Pelvic Mass

Question 1

Investigating Ovarian Cysts

Answer 1

Size

Complexity

Nodules

Ascites

Doppler

hCG

Ca125

Question 2

indications for SURGICAL management of pelvic masses

Answer 2

malignancy, 10cm premenopause, or 5cm post menopause

Question 3

: monoclonal benign tumor. High incidence, age related (peaks at reproductive years, reduces as pt gets much older) , higher prevalence groups.

What mass is this?

Answer 3

fibroid/leiomyoma

Question 4

risk factors to leiomyoma

Answer 4

early menarche, low parity, family history, ethnicity

Question 5

treatment for leiomyoma

Answer 5

Treatment: medication (SPRM, GnRH), embolization, surgery (leiomyectomy or hysterectomy)

Question 6

difference between leiomyoma and leiomyosarcoma

Answer 6

the sarcoma is malignant. there is necrosis and the tumor obliterates the normal uterine structure. requires surgery, cannot treat with GnRH or SPRM

Question 7

compare and contrast the histology between leiomyosarcoma and leiomyoma (demarcation, necrsois, metastatic property, differentiation, invsivity)

Answer 7

Question 8

Investigations of Ovarian Cysts

Answer 8

Benign or malignant?

Watch or remove?

Surgery: who/what/where/when → dependent on goals of fertility, gyne oncologists often do it

Characterization: size, complexity, nodules, ascites, doppler

Labs: HcG, Ca125

Management: ultrasound, then surgery if its malignant, over 10 cm in young women or 5 cm post menopause

Question 9

aka a chocolate cyst

Answer 9

endrometrioma– essentially endometriosis causing cysts in the obary

Question 10

a cystadenoma has a ___ lining, is ___ (bening or malig), ___ cell shape and makes __ fluid. The lining makes ___-

Answer 10

Ovarian Mass; cystadenoma

Cyst lining is serous– benign, cuboidal and makes watery fluid.

Cyst lining makes mucin