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Flashcards in Ovarian Cysts Deck (66)
1

What groups can ovarian tumours be divided into?

- Functional
- Bengin
- Malignant

2

What % of ovarian cysts are benign?

70%

3

What are the types of benign ovarian tumours?

- Benign epithelial neoplastic cysts
- Benign cystic teratomas
- Benign neoplastic solid tumours

4

What % of benign ovarian tumours are benign epithelial neoplastic cysts?

60%

5

What are the types of benign epithelial neoplastic cysts?

- Serous cystadenoma
- Mucinous cystadenoma

6

Who are serous cystadenomas most common in?

Women 40-50 years

7

What might happen to the size of mucinous cystadenoma?

They may become enormous

8

What are mucinous cystadenomas filled with?

Mucinous material

9

What can happen if mucinous cystademomas rupture?

Can cause pseudomyxoma peritonei

10

Who are mucinous cystadenomas most common in?

20-40 age group

11

What cells do benign cystic teratomas arise from?

Primitive germ cells

12

What is a benign mature teratoma also known as?

Dermoid cyst

13

What might a dermoid cyst contain?

Well-differentiated tissue, e.g. hair, teeth

14

Who are dermoid cysts most common in?

Young women

15

What are the types of benign neoplastic solid tumours?

- Fibromas
- Thecomas
- Adenofibromas
- Brenner's tumoru

16

What is a fibroma?

A small, solid, benign fibrous tissue tumour

17

What are ovarian fibromas associated with?

- Meigs syndrome
- Ascites

18

What are Brenner's tumours?

Rare ovarian tumours displaying benign, borderline/proliferative, and malignant variants

19

What other ovarian tumours might Brenner's tumours be associated with?

- Mucinous cystadenoma
- Cystic teratoma

20

What % of women do benign ovarian cysts occur in?

30% with regular menses
50% with irregular menses

21

Which age group do ovarian cysts occur in?

Premenopausal women (uncommon in post-menopausal and pre-menarchal women)

22

What are the most common type of ovarian cysts in young women?

Benign neoplastic cysts of germ cell origin

23

What are the risk factors for ovarian cysts?

- Obesity
- Tamoxifen therapy
- Early menarche
- Infertility

24

What type of ovarian cysts might run in families?

Dermoid

25

How might ovarian cysts present?

- Incidental finding (asymptomatic)
- Pain
- Dysparuenia
- Swollen abdomen
- Pressure effects
- Symptoms of complications
- Endocrine symptoms

26

Describe the pain in ovarian cysts?

Dull ache or pain in lower abdomen, low back pain

27

Describe the swollen abdomen in ovarian cysts?

Palpable mass arising out of pelvis, which is dull to percussion and does not disappear if bladder is emptied

28

What might ovarian cysts put pressure on causing symptoms?

- Bladder
- Venous return

29

What symptoms might be caused by ovarian cysts putting pressure in the bladder?

Urinary frequency

30

What symptoms might be caused by ovarian cysts putting pressure on venous return?

- Varicose veins
- Leg oedema

31

How might asymptomatic ovarian cysts be found?

Chance finding on bimanual examination or ultrasound

32

When might ovarian cysts cause endocrine symptoms?

If they secrete hormones

33

What endocrine symptoms might be caused by ovarian cysts secreting hormones?

- Virilisation
- Menstrual irregularities
- Post-menopausal bleeding

34

Is it common for ovarian cysts to cause endocrine synmptoms?

No, uncommon

35

What are the differential diagnoses of ovarian cysts?

- Non-neoplastic functional cysts
- Any other cause of pelvic pain
- Polycystic ovary syndrome
- Endometrioma
- Ovarian malignant tumour
- Bowel causes
- Other gynae causes
- Pelvic malignancies

36

What non-neoplastic functional growths are differentials for ovarian cysts?

- Follicle cyst
- Corpus luteum cyst
- Theca lutein cyst

37

What are the bowel differentials for ovarian cysts?

- Colonic tumour
- Appendicitis/appendix mass
- Diverticulitis

38

What are the other gynaecological differentials for ovarian cysts?

- Pelvic inflammatory disease
- Tubo-ovarian abscess
- Uterine tumour, e.g. fibroid
- Para-ovarian cyst
- Ectopic pregnancy

39

What pelvic malignancies are differentials for ovarian cysts?

- Retroperitoneal tumours
- Small intestine tumours
- Mesothelial tumours

40

What cysts is it important that a correct diagnosis is made?

Some adnexal cysts, including;
- Endometrioma
- Mature cystic teratoma
- Paraovarian cysts

41

Why is important that some adnexal cysts are diagnosed correctly?

As they may affect patients' fertility, and may be associated with significant pelvic disease or put the patient at risk of ovarian torsion

42

What investigations may be done in ovarian cysts?

- Pregnancy test
- FBC
- Urinalysis
- Ultrasound
- CT or MRI scan
- Diagnostic laparoscopy
- Fine needle aspiration and cytology
- CA125

43

What might be indicated on FBC in suspected ovarian cyst?

- Infection
- Haemorrhage

44

When should urinalysis be done in suspected ovarian cyst?

If there are urinary symptoms

45

When should urinalysis be done in suspected ovarian cyst?

If there are urinary symptoms

46

What is the role of ultrasound in ovarian cysts?

A pelvic ultrasound is the single most effective way of evaluating an ovarian mass

47

What type of ultrasound is preferable in ovarian cysts?

Transvaginal

48

What is the role of biopsy in ovarian cysts?

May be used to confirm the impression that a cyst is benign

49

When does CA125 not need to be done in ovarian cysts?

In premenopausal women who have had an ultrasound diagnosis of simple ovarian cyst

50

Why should CA125 not be done in pre-menopausal women with an ultrasound diagnosis of ovarian cysts?

Unreliable in differentiating benign from malignant masses in premenopausal women due to increased rate of false positives and reduced specificity

51

What other conditions can result in raised CA125 levels?

- Diverticulitis
- Endometriosis
- Liver cirrhosis
- Uterine fibroids
- Menstruation
- Pregnancy
- Benign ovarian neoplasms
- Other malignancies

52

What other malignancies is CA125 raised in?

- Pancreatic
- Bladder
- Breast
- Liver
- Lung

53

What is the main of use of CA125?

Assessing response over time to treatment for malignancy

54

What are the management options for ovarian cysts?

- Expectant management
- Surgery

55

When do women with ovarian cysts not require follow up?

Small (less than 50mm diameter) simple ovarian cysts

56

Why do women with small simple ovarian cysts not require follow up?

As these cysts are very likely to be physiological and almost always resolve within 3 menstrual cycles

57

What follow up should be given to women with simple ovarian cysts of 50-70mm diameter?

Yearly ultrasound follow-up

58

What should be done in women with simple ovarian cysts of over 70mm diameter?

Consider for either further imaging (MRI) or surgical intervention

59

When are ovarian cysts unlikely to be functional, and may need surgical management?

Those that persist or increase in size

60

Is the oral contraceptive recommended for use in ovarian cysts?

No

61

When is surgery used for ovarian cyst?

If conservative measures fail or criteria for surgery are met

62

What is good about surgery for ovarian cysts?

It is generally very effective and provides cure with minimal effect on reproductive capacity

63

What are the options for surgical management of ovarian cysts?

- Cystectomy
- Oophrectomy

64

When might cystectomy be preferred to oophorectomy?

In children and younger women wishing to preserve maximum fertility

65

What are the complications of ovarian cysts?

- Torsion
- Haemorrhage
- Rupture
- Infertility

66

dont forget to finish the complications

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