6.6 Pelvic and Adnexal masses and neoplasms

Question 1

Pelvic mass presentation is subjected to:

Answer 1

• Genital organs
  Uterus
  Ovaries
  Fallopian tubes:ectopic pregnancy
  Round ligament
  Broad ligament
• Urinary tract
  kidney:association to embryology
• Bowel

Question 2

The ovaries
classification of masses and

Answer 2

Infections
- PID
*lymphoma:in HIV Positive women

Question 3

Classification of ovarian tumors
(Refer back to Dyfunction Notes)

Answer 3

metastatic: never forget them as they also need to be considered.

Question 4

Prevention/early detection

Answer 4

• Not preventable
  Early detection of asymptomatic disease
  Screening
  1. biochemical markers
  2. morphological markers
  3. vascular markers
  4. Combinations (UKCTOCS)
  *BRCA mutation is an exception

Question 5

Clinical Picture

Answer 5

*Age is not include
- Constitional symptoms
weightloss
fatigue
- Vague, non-specific
- Irregular menses
Lower abdominal discomfort /distention
-early satiety
-Urinary sysmptoms: frequency
- Bowel symptoms
Pain

Pelvic mass characteristics

Question 6

Pelvic mass characteristics

Answer 6

cystic vs(solid)
(Bilateral)
(Fixed) or mobile
(Ascites)
> 8 cm
Points to a malignant tumor

Question 7

Imaging

Answer 7

Ultrasound
- Cystic vs soldi or a combination
-Cytis: Multiloculate
-thick vs thin walls
Papillary groths(Nb for malignancy
- Bilateral
- >8 cm
- Ascites

Question 8

IOTA Adnex model

Answer 8

1-9 characteristics
Calculate the lovely of a mass whether it’s benign or malignant
*acoustic shadows present
* Serum/blood
Others mentioned above

Functional:will dissaper
Benign: but not dissappear
malignat:aggressive interventions

Question 9

Special investigations

Answer 9

-Ultrasound
epithelia and ovaria=pleural effusin or lung problems: -CxR
-Cytology of the ascietis and pleural effusion
- U and e .LFT,FBC
- CT if indicated
Gastroscopy/colonscopy
Tumour markesr:not diagnostic

Question 10

Note

Answer 10

Gynecology textbook
-post-menopausal bleeding
-2 other topics