Flashcards in BENIGN OVARIAN TUMOURS/CYSTS Deck (20)
What are the 4 main broad types of benign ovarian tumour which divide tumours based on the type of cell they are derived from?
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)
Apart from physiological tumours, what is the most common type of benign ovarian tumour found in women under 40?
Germ cell tumours
Apart from physiological tumours, what is the most common type of benign ovarian tumour found in women over 40?
What are the risk factors for benign ovarian tumours?
What are the three types of physiological ovarian cyst?
Follicular cyst - most common
Theca lutein cyst
Which type of physiological ovarian cyst is most likely to rupture?
What are the 4 types of benign epithelial ovarian tumour?
Serous cystadenoma - most common
What are the 2 types of benign germ cell ovarian tumour?
Mature cystic teratoma (also called a dermoid cyst)
Mature solid teratomas
What are the 2 types of benign sex cord stromal ovarian tumour?
Theca cell tumours
What are the symptoms associated with benign ovarian tumours/cysts?
Pressure effects on bowel or bladder
Hormonal effects secondary to secretion from tumour
What are the hormonal effects that might be associated with an oestrogen secreting tumour?
How might you be able to exclude gastrointestinal aetiology in a patient who presents with pain consistent with an ovarian cyst?
Bimanual examination will reveal either adnexal tenderness or a mass.
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)?
High vaginal and endocervical swab
Urine pregnancy test/or serum hCG
Serum alpha fetoprotein (if US reveals complex ovarian mass)
What two factors does your management of a patient with a benign asymptomatic ovarian cyst/tumour depend on?
Size of tumour
How would you manage a 25 year old patient found to have a 3 cm ovarian cyst?
Observe cyst with US
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?
Above 5 cm. Above this size, the risk of ovarian torsion is significant.
How do you manage a patient found to have a physiological cyst on their ovaries?
Reassurance. Most will spontaneously resolve. You can monitor with ultrasound.
What are the complications associated with benign ovarian cysts?
Rupture of cyst - can cause sepsis or peritonism
Continued pain and dyspareunia
What is Meig's syndrome?
Triad of ascites, pleural effusion and benign ovarian tumour