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ob_gyn [2020/08/19 09:53] nfasanoob_gyn [2020/08/19 09:59] – [Ovarian Malignancy] nfasano
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 ==== Ovaries ==== ==== Ovaries ====
   * functional cysts – follicular cysts and corpus luteal cysts   * 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, hemorrhagic corpus luteum cyst, dermoid, follicular cyst
 +
 +==== 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, Brenner tumors
 +  * 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
 +{{:fallopian_tube.jpg|:fallopian_tube.jpg}}
 +  * 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 === === Guidelines ===
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     * >5.0cm or complex at any size – Laparoscopy and resection     * >5.0cm or complex at any size – Laparoscopy and resection
  
-{{:ovarian_cyst_wu.png|Ovarian Lesion Workup}}+{{:ovarian_cyst_wu.png?700|Ovarian Lesion Workup}} 
  
-==== Adnexa ==== 
-  * ovary, fallopian tube, and broad ligament(contains fallopian tube and uterine artery) 
-  * fallopian tube segments – intramural, isthmus, ampulla, and infundibulum 
-{{:fallopian_tube.jpg|:fallopian_tube.jpg}} 
-  * isthmus is narrowest segment 
  
 ==== Uterus ==== ==== Uterus ====
 === Congenital Anomalies === === Congenital Anomalies ===
 {{:uterine_anomalies.jpg|Uterine Anomalies}} {{:uterine_anomalies.jpg|Uterine Anomalies}}
- 
- 
- 
- 
- 
  
 ==== Endometrium ==== ==== Endometrium ====
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, hemorrhagic corpus luteum cyst, dermoid, follicular cyst 
- 
-==== 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, Brenner tumors 
-  * 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