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BENIGN OVARIAN TUMORS:Ovarian Cysts Symptoms, Causes & Treatment

BENIGN OVARIAN TUMORS: Ovarian Cysts Pelvic Mass Symptoms, Causes & Treatment

BENIGN OVARIAN
TUMORS

benign-ovarian-tumorssymptoms-causes-treatment .Ovaries are normally not palpable in
pre-menarche, and after the
menopause
.In the reproductive age group
ovaries are palpable in the lean pts.
.Ovarian size of different age groups
Premenopause 3.5 x 2 x 1.5 cm
Early menopause 1 –2 yrs
2 x 1.5×0.5cm
Late menopause 2-5yrs
1.5×0.75×0.5cm
.Ovaries are normally not palpable in
pre-menarche, and after the
menopause
.In the reproductive age group
ovaries are palpable in the lean pts.
.Ovarian size of different age groups
Premenopause 3.5 x 2 x 1.5 cm
Early menopause 1 –2 yrs
2 x 1.5×0.5cm
Late menopause 2-5yrs
1.5×0.75×0.5cm

.If the ovaries are palpable in any of the
age groups when it is not supposed to be
through investigations and work up should
be carried out
.OVARIAN CYSTS CAN BE CLASSIFIED AS
FOLLOWS:
.I. Functional Benign
.II Neoplastic borderline
Malignant
.If the ovaries are palpable in any of the
age groups when it is not supposed to be
through investigations and work up should
be carried out
.OVARIAN CYSTS CAN BE CLASSIFIED AS
FOLLOWS:
.I. Functional Benign
.II Neoplastic borderline
Malignant

FUNCTIONAL OVARIAN CYSTS
INCLUDES:
a. Follicular cysts
b. Corpus luteum cysts
c. Theca luten cysts
BENIGN OVARIAN NEOPLASM
1. Serous cystadenoma
2. Mucinous cystadenoma
3. Endometrioma
4. Dermoid cysts
5. Fibroma
FUNCTIONAL OVARIAN CYSTS
INCLUDES:
a. Follicular cysts
b. Corpus luteum cysts
c. Theca luten cysts
BENIGN OVARIAN NEOPLASM
1. Serous cystadenoma
2. Mucinous cystadenoma
3. Endometrioma
4. Dermoid cysts
5. Fibroma

FUNCTIONAL CYSTS
-These are cysts related to ovarian
function i.e. the process of ovulation
-They are the most common detected
cysts in the reproductive age group
-Can be reach up to 10 cm in diameter
-Resolve spontaneously.
FUNCTIONAL CYSTS
-These are cysts related to ovarian
function i.e. the process of ovulation
-They are the most common detected
cysts in the reproductive age group
-Can be reach up to 10 cm in diameter
-Resolve spontaneously.

.Follicular cysts results from the
growth of a follicle that does not
rupture
.Corpus luteum cyst results from Hge
inside a corpus luteum
.Theca luteum cysts result from over
stimulation of the ovary by HCG. Not
common in normal pregnancy but
common in molar pregnancy,
choriocarcinoma and reproductive
technology
.Follicular cysts results from the
growth of a follicle that does not
rupture
.Corpus luteum cyst results from Hge
inside a corpus luteum
.Theca luteum cysts result from over
stimulation of the ovary by HCG. Not
common in normal pregnancy but
common in molar pregnancy,
choriocarcinoma and reproductive
technology

.Benign ovarian neoplasia
-80% of ovarian neoplasm
are benign
-Benign ovarian neoplasm can
be solid or cystic
.Benign ovarian neoplasia
-80% of ovarian neoplasm
are benign
-Benign ovarian neoplasm can
be solid or cystic

I. Serous Cystadenoma (Commonest)
-Usually do not reach very
large sizes
-unilocular or multilocular
-smooth surface
-fluid filled
I. Serous Cystadenoma (Commonest)
-Usually do not reach very
large sizes
-unilocular or multilocular
-smooth surface
-fluid filled

II. MUCINOUS CYSTADENOMA
-May reach very large size
-Filled with thick mucinous material
-Perforation may lead to a serious
condition called pseudomyxoma
peritonei for which chemotherapy
may be needed.
III. ENDOMETRIOMA (Chocolate cysts)
-Associated with endometriosis
II. MUCINOUS CYSTADENOMA
-May reach very large size
-Filled with thick mucinous material
-Perforation may lead to a serious
condition called pseudomyxoma
peritonei for which chemotherapy
may be needed.
III. ENDOMETRIOMA (Chocolate cysts)
-Associated with endometriosis

IV. DERMOID CYSTS OR BENIGN
CYSTIC TERATOMA
-Usually small and may be bilateral
-Contain sebum, hair, teeth etc.
-Contains elements from endoderm
mesoderm and ectoderm
-Can change into malignant teratoma
-Avoid spilling of contents which leads
to chemical peritonitis
IV. DERMOID CYSTS OR BENIGN
CYSTIC TERATOMA
-Usually small and may be bilateral
-Contain sebum, hair, teeth etc.
-Contains elements from endoderm
mesoderm and ectoderm
-Can change into malignant teratoma
-Avoid spilling of contents which leads
to chemical peritonitis

V. FIBROMA
-Firm in consistency
* Meigs syndrome
Ovarian fibroma + ascites,
hydrothorax
following removal of fibroma, there
is spontaneous resolution of ascites
and hydrothorax
V. FIBROMA
-Firm in consistency
* Meigs syndrome
Ovarian fibroma + ascites,
hydrothorax
following removal of fibroma, there
is spontaneous resolution of ascites
and hydrothorax

•Clinical signs and symptoms of ovarian
masses:
1. .abdominal girth
2. Abdominal discomfort
3. Pressure symptoms bladder
bowel
4. Acute abdomen due to
-Hge
-Rupture
-Torsion
5. Asymptomatic coincidentally diagnosed
•Clinical signs and symptoms of ovarian
masses:
1. .abdominal girth
2. Abdominal discomfort
3. Pressure symptoms bladder
bowel
4. Acute abdomen due to
-Hge
-Rupture
-Torsion
5. Asymptomatic coincidentally diagnosed

•RADIOLOGICAL FEATURES OF
BENIGN OVARIAN MASSES:
1. Unilocular
2. Smooth surface
3. No solid elements
4. No external or internal outgrowth
5. No ascites
6. Unilateral
7. Normal doppler flow
•RADIOLOGICAL FEATURES OF
BENIGN OVARIAN MASSES:
1. Unilocular
2. Smooth surface
3. No solid elements
4. No external or internal outgrowth
5. No ascites
6. Unilateral
7. Normal doppler flow

•CLINICAL FEATURES OF BENIGN
OVARIAN TUMORS
.Unilateral
.Cystic
.Mobile
.No ascites
.No cul de-sac nodules
.Slow or no growth
•CLINICAL FEATURES OF BENIGN
OVARIAN TUMORS
.Unilateral
.Cystic
.Mobile
.No ascites
.No cul de-sac nodules
.Slow or no growth

EVALUATION OF THE PATIENT WITH
OVA ADNEXAL MASS.
.Complete Hx and physical exam
.U/S
.CT scan with contract or IVP
.Ba enema or colonoscopy
.Laparoscopy or laparotomy
accordingly
EVALUATION OF THE PATIENT WITH
OVA ADNEXAL MASS.
.Complete Hx and physical exam
.U/S
.CT scan with contract or IVP
.Ba enema or colonoscopy
.Laparoscopy or laparotomy
accordingly

•INDICATIOONS FOR SURGERY
.Ovarian cyst >5 cm followed for 6-
8wks.
.Solid lesions
.Papillary vegitation
.Mass >10 cm at the time of
presentations
.Ascites
.Palpable mass in premenarchal or
post menopausal
.Suspicion of torsion or rupture
•INDICATIOONS FOR SURGERY
.Ovarian cyst >5 cm followed for 6-
8wks.
.Solid lesions
.Papillary vegitation
.Mass >10 cm at the time of
presentations
.Ascites
.Palpable mass in premenarchal or
post menopausal
.Suspicion of torsion or rupture

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