73. Benign ovarian tumors.

Question 1

what are the benign ovarian tumors ?

Answer 1

non functional cyst :

mucinous cyst adenoma - 20 percent malignancy

serous cyst adenoma (most common benign and malignant) - 40 percent malignancy
have psammoma bodies

brenner tumor -2-5 percent malignancy

dermoid cyst / mature teratoma

Question 2

what are the signs and symptoms of these benign ovarian cysts ?

Answer 2

usually asymptomatic

they can cause metrorrhagia ,

bloated abdomen and mild abdominal ache

pain during intercourse

Question 3

what are the risk factors for cysts ?

Answer 3

taking fertility drugs

anything that causes a longer period of ovulation such as
not being pregnant , early menarche , not breastfeeding

hormone therapy after menopause

PCOS

smoking / older age

Question 4

how do we diagnose cyst tumors ?

Answer 4

pelvic examination - the tumor is mobile and the surface is smooth

ultrasound if functional ovarian cyst :
functional - thin walled ,
no septae or thin walled septae usually no solid components , less than 6cm ,
avascular in colour doppler , disappear within 6-8 weeks

ASCITIS ia absent unlike in malignant ovarian tumors

CA-125, CA-19.9, CEA tumor markers maybe raised but not helpful in diagnosis because it is raised in malignancy aswell

need laparoscopic biopsy to confirm

Question 5

what is the treatment for mucinous cyst adenoma

Answer 5

Since most mucinous tumors of the ovary are large laparotomy removal of cyst

Question 6

what is the treatment for serous cyst adenoma’s

Answer 6

unilateral salpingo-oophorectomy or ovarian cystectomy is adequate treatment

Question 7

what are some features of brenner tumor ?

Answer 7

squamous metaplasia of surface epithelium

Majority of the tumor are solid. “coffee bean” nuclei as the nuclei have longitudinal grooves

Estrogen is secreted by the tumor and the woman may present with abnormal vaginal bleeding

Question 8

what is the treatment method for brenner tumor ?

Answer 8

laparoscopic tumor excision

Question 9

what are the features of mature teratoma

Answer 9

dermoid cyst -
torsion is very common

cystic unlike immature solid

all three germinal layers, that is, ectoderm, mesoderm, and endoderm

frequently consists of skin, hair follicles, sweat glands, while other commonly found fat, bone, nail, teeth, eyes, cartilage, and thyroid tissue

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struma ovarii
made up of only thyroid tissue - - thyroid hormones increase leading to hyperthyroidism

Question 10

what is the treatment method for dermoid cyst ?

Answer 10

laparotomy cystectomy