L9 (T3): Ovarian cysts

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Questions and Answers

Which type of ovarian tumor is often rapidly growing, usually unilateral, and usually cured?

Epithelial ovarian tumor

Stromal tumor

Borderline tumor

Germ cell tumor (correct)

What is the usual surgical treatment for ovarian cyst torsion?

Salpingo-oophorectomy (correct)

Oophorectomy

Myomectomy

Hysterectomy

What is the most common histology for a dermoid cyst in the ovary?

Sertoli-Leydig tumor

Granulosa cell tumor

Dermoid cyst (correct)

Epithelial tumor

What is the recommended screening for ovarian cancer for individuals with a family history of ovarian or breast cancer?

Screening is of no proven benefit Signup and view all the answers

What is the targeted by Bevacizumab (Avastin) in the treatment of ovarian cancer?

Cancer cell vascular endothelial growth factor (VEGF) Signup and view all the answers

What is the lifetime risk for ovarian cancer if an individual has one first degree relative with ovary or breast cancer?

1% Signup and view all the answers

Which type of ovarian tumor is hormone producing and of stromal origin?

Stromal tumor Signup and view all the answers

What is the common presentation of epithelial ovarian tumors?

Ascites and upper abdominal disease Signup and view all the answers

What is the main type of tissue in dermoid cysts?

Fat, hair, and other tissues Signup and view all the answers

What is the common management for benign epithelial ovarian tumors?

Surgery Signup and view all the answers

What is the typical age range for malignant germ cell tumors in the ovary?

Adolescents Signup and view all the answers

What is the characteristic feature of stromal tumors in the ovary?

Hormone production Signup and view all the answers

What percentage of women in the community have an ovarian cyst?

10% Signup and view all the answers

What is the most common cause of gynaecological admission?

Ovarian cysts Signup and view all the answers

What percentage of all women in the U.K. will be admitted with ovarian cysts by age 65 years?

4% Signup and view all the answers

What percentage of ovarian cysts are benign?

90% Signup and view all the answers

What percentage of surgically managed ovarian tumors in the premenopausal group are malignant?

10% Signup and view all the answers

What are the symptoms of ovarian cysts?

Pain and menstrual disruption Signup and view all the answers

When should you worry about asymptomatic ovarian cysts?

Greater than 5cm Signup and view all the answers

What are the complications of ovarian cysts?

Torsion and rupture Signup and view all the answers

What may be appropriate for mild ovarian cyst rupture?

Conservative management Signup and view all the answers

What are the sequelae of ovarian cyst rupture?

Peritonitis and pseudomyxoma peritonei Signup and view all the answers

What was the size of the ovarian cyst in Case Report 1?

5cm Signup and view all the answers

What symptoms did the woman in Case Report 2 present with?

Lower right-sided abdominal pain Signup and view all the answers

What is the lecturer's main message to the audience?

The content of the lecture is important for medical registrars Signup and view all the answers

What is the reason for the lecture being dated February 2023?

The lecturer recently presented the same lecture to medical students in February 2023 Signup and view all the answers

What does the lecturer promise regarding the exam questions related to the lecture?

The questions will be straightforward if the audience listens Signup and view all the answers

What is the lecturer's attitude towards the audience in terms of answering exam questions?

The lecturer is understanding and supportive Signup and view all the answers

What is the primary focus of the lecture content?

Importance of specific medical knowledge for registrars Signup and view all the answers

What is the lecturer's opinion of the content's relevance to the audience's future careers?

The content is invaluable for the audience's future medical careers Signup and view all the answers

What is the likelihood of a cyst being malignant as women age?

Increases Signup and view all the answers

What can pain during ovulation indicate?

Cyst-related discomfort Signup and view all the answers

What is the common characteristic of ovarian cysts in women not on birth control?

Often asymptomatic Signup and view all the answers

What is the common type of cysts that can occur as part of a normal cycle?

Follicular and luteal Signup and view all the answers

What is the likelihood of a cyst being neoplastic?

Varies, but majority are benign Signup and view all the answers

What is the common presentation of ovarian cysts in healthcare?

Common Signup and view all the answers

What is the recommended threshold size for requiring attention to ovarian cysts in premenopausal women?

8 centimeters Signup and view all the answers

What is a possible cause of infection in ovarian cysts?

PID Signup and view all the answers

What does torsion refer to in the context of ovarian cysts?

Twisting of the ovary around its blood supply Signup and view all the answers

What is a potential complication of ovarian cysts?

Bleeding into a cyst Signup and view all the answers

What is the largest recorded weight of an ovarian cyst?

104 kilograms Signup and view all the answers

What is the purpose of the new scoring system being developed for ovarian cysts?

To determine benign, borderline, or malignant status Signup and view all the answers

What symptoms are commonly associated with ovarian torsion?

Flank guarding and abdominal rigidity Signup and view all the answers

Why is prompt diagnosis and treatment of ovarian torsion emphasized?

Delay can lead to irreversible damage to the ovary Signup and view all the answers

Why is ovarian torsion often misdiagnosed as renal colic?

Due to the severity of the pain Signup and view all the answers

What is the consequence of delaying surgical intervention in cases of suspected ovarian torsion?

Irreversible damage to the ovary Signup and view all the answers

Why does the lecturer criticize the delay in diagnosing ovarian torsion compared to male reproductive organ torsion?

To highlight the urgency required for ovarian torsion cases Signup and view all the answers

Where does the blood supply to the ovary originate, resulting in the high location of the mass felt in the abdomen?

Near the kidneys Signup and view all the answers

What is a potential complication of dermal cyst rupture?

Toxic sebaceous material causing peritonitis Signup and view all the answers

In which scenario is surgical intervention for haemorrhagic cysts rare?

Cases with severe, unmanageable pain or extensive bleeding Signup and view all the answers

What is emphasized as a need in reproductive age women presenting with acute abdominal pain?

The need to rule out ectopic pregnancy Signup and view all the answers

What distinguishes endometriosis-related haemorrhagic cysts from other haemorrhagic cysts?

Thicker walls and less likelihood of rupture Signup and view all the answers

What is indicated by sudden severe pain and vomiting in the context of ovarian torsion?

Ovarian torsion Signup and view all the answers

What is essential in the initial evaluation of women presenting with acute abdominal pain to rule out life-threatening conditions?

Pregnancy tests Signup and view all the answers

What is the typical resolution time for ovarian cyst rupture with conservative management?

24-48 hours Signup and view all the answers

What is the potential consequence of rupture of a dermal cyst in the ovary?

Toxic sebaceous stuff leading to peritonitis Signup and view all the answers

What is the most appropriate surgical approach for a haemorrhagic cyst in the ovary?

Removing the cyst from the ovary Signup and view all the answers

What is the differential diagnosis for acute abdominal pain in a reproductive age woman presenting to A&E?

Ectopic pregnancy Signup and view all the answers

What is the characteristic feature of haemorrhagic cysts associated with endometriosis?

Thicker wall and more defined appearance Signup and view all the answers

What is the typical presentation of ovarian torsion?

Acute abdominal pain and vomiting Signup and view all the answers

Study Notes

Ovarian Torsion Lecture Summary

A patient presents with tachycardia, high temperature, flank guarding, abdominal rigidity, and elevated white count
The lecturer explains that ovarian torsion occurs when the ovary twists around its blood supply, leading to ischemia and potential organ death
The blood supply to the ovary originates high up near the kidneys, explaining why the mass is felt high in the abdomen
Ovarian torsion can cause severe symptoms such as fever, tachycardia, and elevated white count due to tissue ischemia
The lecturer emphasizes the importance of prompt diagnosis and treatment, as delay can lead to irreversible damage
The lecturer criticizes the delay in diagnosing ovarian torsion compared to the urgency given to male reproductive organ torsion
Prompt action, such as untwisting the ovary in surgery, can save the organ if done early, but delay can lead to irreversible damage
Ovarian torsion can be misdiagnosed as renal colic due to the severity of the pain, leading to potential delays in treatment
The lecture serves as a learning point, highlighting the need for prompt recognition and treatment of ovarian torsion
Urges healthcare professionals to consider ovarian torsion as a potential diagnosis in women presenting with severe abdominal pain
Emphasizes the need for swift action and early surgical intervention in cases of suspected ovarian torsion
Stresses the importance of recognizing and promptly addressing ovarian torsion to prevent irreversible damage to the ovary

Ovarian Cyst Rupture, Haemorrhage, and Torsion: Key Points

Ovarian cyst rupture can be spontaneous or traumatic, causing severe pain that typically settles within 24-48 hours with conservative management.
Traumatic rupture can occur during activities like sailing, while spontaneous rupture may occur with a thin-walled cyst.
Rupture of dermal cysts can lead to toxic sebaceous material causing peritonitis, while mucus-containing cysts can be tricky to manage if ruptured.
A case report describes a 29-year-old with a haemorrhagic cyst on the right ovary, often resolving within 48 hours with conservative treatment.
Surgical intervention for haemorrhagic cysts is rare, typically reserved for cases with severe, unmanageable pain or extensive bleeding.
An example of dramatic haemorrhagic cyst presentation is compared to a flat ectopic pregnancy, emphasizing the need to rule out ectopic pregnancy in reproductive age women presenting with acute abdominal pain.
Endometriosis-related haemorrhagic cysts have thicker walls and are less likely to rupture compared to other haemorrhagic cysts.
Torsion of the ovary, as in the case of a 72-year-old woman, can cause acute abdominal pain and vomiting, requiring prompt medical attention.
Twinges on the left side can be non-specific, but sudden severe pain and vomiting may indicate ovarian torsion.
Ovarian cysts, haemorrhage, and torsion are differential diagnoses to consider in cases of acute abdominal pain in women, particularly those of reproductive age.
Pregnancy tests are essential in the initial evaluation of women presenting with acute abdominal pain to rule out ectopic pregnancy, which can be life-threatening.
Ultrasound is a valuable tool for diagnosing ovarian cysts, haemorrhage, and torsion, aiding in the decision-making process for conservative management or surgical intervention.

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Test your knowledge about ovarian cysts with this quiz. Explore the different types, prevalence, and impact of ovarian cysts on women's health.