Ovarian Pathologies Flashcards
Follicular cyst:
Symptoms
(functional cyst)
asymptomatic, dull adnexal pressure/pain, delay in menstruation
Follicular cyst:
Sonographic Appearacne
thin walled, translucent, watery filled
simple cyst description
Corpus Luteual cyst:
Sonographic Appearance
(functional cyst)
simple cyst description, may have internal echoes
Hemorrhagic cyst:
Symptoms
(functional cyst)
acute onset of pelvic pain
Hemorrhagic cyst:
Sonographic Appearance
hyperechoic, smooth posterior wall, posterior enhancement
Theca-Lutein Cysts:
Sonographic Appearance
(functional cyst)
bilateral, multiloculated, large
Theca-Lutein Cysts:
Symptoms
high HCG levels, nausea, vomiting
Ovarian Hyperstimulation Syndrome:
Symptoms
in mild form:
pelvic discomfort
severe form:
severe pelvic pain, abdominal distention
Ovarian Hyperstimulation Syndrome:
Sonographic Appearance
in mild form:
enlarged ovaries (<5cm in diameter)
in severe form:
notably enlarged ovaries (>10cm in diameter), ascites, pleural effusion, numerous large thin walled cysts throughout periphery
**Polycystic Ovarian Syndrome:
Symptoms
triad: oligoovulation (ovulates once in a while), hyperandrogenism, polycystic ovaries
**Polycystic Ovarian Syndrome:
Sonographic Appearance
multiple tiny cysts around periphery of ovary: “String of Pearls”, ovary may be normal or enlarged
What is another name for the focal form of Endometriosis?
endometrioma
“chocolate cyst”
Endometrioma:
Symptoms
cyclic pain (peak 2 days before menses), metrorrhea, dysmenorrhea, dyspareunia (especially with deep penetration)
Endometrioma:
Sonographic Appearance
well defined, commonly unilocular, homogeneous, low-level internal echoes
Paraovarian Cysts:
Symptoms
asymptomatic unless torsion
Paraovarian Cysts:
Sonographic Appearance
simple cyst adjacent to ovary
Ovarian Torsion:
Symptoms
acute severe unilateral pain, fever, nausea, vomiting, palpable mass
Ovarian Torsion:
Sonographic Appearance
enlarged, edematous ovary, “string of pearls”, free fluid in pelvis, absent Doppler flow
**What is the number one cause of death in neoplasms?
ovarian carcinoma
**What is the fourth leading cancer death?
ovarian carcinoma
**Who has a greater incidence of developing ovarian cancer?
females with a personal or family history of breast or colon cancer
Obesity is also a risk factor
**Ovarian Carcinoma:
Symptoms
vague abdominal pain, swelling, indigestion, frequent urination, constipation, weight change due to ascites
symptomless in early stages of disease
**Ovarian Carcinoma:
Sonographic Appearance
cystic mass with solid components, ascites, unilateral, enlarged ovaries
Mucinous Cystadenoma:
Symptoms
(epithelial tumor)
pressure, pain, increased abdominal girth
Mucinous Cystadenoma:
Sonographic Appearance
simple/septate thin walled multilocular cysts, internal echoes, unilateral
Mucinous Cystadenocarcinoma:
Symptoms
(epithelial tumor)
pelvic pressure, pain when ruptured
Mucinous Cystadenocarcinoma:
Sonographic Appearance
ascites, thick irregular walls and septations
Sereous Cystadenoma:
Symptoms
(epithelial tumor)
pelvic pressure, bloating
Sereous Cystadenoma:
Sonographic Appearance
multilocular cyst, may have nodule
Sereous Cystadenocarcinoma:
Symptoms
(epithelial tumor)
pelvic fullness, bloating, ascites
Sereous Cystadenocarcinoma:
Sonographic Appearance
cystic structures with septations and/or papillary projections, internal/external papillomas
What are all the epithelial tumors?
mucinous cystadenoma, mucinous cystadenocarcinoma, sereous cystadenoma, sereous cystadenocarcinoma
What are all the functional cysts?
follicular cyst, corpus luteum cyst, hemorrhagic cyst, theca-lutein cysts
What is another name for dermoids?
cystic mature teratoma
Dermoids:
Symptoms
(germ cell tumor)
asymptomatic, abdominal pain, enlargement and pressure
Dermoids:
Sonographic Appearance
complex, echogenic components, acoustic shadowing due to dermoid plug, fat-fluid level
What is the most common ovarian neoplasm?
dermoid cyst
Immature teratomas are…
cancerous and small
What are the most common ovarian neoplasms seen in pregnancy?
dysgerminoma and serous cystadenoma
Fibroma:
Sonographic Appearance
unilateral, hypoechoic mass, posterior attenuation, ascites
What is the most common hormone-active estrogenic tumor of the ovary?
granulosa
Granulosa:
Symptoms
precocious puberty, vaginal bleeding, full breasts
pain, pressure, fullness
Granulosa:
Sonographic Appearance
low level homogeneous echoes
if torsion: multilocular cyst containing blood/fluid
What are the two main stromal tumors?
fibroma, granulosa
What are all the stromal tumors?
granulosa cell tumor, thecoma, fibroma, androblastoma
Where can metastatic cancer arise from?
breast, upper GI tract, other pelvic organs
What is the least common gynecologic malignancies?
carcinoma of the fallopian tube
Metastatic Disease:
Sonographic Appearance
bilateral, ascites, solid or solid with moth-eaten cystic pattern (occurs when necrotic)
Which ovary is three times more likely to torse?
right ovary
What are the demographics for mucinous cystadenoma?
found in women 13-45 years old
What are the demographics for mucinous cystadenocarcinoma?
frequently occurs in women 40-70 years old
What is the second most common benign tumor of the ovary?
serous cystadenoma, only after dermoid cyst
**What is the most common malignancy in young females of 16-20 years old?
immature teratomas
**What is totipotent?
the ability to give rise to any human tissue
What is the “crescent sign”?
normal ovarian tissue adjacent to a benign cystic teratoma
signifies a benign tumor
Corpus luteum cyst:
Symptoms
irregular menses, pain (can rupture)
mimic ectopic pregnancy
What are the differential diagnoses for a cystic or homogeneous ovarian mass?
follicular cyst, corpus luteum cyst of pregnancy, cystic teratoma, paraovarian cyst, hydrosalpinx, endometrioma, hemorrhagic cyst
What are the differential diagnoses for a solid mass?
solid teratoma, adenocarcinoma, arrhenoblastoma, fibroma, dysgerminoma, torsion
What are the differential diagnoses for a complex mass?
cystadenoma, dermoid cyst, TOA, ectopic pregnancy, granulosa cell tumor
What are the most common solid tumors?
serous cystadenoma and serous cystadenocarcinoma
