Ovaries Flashcards
Follicular development before ovum release
- Primary follicle
- Best one selected to develop - Early antrum
- Atretic follicle
- Graafian follicle.
Corpus luteum
Structure in the ovary that secretes progesterone after ovum release.
After it matures, and secretes progesterone, becomes corpus albicans
Corpus albicans
Scar tissue of degenerated corpus luteum.
Non-functioning/
Epidemiology
- Gynae admission
- % of women in UK admitted by 65
4th most common gynae admission
4% of women in UK admitted by 65
Complications of ovarian cysts
Torsion
Rupture
Haemorrhage
Infection
Ovarian torsion
- Description
- Presentation
Occurs when the ovaries becomes twisted around vascular pedicle.
Presentation
- Acute abdominal pain
- Nausea/ vomitting
- Tachycardia
- Guarding, rigidity
- Ovary can be rotated higher into abdomen
Ovarian torsion
- Complication
- Management
Infarction of the ovaries
- Ovarian necrosis
Salpingo-oophorectomy surgery
Ovarian cyst rupture
- Presentation
- Treatment
Cyst can rupture spontaneously or as a result of trauma.
Can present with vague/ sharp pain
- Lower abdominal pain
- Tenderness and guarding
- USS free fluid
Treatment
- If mild consequences- conservative management
Ovarian cyst haemorrhage
- Presentation
- Treatment
Acute lower abdo pain
- Minial abdo symptoms
USS- haemorrhage into cysts
Conservative or operative treatment depending on symptoms and bleeding
Ovarian cyst rupture sequelae
Peritonitis
Pseudomyoxma peritonei
Dermoid ovarian cyst
Benign tumour that develops from totipotential germ cell (primary oocyte)
- Contains all the 3 germ cell layers (mesoderm, endoderm, ectoderm
Dermoid ovarian cyst
- Presentation
If it grows large
- Fullness in pelvis
- Deep dysparunia
- Increasing urinary frequency
Diagnoses confirmed with USS
Dermoid ovarian cyst management
Laparoscopic ovarian cystectomy
Sertoli-leydig tumour of the ovary
- Description
- Bilateral?
- Prognosis
Tumour of stromal origin
- Secreting hormones (androgens)
Rarely bilateral
Prognosis mainly good
Sertoli-leydig tumour of the ovary
- Presentation
Amenorrhea/ menstruation problems
Hair recession
Hirsutisim
Clitoromegaly
Acne
Voice deepening
Risk of malignancy index for ovarian tumours
Composed of
- Menopause
- USS scan
- CA125 levels
> /= 250= referred
Removal of ovaries in breast cancer
Removes source of oestrogen which promotes growth of breast cancer.
Cyst
A closed hollow lesion, lined by epithelium
Oestrogen secreting stromal tumour
Presents with post-menopausal bleeding
- Example: granulosa cell tumour
Classification of ovarian tumours [5]
Tissue of origin
- Epithelial or stromal
Macroscopic appearance
- Cystic or solid
Content of the cyst
- Serous, mucin, dermoid
Histological
- Benign
- Borderline
- Malignant
Number of cavities
- Multiocular or uniocular
Draining of a cyst
Reduces the risk of bursting
Reduces the size- smaller surgical incision
Resection of ovarian tumour
Must be intact
- Leakage of contents can put cancer cells into abdomen
Borderline tumour features
Contains cellular features of cancer without invasion
Cystological atypia
- Varied nuclear size and shape
Nuclear stratification
Mitotic activity
Complex architecture
No invasion of the wall
Ovarian tumour and haemorrhagic
Malignant tumours can erode their blood supply and cause bleeds
- Torsion increases pressure in capillaries
Chocolate cysts
Blood collecting in cysts from endometriosis of the ovary
