Ovary Flashcards
(31 cards)
follicular cyst
graafian follicle does not rupture at ovulation, continues to grow
resolves spontaneously
Corpus luteum cyst
corpus luteum does not degenerate
filled w/ fluid
resolve spontaneously
frequently hemorrhagic
Theca-Lutein cyst
high hCG levels
multiple gestations, molar pregnancies
gestational trophoblastic dz
assistive reproduction techniques
B/L, multiple
Dermoid cyst
benign cystic teratoma
tissue of multiple germ layers
Hemorrhagic cyst
cyst w/ blood - any type
Endometroid cyst
endometriosis inside ovary
cyclic bleeding in ovary –> chocolate cyst
Ovarian torsion
twisting of supportive ligaments –> impaired vascular supply –> ischemia and necrosis
Risk increases with ovarian mass >5cm diameter
Acute onset of severe pelvic pain -sharp, stabbing
possible radiation to back or groin
+/- N/V
Dx: clinical, pelvic US
Tx: surgery
Clomiphene
first line SERM for infertility d/t anovulation
Hypothalamus:
Binds estrogen receptors –> blocked negative feedback of endogenous estrogens
–>increased LH, FSH –> follicle maturation and ovulation
SE: hot flashes ovarian enlargement multiple gestations Visual disturbances - blurred vision, scotomida, retinal toxicity
Evidence of ovulatory cycles
cyclic menses
Mittelschmerz - midcycle pelvic pain assoc w/ ovulation
LH surge: tested for by OTC ovulation prediction kits
Biphasic basal body temperature - 1/2 degree rise after ovulation
Infertility
inability to conceive after 1 year
1/3 of females
- PCOS - anovulation
- endometriosis
- uterine fibroids
- PID
- Turners
- Intrauterine adhesions
- Asherman Syndrome
Use hysterosalpingography to check abnormal anatomy
Symptoms of ovarian cancer
ascites abdominal distention abdominal pain Nausea early satiety vaginal bleeding urinary sx
Risks of ovarian cancer
Family Hx - BRCA1 or 2
Lynch Syndrome - HNPCC
-risk colon, ovarian, endometrial cancers
Uninterrupted ovulatory cycles
- nulliparity
- infertility
- early menache
- late menopause
CA125
elevated w/ anything causing peritoneal irritation
Can be used for ovarian cancer marker to monitor
4 main categories of ovarian tumors with origin
Surface epithelium –> epithelial tumors
Stroma –> sex-cord - stromal tumors
Primordial germ cell –> germ cell tumors
Metastatic
- Uterus, tubes, ovary
- Krukenberg tumors - gastric adenocarcinoma - met to ovaries b/l; signet ring cells - filled with mucin, nuclei pushed to peiphery
Epithelial tumors
“Serious Epithelial Malignancies are Clearly Bad”
Serous tumors Endometroid tumors Mucinous tumors Clear cell tumors Brenner tumor
40s-60s
often b/l
Poor prognosis
Germ cell tumors
Teratomas
Dysgerminoma
Yolk sac aka endodermal sinus tumors
Choriocarcinomas
teens-20s
u/l (15% teratomas b/l)
excellent prognosis, responsive to chemo
Sex Cord-Stromal tumors
Granulosa cell tumors
sertoli-Leydig tumors
Fibromas
Thecomas
All ages
u/l
good prognosis, found early
Serous tumors
originate in fallopian tubes
ciliated columnar epithelium
Psammoma bodies
Benign: serous cytoadenoma
Malignant: serous cystadenocarcinoma
Mucinous tumors
multiloculated
filled w/ mucin - to 50 lbs
can look like gastric or intestinal tissue
Benign: mucinous cystadenoma
Malignant: mucinous cystadenocarcinoma
Pseudomyoma peritonei
abundant mucinous ascites
primary cancer of appendix
Endometroid tumors
malignant
look like endometrium w/ tubular glands
assoc w/ endometriosis
30% coexist w/ endometrial cancer
Clear cell tumors
variant of endometroid cancer
clear cytoplasm
Brenner tumor
benign
urinary tract-like epithelium
Teratomas
tissue from all 3 germ layers
Benign: mature teratoma
Malignant: immature teratoma
neuroectoderm
Struma ovarii - functional thyroid tissue –> hyperthryoidism, ovarian mass
