13: Benign Conditions of Uterus, Cervix, Ovary, Fallopian Tubes Flashcards
Cause of uterus didelphysis, bicornate uterus
Failure of paramesonephric ducts to fuse
Cause of septate uterus
Incomplete dissoluation of midline fusion
Meyer-Rokitansky-Kuster-Hauser syndrome
Mullerian agenesis; complete lack of uterus and vagina
Most common cause of congenital cervical abnormalities
Malfusion of paramesonephric ducts
Characteristic T-shaped uterus caused by
Maternal exposure to DES
Most common neoplasm of the uterus
Fibroids/uterine leiomyomas
Characteristics of fibroids
Spherical, well circumscribed white whorled lesions
Most common location of fibroids
Intramural - arises within myometrium
Treatment of leiomyomas
Estrogen + Progesterone, progesterone, Depo-Lupron (GnRH agonist); hysterectomy if severe sx
Endometrial polyps
Usually benign soft friable masses, removed with hysteroscopy
Nabothian cyst
Normal variant with opaque/yellowish/blue hue on surface of cervix
Cervical polyps
Generally benign, usually asymptomatic, endocervical are more common and beefy red in color
Endometrial hyperplasia
Overgrowth of endometrial lining usually d/t persistent unopposed estrogen; precursor to endometrial cancer
Classify types of endometrial hyperplasia from best prognosis to worst
- Simple without atypia (1% progress to cancer)
- Complex without atypia (3%)
- Simple with atypia (9%)
- Comples with atypia (27%)
Symptoms and diagnosis of endometrial hyperplasia
Sx: heavy. prolonged unexplained bleeding
Dx: US reveals endometrial lining greater than 4 mm thickness in postmenopausal women
Treatment of hyperplasia without and with atypia
- Without: progestin, re-sample in 3 months
2. With: hysterectomy
Syndrome associated with rudimentary streaked ovaries and early menopause
Turner syndrome
Theca-Lutein cyst
Bilateral, can be very large, tend to form in patients with high hCG and regress when gonadotropin levels fall
Luteoma of pregnancy
Hyperplastic ovarian theca cells due to hCG stimulation; red-brown nodules, regress postpartum
Polycystic ovarian cyst
Associated with chronic anovulation, hyperandrogenism, insulin resistance; enlarged ovaries with small follicles
Most common ovarian neoplasms
Epithelial tumors (serous, mucinous, brenner)
MOST COMMON benign ovarian neoplasm in PREMENOPAUSAL female
Dermoid cyst/benign cystic teratoma
Most common epithelial tumor
Serous cystadenoma; usually benign
Mucinous cystadenoma
Can become huge; most benign, can be associated with mucocele of appendix and lead to pseudomyxoma peritonei
Brenner tumor
Usually benign, resemble urothelium
Granulosa-theca cell tumors
Produce estrogenic components, not usually malignant, feminizing signs and symptoms
Sertoli-Leydig tumors
Androgenic components, not usually malignant, virilizing effects
Most common benign SOLID ovarian tumor
Fibroma
Meigs syndrome
Ovarian fibroma associated with ascites and pleural effusion
Cystic teratoma
Mostly benign, elements of all 3 germ layers; MOST COMMON ovarian neoplasm in all women
Ovarian torsion
Complete or partial rotation of ovary on ligaments; impedes blood supply; one of the MOST COMMON gynecologic emergencies
Primary risk factor for an ovarian torsion
Ovarian mass 5+ cm
S/S of ovarian torsion
Acute onset of unilateral pain, nausea, vomiting
