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ob_gyn [2019/04/12 10:40] – [OB - General] nfasanoob_gyn [2020/08/19 09:59] (current) – [Ovarian Malignancy] nfasano
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 ===== GYN ===== ===== GYN =====
-==== Uterus ==== 
-=== Congenital Anomalies === 
-{{:uterine_anomalies.jpg|Uterine 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, 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 ===
 +  * Premenopausal:
 +    * <2.5cm and simple – Physiologic follicle.  No follow up
 +    * 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
 +
 +{{:ovarian_cyst_wu.png?650|Ovarian Lesion Workup}}
 +
 +
 +
 +==== Uterus ====
 +=== Congenital Anomalies ===
 +{{:uterine_anomalies.jpg|Uterine 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.  No follow up 
-    * 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 
- 
-{{:ovarian_cyst_wu.png|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 
  
 ==== 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, 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.1555080048.txt.gz · Last modified: 2019/04/12 10:40 by nfasano