Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gynecology > Adnexal masses > Flashcards

Adnexal masses Flashcards

1
Q

Features making adnexal mass more likely to be malingant:

A
  • older age
  • bilateral
  • > 10 cm (ACOG)
  • solid components/papillations (ACOG)
  • ascites (ACOG)
  • increased doppler flow (ACOG)
  • complex
  • excrescences
  • septations
  • persistent duration (rather than reduction with menses or on OCPs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is most important personal risk factor for ovarian cancer?

A

family history with ovarian or breast cancer

  • if first degree relative, 5%
  • BRCA 1: 41-46%
  • BRCA 2: 10-27%
  • Lynch syndrome: 5-10%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ddx for adenxal mass

A

cystic:

  • functional cysts
  • mucinous or serous neoplasms
  • mature cystic teratoma

solid:

  • fibroid
  • fibroma
  • thecoma
  • brenner cell tumor
  • germ cell tumors
  • sex cord stromal tumors
  • teratoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how often are the following tumors bilateral?

  • germ cell tumors
  • fibroma
  • serous carcinoma
  • mucinous carcinoma
  • krukenburg (bonus- order of primary)
A
  • germ cell tumors: 5-10%, except gonadoblastoma (40%)
  • fibroma: 10%
  • serous carcinoma: 66%
  • mucinous carcinoma: 20%
  • krukenberg: 100%; breast, GI, endometrium, renal, lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when to intervene surgically on adnexal mass?

A
  • symptomatic

- concern for malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when to intervene on endometrioma or teratoma?

A
  • increased size
  • large size
  • symptomatic
  • concern for malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

management of adolescent/peds mass

A
  • TAUS if possible
  • HCG, AFP, inhibin, CA 125
  • if surgical - tumor removal, spare fallopian tube if not adherent, harvest ascites, eval omentum for nodules (remove if so), eval PA and pelvic LN for enlarged (remove if so)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is dysgerminoma managed

A

in young pt- conservative staging; USO, conserve contralateral ovary and uterus. Serial LDH and HCG tumor markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what two histologic findings are with granulosa cell tumors?

A
  • call-exner bodies

- coffee bean nuclei (also present in brenner tumors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when to intervene surgically in pregnancy?

A
  • suspected torsion
  • concern for malignancy
  • debilitating symptoms due to mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

most common adnexal masses in pregnancy?

A
  • teratoma (#1)
  • cystadenoma
  • paratubal cyst
  • corpus luteum
  • hemorrhagic cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the risk of malignancy for an adnexal mass in pregnancy?

what % of masses resolve in/after pregnancy?

A

1-6% malignancy

50-90% resolve in/after pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

mass at the time of cesarean section?

A
  • do not perform c-section for this indication only
  • if mass at time of c-section, and you need to remove ovary/tube with mass- defer until after unless suspicion for malignancy high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dysgerminoma

hcg/afp/ldh/ca125

A

hcg +, ldh +

afp -, ca125 -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

endodermal sinus tumor

hcg/afp/ldh/ca125

A

afp +

hcg -, afp -, ca125-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

choriocarcinoma

hcg/afp/ldh/ca125

A

hcg +

afp -, ldh-, ca125-

17
Q

immature teratoma

hcg/afp/ldh/ca125

A

afp +, ldh+, ca 125+

hcg -

18
Q

embryonal carcinoma

hcg/afp/ldh/ca125

A

afp +, hcg -

ldh -, ca125-

19
Q

what are histologic features of borderline tumor?

A
  • epithelial stratification
  • papillations
  • nuclear atypia

but no stromal invasion

20
Q

frozen borderline/LMP tumor– management?

A
  • pelvic washings, peritoneum and contralateral adnexal inspection (bilateral 50% of time)
  • if compelted child bearing: hyst/BSO with staging
  • if fertility sparing desired: USO or oopherectomy
  • comprehensive staging: unilateral oopherectomy, omentectomy, peritoneal biopsies
  • excision of extraovarian implants is most important to improve survival, and reduce recurrence risk
  • recurrence rate of borderline tumor if USO: 15%, if cystectomy 30%. Non-invasive peritoneal implants, recurrence rate 40%.
21
Q

differential for solid adnexal mass

A
  • pedunculated fibroid
  • fibroma
  • ectopic pregnancy
  • GI solid tumor
22
Q

managment of solid adnexal masses?

A
  • unless confident it is a pedunculated myoma, needs surgical eval/excision
  • if suspected benign can do yourself, if suspected malignant get GYN or surg oncologist
  • surgical for boards: ex-lap, peritoneal washings, intact specimen, frozen if appropriate, full staging if appropriate
23
Q

risk of malignant transformation for dermoid?

A
  • 1-2%

- resect if large size (5-10 cm), enlarging over time, suspicion of malingnacy

Gynecology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions