Pelvic Mass Flashcards
Give some non-gynaecological causes of a pelvic mass
Constipation
Caecal carcinoma
Appendix/diverticular abscess
Urinary retention
Where do gynaecological causes of a pelvic mass arise from?
Uterus (body/cervix)
Tubal
Ovarian
What is the most common cause of a uterine mass?
Fibroids
What type of tumour are uterine fibroids?
Leiomyomas
How can uterine fibroid location be classified?
Pedunculated Intracavitary Intramural Subserous Submucous
How do uterine fibroids commonly present?
Pelvic mass
Menorrhagia
Pressure symptoms (frequency/retention)
Pain/tenderness
What is the first-line imaging for suspected fibroids?
USS
What imaging can be used to precisely localise suspected fibroids?
MRI
How are fibroids treated?
Hysterectomy (if family complete)
Myomectomy
Uterine artery embolisation
Hysteroscopic resection
Give some causes of tubal swellings
Ectopic pregnancy
Hydrosalpinx
Pyosalpinx
Paratubal cysts
What is the cause of endometriotic cysts?
Growth of endometrium outside the endometrial cavity
How do endometriotic cysts on the ovaries classically present?
Chocolate cysts
Give some clinical features of endometriotic cysts
Severe dysmenorrhoea
Premenstrual pain
Dyspareunia
Subfertility
The most common ovarian tumours arise from what?
Surface epithelium
What are the types of primary ovarian tumours that arise from surface epithelium?
Serous Mucinous Endometrioid Clear cell Brenner
A benign ovarian tumour arising from the surface epithelium is known as what?
Cystadenoma
A malignant ovarian tumour arising from the surface epithelium is known as what?
Cystadenocarcinoma
What is the main primary ovarian tumour arising from germ cells?
Benign cystic teratoma
Give examples of primary ovarian tumours arising from the stroma
Granulosa cell tumour
Fibroma
Malignant germ cell tumours may produce what?
HCG
AFP
Give some clinical features of ovarian cancer
Pelvic mass (not always) Heartburn Weight loss Bloating Change of bowel habit
Mutations in which genes are highly associated with ovarian cancer?
BRCA 1 & 2
The oral contraceptive pill leads to increased/decreased risk of ovarian cancer
Decreased
Give some important tumour markers of ovarian cancer?
CA-125
CEA
Which imaging modality is better for the ovarian cyst itself?
USS
Which imaging modality is better for assessing disease outwith the ovary?
CT
What is CA-125 a marker of?
Peritoneal inflammation
Give some other conditions where CA-125 could be raised
Endometriosis Peritonitis Pregnancy Pancreatitis Ascites
What is the function of CEA as a marker?
To exclude metastases from GI cancer
How are benign ovarian cysts treated?
Removal/drainage
How are early stage malignant ovarian tumours treated?
Removal of the ovaries
