Ovarian cyst Flashcards
Name 4 different types of cysts
Physiological
Germ cell tumours
Stroma cell tumours
Epithelial tumours
Type of physiological cysts
Follicular cyst (≤ 3cm) Corpus luteal cyst (≤ 5cm)
Type of germ cell tumours
Teratoma/Dermoid cyst
Yolk Sac tumour
Dysgerminoma
Types of epithelial tumours?
Mucinous cystadenoma
Clear cell carcinoma
Serous cystadenoma (most common benign epithelial tumour)
Brenner cystadenoma
Type of sex chord tumours?
Sertoli cell tumours
Fibroma
Granulosa cell tumours
Investigations?
Pre-menopausal (done if USS shows suspicious lesion): AFP CA 19-9 B-hCG CEA LDH
CA-125 is less sensitive in younger women
Post-menopausal:
CA125 levels
Transvaginal ultrasound
Perform CT abdo + pelvis if RMI > 200
Components of Risk of Malignancy Index
Ultrasound result (0,1 or 3) Menopausal status (1 - premenopausal or 3- postmenopausal) CA-125 level
RMI = U x M x CA125 level
RMI > 200, low risk of malignancy, do what?
Laparotomy: Pelvic clearance
RMI > 200, high risk of malignancy, do what?
Laparotomy: Full staging procedure
RMI < 200, asymptomatic cyst, simple, cyst < 5cm do what?
Conservative Mx
RMI < 200, symptomatic cyst/ bilateral/ cyst > 5cm, do what?
Bilateral salpingoophorectomy
USS findings for ovarian cyst?
Unilateral mass
Simple cystic mass
Adnexal mass
Hypoechoic mass
How does an ovarian cyst rupture?
With physical activity (i.e sex, exercise)
What are the symptoms of ruptured ovarian cyst?
Symptoms range from asymptomatic, acute unilateral pain, to intra-peritoneal haemorrhage with haemodynamic compromise.
What are the most common type of cysts found in pre-menopausal and post-menopausal women?
Pre-menopausal:
- Physiological
- Germ cell tumours
Posts-menopausal:
- Epithelial tumours
