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Gynaecological pathology & sexual health > Lec7 Ovarian Cysts > Flashcards

Lec7 Ovarian Cysts Flashcards

(49 cards)

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1
Q

How are the ovaries linked to the uterus?

A

By the ovarian ligament

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2
Q

What is separates the uterus and rectum?

A

The peritoneal pouch - the Pouch of Douglas

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3
Q

From when are the primordial follicles present in a female?

A

Primordial follicles are present in the baby in utero

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4
Q

Name two types of cyst and when they occur

A

Functional cyst - forms in the Graafian follicle stage

Luteal cyst - form in the corpus luteum stage

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5
Q

When women ovulate, they often feel a pain in one side, what is this pain from?

A

When the corpus luteum has breached the capsule and causes injury.

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6
Q

What can happen in a luteal cyst?

A

May have some bleeding - haemorrhage - from it

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7
Q

What are the complications of ovarian cysts?

A
  1. Torsion
  2. Rupture
  3. Haemorrhage
  4. Infection
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8
Q

What must you try to do in an ovarian cyst rupture?

A

Try to manage conservatively if this is appropriate i.e. only if it is not a medical emergency

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9
Q

What is important to consider in a ruptured cyst?

A

The contents of the rupture and how much of it there is

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10
Q

Why is it important to consider the contents of the rupture?

A

Can cause peritonitis
or
pseudomyxoma peritonei

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11
Q

What does adnexum mean?

A

Next to the womb

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12
Q

What must you always remember to do?

A

Do a pregnancy test

CANNOT MISS an ECTOPIC PREGNANCY

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13
Q

What might be causing tenderness in an ovarian cyst haemorrhage?

A

The bleeding likely to cause the pain

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14
Q

What can be the result of untreated ectopic pregnancy?

A

Death

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15
Q

Why are ovaries prone to cyst formation?

A

Because of their dynamic nature

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16
Q

Why does torsion occur?

A

The ovarian arteries (come from high up near the renal arteries) and ovarian ligament make a sort of hammock which the ovaries hang off. The ovarian arteries wrap around the ovary so in torsion the ovary can get twisted and pulled upwards

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17
Q

Name the different cell types in the ovary

A

Germinal epithelium
Germ cells
Stroma

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18
Q

What happens in the germinal epithelium?

A

Most cysts occur from the germinal epithelium

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19
Q

What does the germ cell layer produce?

A

Makes eggs

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20
Q

What does the stroma produce?

21
Q

What other tissue types can form tumours?

Study These Flashcards
A

Fibrous tissue and fat

22
Q

What is the usual treatment of ovarian torsion?

Study These Flashcards
A

Salpingo-oophorectomy

23
Q

How can most cysts be treated?

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A

With conservative management

24
Q

Are most cysts symptomatic or asymptomatic?

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A

Asymptomatic - a woman may have cysts that come and go away and not even be aware of it

25
What is the first type of imaging you would do with any presentation of pain in these kind of scenarios?
Ultrasound
26
What are the second most common cysts after functional cysts?
Benign dermoid cysts
27
What cell type do benign dermoid cysts come from?
The germ cell layer
28
What do you test for if you are worried the dermoid cyst might be malignant?
Tumour markers e.g. Beta HCG - raised in germ cell tumours Alpha lactate dehydrogenase - raised in dysgerminomas
29
What can often be found inside germ cell cysts?
Teeth, hair, nails, thyroid tissue, bone because the germ cells make the eggs - make the babies so have the potential to make any cell type in the body
30
What can rupture of a dermoid cyst cause?
Peritonitis
31
A pt presents with recent onset of amenorrhoea, hair recession, hirsutism, clitoromegaly and tender mass on left side of pelvis. What is the diagnosis likely to be?
A androgen producing tumour | Sertoli-leydig cell tumour most common in this scenario
32
Which cell layer do androgen producing tumours come from?
The stroma
33
What is the treatments and prognosis for a stage 1 androgen producing tumour?
Treatment is laparotomy of the tumour and prognosis is good because rarely bilateral
34
What are the types of epithelial ovarian tumour possible?
Benign Borderline Malignant
35
How do you calculate the Risk of malignancy index?
RMI = Menopausal status x Ultrasound score x CA125
36
Above what score is deemed cancer?
A score of 250 and above
37
Why is USS complexity important?
Important but not the be all and end all | If there is high complexity - more septae or more divisions it is more worrying likely to be malignant
38
Out of the cancers limited to the ovary - how many out of ten produce CA125?
7/10
39
What is the prognosis of women diagnosed with Epithelial Ovarian Cancer?
It is rare | Of those women diagnosed with it - most women won't survive 5 years
40
Why is there no screening test rolled out nationally?
Because can use USS and CA125 but they are not accurate enough to create a nationwide screen - not cost effective - could miss lots of cases or could give lots of false positives
41
Why is epithelial ovarian cancer a silent disease?
60-80% women present at an advanced stage Due to abdominal symptoms or symptoms from distant metastasis General malaise, weight loss
42
A stage one epithelial ovarian tumour once lifted out you might have cured her: true or false?
True - if it is smooth - even if it is heavy - can get really heavy ones weighing 30kg+ but likely to be cured
43
What presentation is harder to get rid of?
Cauliflower presentation of the tumour - harder to get all the bits out - more likely to metastasise
44
Why is there an opportunity for several different types of tumours in the ovary?
Because of the diversity of the tissue types
45
What is the effect on malignancy with increasing age?
Increasing age = increasing malignancy
46
What determines management of a tumour?
The type of tumour and stage of disease at presentation
47
When is it more likely that a cure is possible
At early stages of the disease
48
What increases chances of malignancy?
Increasing age | High complexity of the tumour
49
How common are ovarian cysts presenting in gynae?
4th most common cause of gynae admission

Gynaecological pathology & sexual health (1 decks)

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