Benign Tumors & Anatomy of Female Reproductive System

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Questions and Answers

What is a common clinical presentation of benign ovarian cysts?

Chronic fatigue

Pelvic/abdominal pain (correct)

Weight loss

Increased appetite

Which of the following is NOT a type of benign ovarian cyst?

Hemorrhagic cyst (correct)

Follicular cyst

Theca luteal cyst

Serous cystadenoma

What is the primary mode of investigation for benign ovarian cysts?

Laparoscopy only

Ultrasound (correct)

MRI only

Blood tests only

Which type of benign ovarian tumor is commonly found in premenopausal women?

Serous cystadenoma Signup and view all the answers

What is the treatment approach for a tubo-ovarian abscess usually associated with PID?

Analgesia and antibiotics Signup and view all the answers

Which tumor marker is used for monitoring benign ovarian conditions?

CA 125 Signup and view all the answers

Which type of benign ovarian tumor is characterized by the presence of teeth, hair, and fat?

Dermoid cyst (mature teratoma) Signup and view all the answers

Which phase of life is most associated with benign sex cord stromal ovarian tumors?

Postmenopause Signup and view all the answers

What is a common clinical feature associated with uterine fibroids?

Menorrhagia Signup and view all the answers

Which type of fibroid is located within the wall of the uterus?

Intramural fibroid Signup and view all the answers

What is the recommended management for symptomatic endometrial polyps persisting for at least three months?

Removal of the polyp Signup and view all the answers

What is the purpose of conducting an excisional biopsy in perimenopausal women with endometrial polyps?

To exclude simple and atypical hyperplasia Signup and view all the answers

Which benign tumor of the cervix typically has postcoital bleeding as a symptom?

Cervical polyp Signup and view all the answers

Which management option is NOT typically indicated for uterine fibroids?

Immediate chemotherapy Signup and view all the answers

What are Nabothian follicles characterized by?

Mucus-filled cysts with no significant treatment required Signup and view all the answers

Which of the following treatment options is inappropriate for a patient with heavy menstrual bleeding due to uterine fibroids?

Observation without treatment Signup and view all the answers

Study Notes

Benign Tumors of the Female Genital Tract

Presentation by Dr. Alamin Babeker Mohamed, assistant professor of obstetrics & gynecology
Objectives:
- Describe benign tumors of the genital tract
- Identify clinical presentation and management

Anatomy of the Female Reproductive System

Shows the uterus, ovaries, fallopian tubes, endometrium, cervix, and vagina.
Labels key components for understanding location.
Diagrams illustrate the relative positioning.

Benign Ovarian Cysts

Images of a woman's reproductive organs depict ovarian cysts.
Labels show follicular cyst and its location.

Clinical Presentation

Possible symptoms in patients with benign tumors of female reproductive organs include a pelvic/abdominal mass.
Pelvic/abdominal pain may occur due to pressure on the bladder or bowels, or possibly from torsion.
Benign tumors can be found incidentally during diagnostic imaging (ultrasound) or surgery.
Differential diagnoses include pregnancy, appendicitis, and tubo-ovarian abscess.
- Other possible diagnoses include uterine or ovarian tumors, fallopian tube tumors, bowel tumors and urinary bladder tumors.

Causes of Benign Ovarian Cysts

Functional cysts:
- Follicular cyst
- Corpus luteal cyst
- Theca luteal cyst
Inflammatory cysts:
- Tubo-ovarian abscess
- Endometrioma
Germ cell cysts:
- Benign teratoma
Epithelial cysts:
- Serous cystadenoma
- Mucinous cystadenoma
- Brenner tumor
Sex cord stromal cysts:
- Fibroma
- Thecoma

Investigations

Common diagnostic tests for a variety of female reproductive organ conditions:
- Complete blood count (CBC)
  - White blood cell count (WBC)
  - C-reactive protein (CRP)
- Ultrasound (transvaginal or abdominal)
- Computed tomography (CT) scan of the pelvis
- Magnetic resonance imaging (MRI)
- Human chorionic gonadotropin (hCG): used to rule out pregnancy.
- Tumor markers (CA 125, CAE, CA-19, AFP, beta-hCG, Inhibin): used to evaluate possible tumor presence

Functional Cysts

Follicular ovulatory cyst average size: 2.5 cm.
Can enlarge to 3-10 cm.
Corpus luteal cysts are postovulatory.
Theca luteal cysts may be associated with pregnancy.
Management includes monitoring with ultrasound and analgesia.
Rare cases may require surgical or laparoscopic cystectomy.

Inflammatory Ovarian Cyst

Usually associated with pelvic inflammatory disease (PID).
Potential involvement of ovaries, fallopian tubes, or even the bowel.
Characterized by symptoms and signs of PID and inflammatory markers.
Treatment typically involves analgesia and antibiotics.
Surgical excision may be required in some cases.

Benign Germ Cell Tumor

Dermoid cyst (mature teratoma) is a common benign germ cell tumor.
Primarily affects young females.
10% of cases are bilateral.
Contains tissues like teeth, hair, and fat.
Malignant transformation is rare.
MRI is the diagnostic technique of choice.
Management often involves cystectomy, possibly with ovariectomy (removal of the ovary).

Benign Epithelial Ovarian Tumors in Females

Peri-menopausal women commonly develop benign epithelial ovarian tumors.
Serous cystadenoma are typically unilateral and unilocular.
Mucinous cystadenomas are typically multilocular.
Brenner tumors are small and may secrete estrogen.

Sex Cord Stromal Ovarian Tumors

Commonly found in postmenopausal women.
Ovarian fibromas are benign, solid tumors.
Meigs' syndrome is characterised by a combination of ovarian fibroma, pleural effusion, and ascites.
Thecoma is an estrogen-secreting tumor, and postmenopausal bleeding suggests this type of tumor as a potential cause.
Patients with thecoma have a possible risk of endometrial cancer.

Benign Tumors of the Uterus

Uterine fibroids (leiomyomas)
Endometrial and cervical polyps

Uterine Fibroids

Benign, firm, whorled tumors of uterine smooth muscle.
Typically estrogen-dependent, with rapid growth potential, possible during pregnancy's second trimester.
Potential complications include red degeneration, hyaline change, cystic formation, calcification, necrosis, and inflammation.
Malignant transformation (sarcoma) is infrequent (1 in 200 cases).
Clinical presentations:
- Menorrhagia (heavy menstrual bleeding) can lead to anemia, if caused by submucous fibroids
- Pain, if caused by intramural or submucous fibroids.
- Subfertility from obstructions of the endometrial cavity and/or fallopian tubes.

Types of Fibroids

Intramural fibroids: located within the uterine wall.
Subserosal fibroids: located beneath the outer layer of the uterus.
Submucosal fibroids: located beneath the inner lining of the uterus.

Investigation & Management of Fibroids

Investigation Includes hemoglobin level, and ultrasound of fibroid site, size, and urinary system.
Management:
- Conservative (medical): treatments such as tranexamic acid, mefenamic acid, combined oral contraceptive pills, and gonadotropin releasing hormone agonists.
- Surgical: procedures like myomectomy (fibroid removal) and hysterectomy (removal of uterus), or uterine artery embolization (UAE).

Endometrial Polyps

Outgrowths of the uterine lining.
Can be pedunculated or sessile (attached directly).
May be multiple or single.
Treatment involves removal if symptoms persist for three months or more.
Considered insignificant in those under 40 years.
Diagnosis typically via ultrasound or hysteroscopy.
Biopsy may be needed in perimenopausal women to rule out simple or atypical hyperplasia.

Cervical Benign Tumors: Cervical Polyps

Asymptomatic or present with postcoital bleeding (PCB).
May cause intermenstrual bleeding (IMB).
Diagnosis via pelvic examination and speculum.
Management usually involves polypectomy, surgically removing the polyp.

Nabothian Follicles

Mucus-filled cysts on the cervix.
Typically not significant.
Rarely require treatment, though large ones might require drainage.

Vulval Benign Tumors: Bartholin's Cyst

Cysts in the Bartholin's gland area.
Common findings with inclusion cysts.

General

A question-and-answer section follows the presentation.
Presenter expresses gratitude to the audience.

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Description

This quiz explores benign tumors of the female genital tract, highlighting their clinical presentation and management. Additionally, it covers anatomy with labeled diagrams of reproductive organs, helping to understand the location of specific conditions such as benign ovarian cysts. Test your knowledge on these crucial topics in obstetrics and gynecology.