Benign Ovarian Tumours

Question 1

What are the different types of cysts?

Answer 1

functional cysts
endometriomas
serous cystadenomas
mucinous cystadenomas
fibromas
teratomas
other germ cell tumorus
sex-cord tumours

Question 2

What are functional cysts

Answer 2

sac that forms on the surface of a woman’s ovary during or after ovulation.

Question 3

What do functional cysts originate from?

Answer 3

follicles or corpus luteums

Question 4

What are the complications of functional cysts?

Answer 4

rupture
failure to rupture at ovulation
bleeding

Question 5

What are endometriomas ?

Answer 5

chocolate cysts

Question 6

When are serous cystadenomas commonest?

Answer 6

30-40yrs

Question 7

What are the commonest large ovarian tumours?

Answer 7

mucinous cyst adenomas

Question 8

what % of mucinous cyst adenomas become malignant?

Answer 8

5%

Question 9

What are fibromas?

Answer 9

Small, solid, benign, fibrous tissue tumours

Question 10

What syndrome are fibromas associated with?

Answer 10

Meig’s - pleural effusion, often R sided and ascites

Question 11

What do teratomas arise from?

Answer 11

primitive germ cells

Question 12

What are teratomas?

Answer 12

tumours containing well differentiated tissue

Question 13

In which women are teratomas commonest?

Answer 13

young

Question 14

Name examples of other germ cell tumorus

Answer 14

non-gestational choriocarcinoma
ectodermal sinus tumours
dysgerminomas

Question 15

What is the presentation of benign ovarian tumours?

Answer 15

asymptomatic 
pain - chronic or acute 
irregular vaginal bleeding
hormonal effects 
abdo swelling

Question 16

What sx would suggest cyst rupture?

Answer 16

features of haemorrhagic shock
severe lower abdo pain
vomiting

Question 17

What sx suggest malignancy?

Answer 17

ascites

Question 18

What are the causes of chronic pain?

Answer 18

pressure effects, dull ache, dyspareunia

Question 19

What are the causes of acute pain?

Answer 19

bleeding into the cyst, ovarian torsion/rupture

Question 20

Give an example of a hormonal effect of benign ovarian tumours?

Answer 20

sudden development of androgenic features

Question 21

What may be found on abdo examination?

Answer 21

pelvic mass
tenderness
peritonism
ascites

Question 22

When is examination normal with cysts?

Answer 22

if small or woman is obese

Question 23

What may a vaginal examination show?

Answer 23

vaginal discharge/bleeding
cervical excitation
adnexal masses
tenderness

Question 24

What is cervical excitation?

Answer 24

pain on examination w moving the cervix w the hand, indicative of inflammation

Question 25

What are Ix for benign ovarian tumours

Answer 25

FBC tumour markers
CA125
AFP, CA19-9,LDH, hCG, CEA
TVS

Question 26

What is the management of benign ovarian tumours in premenopausal women?

Answer 26

exclude malignancy

laparoscopic ovarian cystectomy

Question 27

When is surgery for BOT not indicated in premenopausal women?

Answer 27

<5cm
asymptomatic
benign

Question 28

When is surgery for BOT indicated in premenopausal women?

Answer 28

> 5cm
symptomatic
features of dermoid or endometriosis

Question 29

Why should the cyst not burst when removing?

Answer 29

if it Is dermoid it can lead to chemical peritonitis and if malignancy can upstage disease

Question 30

What is the management in postmenopausal women?

Answer 30

RMI
Low risk - conservative mx, repeat TVS and CA125 every 4 m
mod - bilateral oophorectomy
sev - referral to specialist