Ovaries Flashcards
Ovaries or testis by
7 weeks
Clinical signs of ovarian cancer
Abdominal pain Vaginal bleeding Nausea/Vomiting Increased abdominal girth (ascites) Inc CA125 (blood test) Diarrhea/GI symptoms
Ovary size
3 cm L adult
Volume 9.8cm Adult
Volume 3cm child
Volume 5.8cm post menopausal
Ovarian ligament
Inf ovary to uterine cornu
Infundibulopelvic ligament
Suspends superior ovary from post/lat pelvic wall
Mesovarium
Post surface of broad ligament
Ovarian layers
- Germinal epithelial: outer
- Fibrous capsule: tunica albuginea
- Ovarian parenchyma: cortex. Has follicles
- Central medulla
Graafan follicle reaches ___ before rupture
1.8-2.4cm
Mittelschermz
Pain with ovulation
Corpus Luteum
Supports pregnancy
If not pregnant becomes corpus albicans
Location
True pelvis
Ovarian fossa aka Waldeyer’s Fossa
Vessels
Adnexal branch of uterine artery
Ovarian artery
Ovarian vein: rt dumps to IVC, left dumps to lt renal vein to IVC
High resistance, early dicrotic notch
Abnl: < 1
Low resistance with cancer.
Functional Cyst
MC cause of ovarian enlargement
- Follicular
- Corpus Luteum after ovulation. Ring of fire. Unilateral. Makes progesterone.
- Hemorrhagic
- Theca-Lutein in molar preg. Inc hCG. Large. Bilateral. Septated.
Normal follicles 2.5 cm.
Regress
CDS fluid
Ovarian Remnant Syndrome
Take out ovary and residual tissue produces functional cyst.
Para ovarian cyst
Embryonic remnant. Separate from ovary.
Polycystic Ovaries
Endocrine disorder. LH/FSH ratio inc
Anovulatory.
Numerous small follicles that don’t mature. Displaced.
String of pearls
Assoc: Stein Leventhal Syndrome: infertility, oligomenorrhea, hirsutism:hairy, obese.
Ovarian Torsion
Ovary rotates cuts off blood supply Hemorrhage/infarction Pain fever palp mass Adolescence/children Assoc with adnexal mass
Enlg hypo ovary with little-no Doppler flow
Endometrioma / Chocolate Cyst
Localized endometriosis ectopic endo tissue
Homogeneous mass
Cystic Teratoma / Dermoid Cyst
MC germ cell tumor MC ovarian tumor Malignant degeneration rare Ca+, hair, fat, complex Tip of iceberg sign. Shadow
Serous cystadenoma
Post menopausal
Epithelial
2nd MC tumor
Large thin septations
Mucinous Cystadenoma
Less common
Very large 15-30cm
Multi septated, debri
Benner Tumor
Benign epithelial tumor
Rare
Fibroma
Benign stromal tumor
Rare
Post menopausal
Meig’s Syndrome
Fibroma & Brenners tumor cause it
Massive ascites
Pleural effusion
Thecoma / Theca Cell Tumor
Stromal tumor
Estrogen producing
Abnl ut bleeding
Sertoli-Leydig Cell / Androblastoma
Secretes hormones
Masculinization
Can become malignant
Granulosa Cell Tumor
Feminizing
Post menopausal
Precocious puberty & full breasts
Arrhenoblastoma
Masculizing tumors
Amenorrhea
Ovarian cancer
Post menopausal 90% epithelial 94% cystic components Inc CA125 Silent killer
Stage 1: ovary
Stage 2: 1 or both ov with pelvic extension
Stage 3: 1 or both ov, intraperitoneal mets, nodes, omentum/sm bowel involvement. In true pelvis.
Stage 4: ovaries, mets, pleural effusion.
History of breast cancer. Fam hx ov Cancer Nulliparous Hx colon cancer Talcum powder
Serous cystadenocarcinoma
MC ovarian cancer
Bilateral. Large. Older.
Mucinous cystadenocarcinoma
Young. Huge. Bilateral. Thick septation.
Endometroid Tumor
Malignant.
Assoc with endo cancer and endometriosis
Teratoma
Rare
Child/young adults
Germ cell.
Ca+ shadow
Dysgerminoma
MC pediatric ovarian mass
Rapid growth
May torse
Mets to ovary
GI, Endo, Breast, melanoma, lymphoma
Krukenberg Tumor
Specific type of ov met.
Has signet ring cells.
Usually from gastric primary.
Tunners Syndrome
MC gonadal dysgenesis 45XO Complete/ partial absent ov Coarctation of aorta Cystic hygroma : neck webbing Shield chest
