Lesson 6 (Part 3) Flashcards
How long does it take for functional cysts to resolve?
Within 1 to 2 menstrual cycles
- follow up with US in 6 weeks
What are US limitations for cysts?
Can be difficult to detect small mural nodules
What is recommended if a cyst is > 7cm? (2)
- Surgery
2. MRI
Ovarian Remnant Syndrome
Patient has undergone a bilateral oophorectomy and a cystic mass may develop due to residual tissue left behind
What can ovarian remnant syndrome cause? (2)
- Pelvic pain
2. Compression of distal ureter
What does ovarian remnant syndrome look like on US? (4)
- Small to large cysts
- Simple to complex
- Thin rim of ovarian tissue
- Looks like 2 different levels of fluids
- based on densities
Surface Epithelial Inclusion Cysts
Are nonfunctional cysts that are usually in postmenopausal women
Where are surface epithelial inclusion cysts located?
On the periphery
What do surface epithelial inclusion cysts look like on US? (5)
- Tiny
- Sometimes punctate foci
- Can grow to several cms
- Not likely but can hemorrhage
- Nonfunctional
- doesnt change with the cycle
What are 3 examples of extraovarian cysts?
- Paraovarian Cysts
- Paratubal Cysts
- Peritoneal Inclusion Cysts
Peritoneal Inclusion Cysts
Fluid accumulates within adhesions separate from ovary
What percentage do paraovarian and paratubual cysts make up of all adnexal masses?
10-20%
What is the most common age group for paraovarian and paratubual cysts?
30-40
Are paraovarian and paratubual cysts symptomatic or asymptomatic?
Asymptomatic
- typically small
Where are paraovarian and paratubual cysts located?
In the broad ligament
What do paraovarian and paratubual cysts look like on US? (3)
- Anechoic
- Can have internal echoes within
- Do not change with cycle
- nonfunctional
Peritoneal Inclusion Cysts
Benign cystic mesothelioma or benign encysted fluid
Who do peritoneal inclusion cysts occur in?
Premenopausal women
What kind of patient history do you need with peritoneal inclusion cysts? (4)
- Abdominal surgery
- Trauma
- PID
- Endometriosis
What does endometriosis cause? (2)
- Pain
2. Scarring
What does fluid accumulation in adhesion do?
Entraps the ovary
What is treatment for peritoneal inclusion cysts? (2)
- Suppression with oral contraceptives
2. Fluid aspiration
What does peritoneal inclusion cysts look like on US? (3)
- Multiloculated cystic adnexal masses
- Bizarre shape
- Presence of an intact ovary amid septations and fluid
What are differential diagnosis for peritoneal inclusion cysts? (2)
- Paraovarian
2. Hydrosalpinx
What are 3 paraovarian characteristics?
- Usually round or ovoid
- Not associated with surgery, infection or trauma,
- Separate from ovary
What are 3 hydrosalpinx characteristics?
- Tubular or ovoid structure
- Visible folds
- Ovary is outside
When should a premenopausal women get a follow up on asymptomatic Adnexal Cysts? (2)
- Simple or hemorrhagic 3-5 cm
2. Recommended follow up >5cm in 6 weeks
When should a post menopausal women get a follow up on asymptomatic Adnexal Cysts? (2)
- When cysts are >1cm
2. Yearly
What are 4 examples of Pregnancy-Associated Ovarian Lesions?
- Hyperstimulated Ovaries
- theca luteal cysts - Ovarian Hyperstimulation Syndrome
- Hyperreactio luteinalis
- Luteoma
- rare
