Benign Ovarian Tumours Flashcards

1
Q

What are the different types of cysts?

A
functional cysts
endometriomas
serous cystadenomas
mucinous cystadenomas
fibromas
teratomas
other germ cell tumorus
sex-cord tumours
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2
Q

What are functional cysts

A

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

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3
Q

What do functional cysts originate from?

A

follicles or corpus luteums

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4
Q

What are the complications of functional cysts?

A

rupture
failure to rupture at ovulation
bleeding

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5
Q

What are endometriomas ?

A

chocolate cysts

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6
Q

When are serous cystadenomas commonest?

A

30-40yrs

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7
Q

What are the commonest large ovarian tumours?

A

mucinous cyst adenomas

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8
Q

what % of mucinous cyst adenomas become malignant?

A

5%

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9
Q

What are fibromas?

A

Small, solid, benign, fibrous tissue tumours

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10
Q

What syndrome are fibromas associated with?

A

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

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11
Q

What do teratomas arise from?

A

primitive germ cells

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12
Q

What are teratomas?

A

tumours containing well differentiated tissue

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13
Q

In which women are teratomas commonest?

A

young

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14
Q

Name examples of other germ cell tumorus

A

non-gestational choriocarcinoma
ectodermal sinus tumours
dysgerminomas

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15
Q

What is the presentation of benign ovarian tumours?

A
asymptomatic 
pain - chronic or acute 
irregular vaginal bleeding
hormonal effects 
abdo swelling
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16
Q

What sx would suggest cyst rupture?

A

features of haemorrhagic shock
severe lower abdo pain
vomiting

17
Q

What sx suggest malignancy?

18
Q

What are the causes of chronic pain?

A

pressure effects, dull ache, dyspareunia

19
Q

What are the causes of acute pain?

A

bleeding into the cyst, ovarian torsion/rupture

20
Q

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

A

sudden development of androgenic features

21
Q

What may be found on abdo examination?

A

pelvic mass
tenderness
peritonism
ascites

22
Q

When is examination normal with cysts?

A

if small or woman is obese

23
Q

What may a vaginal examination show?

A

vaginal discharge/bleeding
cervical excitation
adnexal masses
tenderness

24
Q

What is cervical excitation?

A

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

25
What are Ix for benign ovarian tumours
FBC tumour markers CA125 AFP, CA19-9,LDH, hCG, CEA TVS
26
What is the management of benign ovarian tumours in premenopausal women?
exclude malignancy | laparoscopic ovarian cystectomy
27
When is surgery for BOT not indicated in premenopausal women?
<5cm asymptomatic benign
28
When is surgery for BOT indicated in premenopausal women?
>5cm symptomatic features of dermoid or endometriosis
29
Why should the cyst not burst when removing?
if it Is dermoid it can lead to chemical peritonitis and if malignancy can upstage disease
30
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