys, but in teenagers, a radical orchiectomy and unilateral retroperitoneal lymph node dissection are indicated: T or F?
1. True
2. False
Seminoma is rare in childhood; it has an increased risk in association with what ?
1. Intersex
2. XXY chromosomes
3. Undescended testes
4. Prune Belly syndrome
True or false: seminoma is extremely sensitive to radiation therapy ?
1. True
2. False
What is the treatment of Leydig cell tumor of the testis ?
1. Radical orchiectomy and unilateral LN dissection
2. Radical orchiectomy and bilateral LN dissection
3. Radical orchiectomy
4. Enucleation
In what sort of testicular tumor are Reinke's crystals seen ?
1. Leydig cell tumor
2. Dysgerminoma
3. Yolk sac tumors
4. Gonadolblastoma
Sertoli cell tumors are a very rare form of non germ cell tumor which present as a painless mass, occasionally in association with what ?
1. Virilization
2. Gynecomastia
3. Azospermia
4. Undescended testes
Patients that develop gonadoblastoma (a form of non germ cell tumor) are typically what type of patient ?
1. 46 XY phenotypic females
2. Intersex
3. Undescended testes
T or F: in leukemia with persistence in the testis is evaluated how?
1. Testicluar scan
2. Transinguinal biopsy
3. Transscrotal biopsy
What is the treatment of gonadoblastoma, usually seen in undescended testes ?
1. Radical orchiectomy and unilateral LN dissection
2. Radical orchiectomy and bilateral LN dissection
3. Orchiectomy
4. Enucleation
In general, what is the false negative rate of the CT scan for detecting retroperitoneal lymph node disease in testicular tumors ?
1. 15 percent
2. 25 percent
3. 50 percent
4. 75 percent
At what age does the alpha-fetoprotein decline to a normal adult model of less than 10 milligrams per milliliter ?
1. 1 week
2. 6 - 8 weeks
3. 6 - 8 months
4. One year
What is the half-life of beta HCG ?
1. 24 hours
2. 5 days
3. 2 weeks
4. 1 month
What are the microscopic characteristics of yolk sac tumors ?
1. Calcification
2. Shiller-Duval bodies
3. Psammoma bodies
4. Basophilic stippling

Gonadal Tumors

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