BENIGN OVARIAN TUMOURS/CYSTS Flashcards Preview

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Flashcards in BENIGN OVARIAN TUMOURS/CYSTS Deck (20)
1

What are the 4 main broad types of benign ovarian tumour which divide tumours based on the type of cell they are derived from?

Physiological cysts

Benign epithelial tumours

Benign germ cell tumours

Benign sex cord stromal tumours

(There are other benign ovarian tumours such as endometriotic cysts, but these 4 are the most important)

2

Apart from physiological tumours, what is the most common type of benign ovarian tumour found in women under 40?

Germ cell tumours

3

Apart from physiological tumours, what is the most common type of benign ovarian tumour found in women over 40?

Epithelial tumours

4

What are the risk factors for benign ovarian tumours?

Obesity

Infertility

Early menarche

Hypothyroidism

Tamoxifen therapy

5

What are the three types of physiological ovarian cyst?

Follicular cyst - most common

Luteal cyst

Theca lutein cyst

6

Which type of physiological ovarian cyst is most likely to rupture?

Luteal cysts

7

What are the 4 types of benign epithelial ovarian tumour?

Serous cystadenoma - most common

Mucinous cystadenoma

Endometrioid cystadenomas

Brenner tumours

8

What are the 2 types of benign germ cell ovarian tumour?

Mature cystic teratoma (also called a dermoid cyst)

Mature solid teratomas

9

What are the 2 types of benign sex cord stromal ovarian tumour?

Theca cell tumours

Fibromas

10

What are the symptoms associated with benign ovarian tumours/cysts?

Pain
Abdominal swelling
Pressure effects on bowel or bladder
Hormonal effects secondary to secretion from tumour

11

What are the hormonal effects that might be associated with an oestrogen secreting tumour?

Menstrual irregularity
Postmenopausal bleeding
Precocious puberty

12

How might you be able to exclude gastrointestinal aetiology in a patient who presents with pain consistent with an ovarian cyst?

Bimanual examination will reveal either adnexal tenderness or a mass.

13

What investigations should be done for someone who presents with any of the symptoms of an ovarian cyst (pain, swelling, pressure effects on bladder/bowel, hormonal effects)?

FBC
CRP
High vaginal and endocervical swab
Urine pregnancy test/or serum hCG
Pelvic ultrasound
Serum CA125
Serum alpha fetoprotein (if US reveals complex ovarian mass)

14

What two factors does your management of a patient with a benign asymptomatic ovarian cyst/tumour depend on?

Age

Size of tumour

15

How would you manage a 25 year old patient found to have a 3 cm ovarian cyst?

Reassure

Observe cyst with US

16

What is the cut off in terms of size of benign ovarian tumour above which you would proceed to surgery despite a lack of symptoms? Why?

Above 5 cm. Above this size, the risk of ovarian torsion is significant.

17

How do you manage a patient found to have a physiological cyst on their ovaries?

Reassurance. Most will spontaneously resolve. You can monitor with ultrasound.

18

What are the complications associated with benign ovarian cysts?

Ovarian torsion

Rupture of cyst - can cause sepsis or peritonism

Continued pain and dyspareunia

19

What is Meig's syndrome?

Triad of ascites, pleural effusion and benign ovarian tumour

20

What are the benign ovarian tumours most commonly associated with Meig's syndrome?

Fibroma

Brenner tumour (epithelial tumour)

Occasionally granulosa cell tumour