BENIGN OVARIAN TUMOURS/CYSTS Flashcards Preview

OBSTETRICS AND GYNAECOLOGY > BENIGN OVARIAN TUMOURS/CYSTS > Flashcards

Flashcards in BENIGN OVARIAN TUMOURS/CYSTS Deck (20)
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1
Q

What are the 4 main broad types of benign ovarian tumour which divide tumours based on the type of cell they are derived from?

A

Physiological cysts

Benign epithelial tumours

Benign germ cell tumours

Benign sex cord stromal tumours

(There are other benign ovarian tumours such as endometriotic cysts, but these 4 are the most important)

2
Q

Apart from physiological tumours, what is the most common type of benign ovarian tumour found in women under 40?

A

Germ cell tumours

3
Q

Apart from physiological tumours, what is the most common type of benign ovarian tumour found in women over 40?

A

Epithelial tumours

4
Q

What are the risk factors for benign ovarian tumours?

A

Obesity

Infertility

Early menarche

Hypothyroidism

Tamoxifen therapy

5
Q

What are the three types of physiological ovarian cyst?

A

Follicular cyst - most common

Luteal cyst

Theca lutein cyst

6
Q

Which type of physiological ovarian cyst is most likely to rupture?

A

Luteal cysts

7
Q

What are the 4 types of benign epithelial ovarian tumour?

A

Serous cystadenoma - most common

Mucinous cystadenoma

Endometrioid cystadenomas

Brenner tumours

8
Q

What are the 2 types of benign germ cell ovarian tumour?

A

Mature cystic teratoma (also called a dermoid cyst)

Mature solid teratomas

9
Q

What are the 2 types of benign sex cord stromal ovarian tumour?

A

Theca cell tumours

Fibromas

10
Q

What are the symptoms associated with benign ovarian tumours/cysts?

A

Pain
Abdominal swelling
Pressure effects on bowel or bladder
Hormonal effects secondary to secretion from tumour

11
Q

What are the hormonal effects that might be associated with an oestrogen secreting tumour?

A

Menstrual irregularity
Postmenopausal bleeding
Precocious puberty

12
Q

How might you be able to exclude gastrointestinal aetiology in a patient who presents with pain consistent with an ovarian cyst?

A

Bimanual examination will reveal either adnexal tenderness or a mass.

13
Q

What investigations should be done for someone who presents with any of the symptoms of an ovarian cyst (pain, swelling, pressure effects on bladder/bowel, hormonal effects)?

A
FBC
CRP
High vaginal and endocervical swab
Urine pregnancy test/or serum hCG
Pelvic ultrasound
Serum CA125
Serum alpha fetoprotein (if US reveals complex ovarian mass)
14
Q

What two factors does your management of a patient with a benign asymptomatic ovarian cyst/tumour depend on?

A

Age

Size of tumour

15
Q

How would you manage a 25 year old patient found to have a 3 cm ovarian cyst?

A

Reassure

Observe cyst with US

16
Q

What is the cut off in terms of size of benign ovarian tumour above which you would proceed to surgery despite a lack of symptoms? Why?

A

Above 5 cm. Above this size, the risk of ovarian torsion is significant.

17
Q

How do you manage a patient found to have a physiological cyst on their ovaries?

A

Reassurance. Most will spontaneously resolve. You can monitor with ultrasound.

18
Q

What are the complications associated with benign ovarian cysts?

A

Ovarian torsion

Rupture of cyst - can cause sepsis or peritonism

Continued pain and dyspareunia

19
Q

What is Meig’s syndrome?

A

Triad of ascites, pleural effusion and benign ovarian tumour

20
Q

What are the benign ovarian tumours most commonly associated with Meig’s syndrome?

A

Fibroma

Brenner tumour (epithelial tumour)

Occasionally granulosa cell tumour