Ovarian Pathology Flashcards
What are cystic ovarian mass types? 3
- Simple
- Bilateral and multiple
- Ovarian torsion
What are different types of simple cystic ovarian mass? 5
- Follicular
- Corpus luteum
- Para ovarian
- Omental
- Urachal
What are two types of bilateral and multiple cystic ovarian masses?
- Theca lutean
- Polycystic ovaries
What stimulates the ovaries to mature then locate?
LH and FSH
Follicles grows from ______ to ________ in about 10 days
3 to 24mm
Are follicular cysts normal?
Yes
Follicular cysts evolves in to what?
Corpus luteum after rupture
When do we see corpus leteum cysts?
Term after ovulation
What is the shape of corpus luteum cysts?
Odd appearing shape
What is the size of corpus luteum cyst?
1 - 10 cm
There is often debris in corpus luteum cysts due to what?
Hemorrhage
If the corpus luteum cysts are large it resolves when? 2 (in terms of pregnancy and without)
- About 8 weeks with out pregnancy
- 12 to 15 weeks with pregnancy
What are persistent cysts?
Follicular or corpus luteum
Persistent cysts may grow how much before rupturing?
Quite large
Do persistent cysts hurt?
May cause pain
Paraovarian cysts are remnants of what?
Remnants of the embryonic ducts
What are paraovarian cysts also called? 2
- Cysts of Morgagni
- Paratubal surosal cysts arising from Müllerian ducts remnants
How thick are the paraovarian cysts walls?
Thin
How big are paraovarian cysts? (In CM)
Usually 1-4 cm, and do not change in size with cycle
Are paraovarian cysts symptomatic or asymptomatic?
Asymptomatic
Paraovarian cysts are never surrounded by what?
Ovarian tissue
Where are urachal cysts located ?
Midline in the anterior abdominal wall between umbilicus and bladder
Urachal cysts are a remnant of what?
A remnant in development of the bladder
Where are omental cysts located? 2
- Higher in the pelvis or abdomen
- Along the omentum
Theca lutean cysts occur in which amounts? 2
- Multiple
- bilateral cysts
How big are Theca lutean cysts?
Several CM in size
What is Theca lutean cysts caused by?
Excessive amounts of hCG
What conditions is Theca Lutean cysts associated with? 4
- Multiple gestation
- Molar pregnancy
- Choriocarcinoma
- Hyper stimulation syndrome
Theca lutean cysts might under go what? 3
- Hemorrhage
- Rupture
- Torsion
What happens with hyper stimulation? 2
- Theca lutean cysts with ascites
- Pergonal over stimulation from an IVF cycle
What is Polycystic ovarian syndrome often referred to as?
- Stein Leventhal syndrome
Which demographic of women are affected by PCOS?
20 - 30 years of age
What is Polycystic ovarian syndrome caused by?3
- Unopposed estrogen with no surge of LH
- Increased androgen secretion from ovarian stroma
- Many immature follicles that never mature or rupture
Does ovulation occur with PCOS?
No
What are some signs and symptoms of PCOS? 5
- Obesity
- HIrsutism
- Amenorrhea or Oligomenorrhea
- An ovulation
- Infertility
Polycystic ovaries can be associated with what?
Endometrial carcinoma
The most extreme form of PCOS is called what?
Hyperthecosis or thecosis
How do we find the diagnosis for Polycystic ovaries?
Blood work (increased testosterone)
What are often ordered to investigate for PCOS but is not the definitive for diagnosis?
Pelvic ultrasounds
What does PCOS look like sonographically? 3
- Slightly enlarged ovaries with multiple small cysts around the periphery
- String of pearls
- Ovarian volumes of greater than 10cm
How does ovarian torsion feel?
Acute sharp pain
How common is ovarian torsion?
Rare to occur in normal ovaries
Ovarian torsion is usually associated with what/
Ovarian masses
What is incomplete ovarian torsion?
Large, edmatous ovaries with multiple peripheral cysts (due to lymphatic and venous congestion)
How does complete ovarian torsion look like, and what is it due to?
Increased or decreased echotexture due to infarct or hemorrhage
How do we evaluate ovarian torsion?
Colour and spectral doppler
Early DX of ovarian might do what for ovarian torsion?
Salvage the ovary
