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Ovarian mass/cyst Flashcards

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1
Q

Benign gynecologic mass:

What are the 3 non-neoplastic ovarian cysts?

A
  • Mesothelial
  • Follicular
  • Inflammatory
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2
Q

Benign gynecologic mass:

What are the 3 benign ovarian neoplasms?

A
  • Epithelial
  • Germ cell
  • Stromal
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3
Q

Benign gynecologic mass:

What are the 2 tubal mass?

A
  • Hydrosalpinx
  • Pyosalpinx
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4
Q

Benign gynecologic mass:

What are the 3 uterine mass?

A
  • Pregnancy
  • Leiomyoma
  • Adenomyosis
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5
Q

Malignant gynecologic mass:

Ovarian cancer types. (5)

A
  • Epithelial
  • Germ cell
  • Stromal
  • Non-specific
  • Metastatic
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6
Q

Malignant gynecologic mass:

What is the tubal cancer?

A

Fallopian tube cancer

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7
Q

Malignant gynecologic mass:

What are 2 uterine cancers?

A
  • Endometrial cancer
  • Leiomyosarcoma
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8
Q

Non - neoplastic cysts:

Mesothelial origin:
How are Germinal Inclusion cysts formed?

How do the cysts enlarge?

A
  • invagination of ovarian surface mesothelium into the cortex or stroma
  • cystic enlargement is due to serous fluid secreted by the mesothelium
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9
Q

Non- neoplastic cysts:

Cysts of follicular origin (functional cysts)

What are the 4 types of functional cysts?

A
  • Follicular cysts
  • Corpus luteal cysts
  • Theca lutein cysts
  • PCOS
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10
Q

Follicular cysts

How do they develop?

What are their 4 characteristics?

A

1) Develop from partially-developed follicles that undergo atresia

2) - Extremely common
- physiological
- multiple (maybe)
- undergo spontaneous regression

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11
Q

Corpus luteal cysts

How do they develop?
Which hormone will be persistent as a consequence?

A

1) Develops after a corpus luteal hematoma formed after ovulation
2) Progesterone

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12
Q

Corpus luteal cysts

How may it present as?
Rearely, what complication?

A

1) Delayed menstruation
2) Delayed menstruation presenting as continuous vaginal bleed

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13
Q

Corpus luteal cysts

Are they vascular?

A

yes

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14
Q

Cells in the Graafian/ corpus luteum

What hormone do granulose cells produce? B/A ovulation

A

Before: Oestrogen
After: progesterone

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15
Q

Cells in the Graafian/ corpus luteum

What hormone do Theca-lutein cells produce? B/A ovulation

A

Before: Androgen
After:Androgen and progesterone

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16
Q

**Theca lutein cysts:**

How are they formed?
When do they form? (Under what circumstances)

A

1) Formed by theca interna cells when corpus luteum is under influence of high BhCG levels
2) In multifetal gestation, GTN, pt on gonadotrpin treatment - OHSS

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17
Q

OHSS

What are the signs and symptoms to watch out for?

A

Abdominal bloating, pain, N/V, ascited, pleural effusion, hypovolemia, hemoconcentration

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18
Q

PCOS

How do they present?

A

1) chronic anovulation
2) Generalized hyperandrogenism

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19
Q

Cysts of inflammatory conditions

What are the two cysts in this category?

Study These Flashcards
A

1) Tubo- ovarian abscess
2) Endometriotic cyst/endometrioma

20
Q

Cysts of inflammatory conditions

What type of ovarian pathology has ground glass appearance?

21
Q

What is the triad of endometrioma symptoms?

Study These Flashcards
A

Chronic pelvic pain
Dysmenorrhea
Deep dyspareunia

22
Q

Large endometrioma can twist and cause…

Study These Flashcards
A

Ovarian torsion

23
Q

CA-125 AKA…

Study These Flashcards
A

Cancer antigen 125

24
Q

CA-125 can be used to assess what in ovarian cancer? (2)

Study These Flashcards
A

Risk assessment & monitoring

25
CA-125 is produced by... (6)
Mullerian derived tissue: Ovarian surface epithelium, fallopina tubes & endometrium peritoneum pleura pericardium
26
Benign causes of elevation of CA-125 are... (6)
Endometriosis Fibroids PID Adenomyosis pregnancy Menstruation
27
Is CA-125 reliable marker in premenopausal women?
No
28
# CA-125 CA-125 is elevated in what malignant diseases?
**Serous ovarian epithelial cancers** Endometrial cancer Fallopian tube cancer Peritoneal, pleural malignancies Pancreatic, colorectal and breast cancer
29
# Interpretation of CA-125 level <35
normal
30
# Interpretation of CA-125 level 35-200
Likley benign
31
# Interpretation of CA-125 level more than 200
Likely cancer in postmenopausal woman
32
# Interpretation of CA-125 level more than 1000
Advancer cancer
33
# Formula What formula to use and it's parameters to risk stratify ovarian cancer?
Risk of Malignancy Index (RMI) RMI= U x M x CA-125 U: ultrasound score (0,1,3) M: menopausal status (1 for pre, 3 for post) CA-125: serum level
34
# RMI Formula If RMI more than 200, what is the cause? To refer to who?
Likely ovarian malignancy; to refer gynecologic oncologist
35
# RMI Formula What are the features in US finding for the RMI formula?
Multilocularity Solid component B/L lesions Ascites Intra-abdominal mets | No feature=0 1 feature= 1 2 or more feature= 3
36
LDH elevated in what ovarian malignancy?
dysgerminoma
37
CEA raised in what ovarian malignancy?
Mucinous epithelial ovarian cancer
38
CA19-9 raised in what ovarian malignancy?
Mucinous epithelial ovarian cancer
39
AFP raised in what ovarian malignancy?
Yolk sac tumor Embryonal carcinoma
40
B-hCG is raised in...
Choriocarcinoma embryonal carcinoma
41
# Ovarian mass List 5 epithelial ovarian ca tumors
Serous Mucinous Endometroid Clear cell Brenner
42
# Ovarian massr List 7 types of germ cell tumours.
Benign cystic teratoma (dermoid cyst) Malignant teratoma Gonadoblastoma Dysgerminoma Choriocarcinoma Yolk sac tumour Embryonal carcinoma
43
# Ovarian mass List all 4 Sex cord/stromal tumors
Granulosa theca cell tumor Sertoli leydig cell tumor Gynandroblastoma Fibroma
44
# Ovarian mass List 4 Common site of primary cancers for ovarian cancer
Breast GIT Uterus, fallopian tube Peritoneum
45

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