Presentation on theme: "Dr. Mashael Al-Shebaili Asst. Prof. & Consultant Ob/Gyn Dept."— Presentation transcript:
1 Dr. Mashael Al-Shebaili Asst. Prof. & Consultant Ob/Gyn Dept. BENIGN OVARIAN TUMORSDr. Mashael Al-ShebailiAsst. Prof. & ConsultantOb/Gyn Dept.
2 Ovaries are normally not palpable in pre-menarche, and after the menopause In the reproductive age group ovaries are palpable in the lean pts.Ovarian size of different age groupsPremenopause 3.5 x 2 x 1.5 cmEarly menopause 1 – 2 yrs2 x 1.5x0.5cmLate menopause 2-5yrs x0.75x0.5cm
3 If the ovaries are palpable in any of the age groups when it is not supposed to be through investigations and work up should be carried outOVARIAN CYSTS CAN BE CLASSIFIED AS FOLLOWS:I. Functional BenignII Neoplastic borderlineMalignant
5 FUNCTIONAL CYSTSThese are cysts related to ovarian function i.e. the process of ovulationThey are the most common detected cysts in the reproductive age groupCan be reach up to 10 cm in diameterResolve spontaneously.
6 Follicular cysts results from the growth of a follicle that does not rupture Corpus luteum cyst results from Hge inside a corpus luteumTheca luteum cysts result from over stimulation of the ovary by HCG. Not common in normal pregnancy but common in molar pregnancy, choriocarcinoma and reproductive technology
7 - 80% of ovarian neoplasm are benign Benign ovarian neoplasia - Benign ovarian neoplasm can be solid or cystic
8 Serous Cystadenoma (Commonest) - Usually do not reach very large sizes- unilocular or multilocular- smooth surface- fluid filled
9 ENDOMETRIOMA (Chocolate cysts) MUCINOUS CYSTADENOMA- May reach very large size- Filled with thick mucinous material- Perforation may lead to a serious condition called pseudomyxoma peritonei for which chemotherapy may be needed.ENDOMETRIOMA (Chocolate cysts)- Associated with endometriosis
10 DERMOID CYSTS OR BENIGN CYSTIC TERATOMA - Usually small and may be bilateral- Contain sebum, hair, teeth etc.- Contains elements from endodermmesoderm and ectoderm- Can change into malignant teratoma- Avoid spilling of contents which leadsto chemical peritonitis
11 FIBROMA- Firm in consistency* Meigs syndromeOvarian fibroma + ascites, hydrothoraxfollowing removal of fibroma, there is spontaneous resolution of ascites and hydrothorax
12 Clinical signs and symptoms of ovarian masses: 1. abdominal girth2. Abdominal discomfort3. Pressure symptoms bladderbowel4. Acute abdomen due to- Hge- Rupture- Torsion5. Asymptomatic coincidentally diagnosed
13 RADIOLOGICAL FEATURES OF BENIGN OVARIAN MASSES: 1. Unilocular2. Smooth surface3. No solid elements4. No external or internal outgrowth5. No ascites6. Unilateral7. Normal doppler flow
14 CLINICAL FEATURES OF BENIGN OVARIAN TUMORS Unilateral Cystic Mobile No ascites No cul de-sac nodules Slow or no growth
15 EVALUATION OF THE PATIENT WITH OVA ADNEXAL MASS. Complete Hx and physical exam U/S CT scan with contract or IVP Ba enema or colonoscopy Laparoscopy or laparotomy accordingly
16 INDICATIOONS FOR SURGERY Ovarian cyst >5 cm followed for wks. Solid lesions Papillary vegitation Mass >10 cm at the time of presentations Ascites Palpable mass in premenarchal or post menopausal Suspicion of torsion or rupture