Pelvic Masses Flashcards
What is the role of hormonal supression in management of a pelvic mass?
May prevent new cyst formation
What is involved with a rupture of a ovarian cyst?
Pain due to leakage of blood/ prostaglandins
Midcycycle pain
Hemiperitoneum from ruptured hemhorragic corpus luteum cyst
-Preggo test
-Culdocentesis: hemiperitonium
What is involved in an ovarian Torsion?
Compro vascular supply=> ischemia Constant or intermittent pain Teratoma most common Tender pelvic mass Color Doppler sonography Surgical Tx: untwist and remove
What is the most common MALIGNANT ovarian tumor?
Serous Cystadenoma and Psammoma bodies
What is the most common MALIGNANT tumor among children and adolescents?
Markers?
Dysgerminoma
hCG and LDH
What are the factors that maka a pelvic mass more likely to be benign?
Unilateral, Cystic, thin walled, mobile, smooth, no ascites, slow growth, younger women.
What are the factors that maka a pelvic mass more likely to be Malignant?
Bilateral, Solid, Thick walled, Fixed, Irregular, ascites, Rapid growth, Older women.
What are the symptoms of uterine leiomyomas?
Bleeding Alteration of normal myometrial Pressure Necrosis Iron Def. anemia Pelvic Pressure Lumpy, bumpy sensation
What is the diagnosis of uterine leiomyomas?
Midline irregulary contoured mobole mass
US to conform findings
What are the medical Tx of Leiomyomas?
Progestin supplementation OCPs Mirena IUD High Dose NSAIDS GnRH agonist can reduce fibroid size
What are the Surgical Tx of Leiomyomas?
Myomectomy if you want to retain childbearing potential Hysterectomy Endometrial Ablation Myolysis Uterine Artery Embolization MRI guided focused US Surgery
What factors should be considered when deciding to operate?
Future Reproductive plans
Amount and timing of bleeding
Degree of Enlargement of tumors
Age and Co-morbidities of Pt
