Benign Ovarian Tumours Flashcards
What are the different types of cysts?
functional cysts endometriomas serous cystadenomas mucinous cystadenomas fibromas teratomas other germ cell tumorus sex-cord tumours
What are functional cysts
sac that forms on the surface of a woman’s ovary during or after ovulation.
What do functional cysts originate from?
follicles or corpus luteums
What are the complications of functional cysts?
rupture
failure to rupture at ovulation
bleeding
What are endometriomas ?
chocolate cysts
When are serous cystadenomas commonest?
30-40yrs
What are the commonest large ovarian tumours?
mucinous cyst adenomas
what % of mucinous cyst adenomas become malignant?
5%
What are fibromas?
Small, solid, benign, fibrous tissue tumours
What syndrome are fibromas associated with?
Meig’s - pleural effusion, often R sided and ascites
What do teratomas arise from?
primitive germ cells
What are teratomas?
tumours containing well differentiated tissue
In which women are teratomas commonest?
young
Name examples of other germ cell tumorus
non-gestational choriocarcinoma
ectodermal sinus tumours
dysgerminomas
What is the presentation of benign ovarian tumours?
asymptomatic pain - chronic or acute irregular vaginal bleeding hormonal effects abdo swelling
What sx would suggest cyst rupture?
features of haemorrhagic shock
severe lower abdo pain
vomiting
What sx suggest malignancy?
ascites
What are the causes of chronic pain?
pressure effects, dull ache, dyspareunia
What are the causes of acute pain?
bleeding into the cyst, ovarian torsion/rupture
Give an example of a hormonal effect of benign ovarian tumours?
sudden development of androgenic features
What may be found on abdo examination?
pelvic mass
tenderness
peritonism
ascites
When is examination normal with cysts?
if small or woman is obese
What may a vaginal examination show?
vaginal discharge/bleeding
cervical excitation
adnexal masses
tenderness
What is cervical excitation?
pain on examination w moving the cervix w the hand, indicative of inflammation
What are Ix for benign ovarian tumours
FBC tumour markers
CA125
AFP, CA19-9,LDH, hCG, CEA
TVS
What is the management of benign ovarian tumours in premenopausal women?
exclude malignancy
laparoscopic ovarian cystectomy
When is surgery for BOT not indicated in premenopausal women?
<5cm
asymptomatic
benign
When is surgery for BOT indicated in premenopausal women?
> 5cm
symptomatic
features of dermoid or endometriosis
Why should the cyst not burst when removing?
if it Is dermoid it can lead to chemical peritonitis and if malignancy can upstage disease
What is the management in postmenopausal women?
RMI
Low risk - conservative mx, repeat TVS and CA125 every 4 m
mod - bilateral oophorectomy
sev - referral to specialist
