ob_gyn
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ob_gyn [2019/04/12 10:40] – [OB - General] nfasano | ob_gyn [2020/08/19 09:59] (current) – [Ovarian Malignancy] nfasano | ||
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===== GYN ===== | ===== GYN ===== | ||
- | ==== Uterus ==== | ||
- | === Congenital Anomalies === | ||
- | {{: | ||
+ | ==== Ovaries ==== | ||
+ | * functional cysts – follicular cysts and corpus luteal cysts | ||
+ | ==== Polycystic Ovaries ==== | ||
+ | * enlarged ovaries | ||
+ | * echogenic stroma | ||
+ | * cysts in periphery (>5 cysts over 5mm in size) | ||
+ | * treated w/ clomiphene | ||
+ | ==== Stein-Leventhal ==== | ||
+ | * PCO, obesity, infertility / amenorrhea, and hirsutism | ||
+ | ==== Hemorrhagic Cysts ==== | ||
+ | * fine reticular septations or heterogeneous mass w/ multiple echoes | ||
+ | * high on T1 and homogeneously bright on T2 | ||
+ | * resolves spontaneously (f/u 6-8 wks) | ||
+ | * ddx: endometrioma, | ||
+ | ==== Ovarian Teratomas ==== | ||
+ | * most common benign ovarian neoplasm | ||
+ | * classic mimicker | ||
+ | * rarely malignant | ||
+ | * at risk for torsion | ||
+ | * complex, partially cystic, w/ echogenic areas that may shadow | ||
+ | * dermoid plug = Rokitansky nodule | ||
+ | * presence of struma ovarii can (rarely) cause thyrotoxicosis | ||
+ | |||
+ | ==== Benign Ovarian Neoplasms ==== | ||
+ | * mucinous or serous cystadenomas, | ||
+ | * granulosa cell tumors, fibromas, thecomas (secrete estrogens –> endometrial hyperplasia) | ||
+ | * Sertoli-Leydig cell tumors (secrete androgens –> virilization) | ||
+ | * cannot differentiate from malignant neoplasms | ||
+ | * complex lesions with septations and solid tumor nodules | ||
+ | * RI > 0.4 (not reliable) | ||
+ | |||
+ | ==== Adnexa ==== | ||
+ | * ovary, fallopian tube, and broad ligament(contains fallopian tube and uterine artery) | ||
+ | * fallopian tube segments – intramural, isthmus, ampulla, and infundibulum | ||
+ | {{: | ||
+ | * isthmus is narrowest segment | ||
+ | |||
+ | ==== Adnexal Mass ==== | ||
+ | * benign or malignant ovarian tumor | ||
+ | * cystic teratoma | ||
+ | * pedunculated fibroid | ||
+ | |||
+ | ==== Cystic Adnexal Mass ==== | ||
+ | * hydrosalpinx | ||
+ | * cystic teratoma | ||
+ | * corpus luteum cyst | ||
+ | * benign or malignant ovarian tumor | ||
+ | |||
+ | ==== Ovarian Malignancy ==== | ||
+ | * solid nodules, thick septations, irregular wall, poorly defined margins | ||
+ | * RI < 0.4 and PI > 1 | ||
+ | |||
+ | === Guidelines === | ||
+ | * Premenopausal: | ||
+ | * <2.5cm and simple – Physiologic follicle. | ||
+ | * 2.5cm to 10cm (simple or complex) – Follow up in 6 weeks x 2 | ||
+ | * >10cm – Laparoscopy and resection | ||
+ | * Postmenopausal: | ||
+ | * <5.0cm and simple – Follow up in 3 months, then 6 months x 2, then 1 year | ||
+ | * >5.0cm or complex at any size – Laparoscopy and resection | ||
+ | |||
+ | {{: | ||
+ | |||
+ | |||
+ | |||
+ | ==== Uterus ==== | ||
+ | === Congenital Anomalies === | ||
+ | {{: | ||
==== Endometrium ==== | ==== Endometrium ==== | ||
Line 67: | Line 132: | ||
* atrophies after menopause | * atrophies after menopause | ||
* bounded by endometrium centrally and serosa peripherally | * bounded by endometrium centrally and serosa peripherally | ||
- | |||
- | |||
- | ==== Ovaries ==== | ||
- | * functional cysts – follicular cysts and corpus luteal cysts | ||
- | |||
- | === Guidelines === | ||
- | * Premenopausal: | ||
- | * <2.5cm and simple – Physiologic follicle. | ||
- | * 2.5cm to 10cm (simple or complex) – Follow up in 6 weeks x 2 | ||
- | * >10cm – Laparoscopy and resection | ||
- | * Postmenopausal: | ||
- | * <5.0cm and simple – Follow up in 3 months, then 6 months x 2, then 1 year | ||
- | * >5.0cm or complex at any size – Laparoscopy and resection | ||
- | |||
- | {{: | ||
- | |||
- | ==== Adnexa ==== | ||
- | * ovary, fallopian tube, and broad ligament(contains fallopian tube and uterine artery) | ||
- | * fallopian tube segments – intramural, isthmus, ampulla, and infundibulum | ||
- | {{: | ||
- | * isthmus is narrowest segment | ||
==== Fibroids ==== | ==== Fibroids ==== | ||
Line 117: | Line 161: | ||
* within cervix | * within cervix | ||
- | ==== Polycystic Ovaries ==== | ||
- | * enlarged ovaries | ||
- | * echogenic stroma | ||
- | * cysts in periphery (>5 cysts over 5mm in size) | ||
- | * treated w/ clomiphene | ||
- | ==== Stein-Leventhal ==== | ||
- | * PCO, obesity, infertility / amenorrhea, and hirsutism | ||
- | |||
- | ==== Hemorrhagic Cysts ==== | ||
- | * fine reticular septations or heterogeneous mass w/ multiple echoes | ||
- | * high on T1 and homogeneously bright on T2 | ||
- | * resolves spontaneously (f/u 6-8 wks) | ||
- | * ddx: endometrioma, | ||
- | |||
- | ==== Ovarian Teratomas ==== | ||
- | * most common benign ovarian neoplasm | ||
- | * classic mimicker | ||
- | * rarely malignant | ||
- | * at risk for torsion | ||
- | * complex, partially cystic, w/ echogenic areas that may shadow | ||
- | * dermoid plug = Rokitansky nodule | ||
- | * presence of struma ovarii can (rarely) cause thyrotoxicosis | ||
- | |||
- | ==== Benign Ovarian Neoplasms ==== | ||
- | * mucinous or serous cystadenomas, | ||
- | * granulosa cell tumors, fibromas, thecomas (secrete estrogens –> endometrial hyperplasia) | ||
- | * Sertoli-Leydig cell tumors (secrete androgens –> virilization) | ||
- | * cannot differentiate from malignant neoplasms | ||
- | * complex lesions with septations and solid tumor nodules | ||
- | * RI > 0.4 (not reliable) | ||
- | |||
- | ==== Ovarian Malignancy ==== | ||
- | * solid nodules, thick septations, irregular wall, poorly defined margins | ||
- | * RI < 0.4 and PI > 1 | ||
==== Cervical Cancer ==== | ==== Cervical Cancer ==== | ||
Line 224: | Line 234: | ||
* endometritis | * endometritis | ||
- | ==== Adnexal Mass ==== | ||
- | * benign or malignant ovarian tumor | ||
- | * cystic teratoma | ||
- | * pedunculated fibroid | ||
- | ==== Cystic Adnexal Mass ==== | ||
- | * hydrosalpinx | ||
- | * cystic teratoma | ||
- | * corpus luteum cyst | ||
- | * benign or malignant ovarian tumor | ||
==== Endometrial Fluid ==== | ==== Endometrial Fluid ==== |
ob_gyn.txt · Last modified: 2020/08/19 09:59 by nfasano