ovarian pathology Flashcards
what is ovarian torsion
partial or complete torsion on it’s supporting ligaments
what is adnexal torsion
ovarian torsion + fallopian tubes
RF ovarian torsion
mass/ repdoductive age // pregnant // ovarian hyperstimulation syndrome
symptoms ovarian torsion
sudden deep colicky abdo pain // vomiting and distress // fever (if necrosis) // vaginal exam –> adenexal tenderness
invx + finding ovarian torsion
USS whirlpool sign
mx ovarian torsion
laparoscopy
what does ovarian endometroosis look like
chocolate cysts
what causes follicular cysts
when dominant cyst does not rupture // or non-dominant cyst fails to atresia // most common cyst
how do corpus luteum cysts present
intraperitoneal bleeding
what are the most common ovarian cysts
follicular, corpus luteum // dermoid (benign germ cell) // serous or mucinous cystadenoma
mx complex (multi-loculated) ovarian cysts
biopsied for malignancy
invx ovarian cyst
USS
symptoms ovarian cyst
pain on intercourse, bloating, bowel or bladder symptoms // rupture = pain, collapse, shock
dermoid cyst + symptoms
(germ cell) - contain skin, hair, teeth // age 30 // common torsion
premenopausal ovarian cyst mx
if <5cm repeat USS in 8-12 weeks (likely to be benign)
mx ovarian cyst postemenopausal women
cysts are unlikely so refer to gynae
what is Meigs syndrome
ascites + ovarian fibroma + pleural effusion
4 main type of ovarian tumours
surface // germ cell // sex stromal // mets
types of ovarian surface tumour
serous cyst adenoma/carcinoma // mucinous cyst adenoma/carcinoma // brenner tumour
most common benign ovarian tumour
serous cystadenoma (surface) (often bilateral)
most common ovarian malignancy
serous adenocarcinoma (surface) (often bilateral)
biopsy brenner tumour
coffee bean nuclei
which ovarian tumour is assoc with psammoma bodies
serous cystadenocarcinoma (malignant surface tumour)
types of germ cell tumours
teratome // dysgerminoma // yolk sac // choroicarcinoma
types of teratoma
mature (dermoid) // immature (malignant) - contain teeth etc
features dysgerminoma
high hCG, LSH, Turners
features yolk sac tumour
secrete AFP
features choriocarcinoma
raised hCG - from moles // often spread to lung
most common malignant germ cell
dysgerminoma
sex cord-stromal tumours
granulosa // sertoli-leydig // fibroma
what does granulosa tumours secrete
oestrogen (malignant)
symtpoms granulosa cell tumour kids vs adults
kids = precocious puberty // women = endometrial hyperplasia
what do Sertoli-Leydig cell tumours secrete + symptoms
androgens –> masculising // assoc with Peutz-Jegher syndrome
symptoms ovarian fibroma
pulling sensation in abdomen // meigs (ascites, fibroma, pleural effusion)
common met to ovarian
krukenbery (GI –> mucin signet ring adenocarcinoma)
peak incidence ovarian cancer
60
RF ovarian cancer
BRCA1 or BRCA2 // many ovulations eg early menarche, late menopause, nullparity
protective ovarian cancer
COCP
symptoms ovarian cancer
vague - abdo distension + bloating, urinary urgency, satiety, diarrhoea
tumour marker ovarian cancer
Ca125 (if >35ml –> USS) // not a screening test
invx and diagnosis ovarian cancer
USS, diagnostic laparatomy
mx ovarian cancer
surgery + platinum chemo
prognosis ovarian cancer
80% advanced presentation // 45% 5 year
at what age in the UK are children given HPV
12-13 year old girls and boys // all MSM under 45
