Benign Tumors of Female Genital Tract PDF

Benign Tumor of female genital tract Dr. Alamin Babeker Mohamed Assistant professor of obstetrics &gynecology  OBJECTIVES By the end of this presentation you must be able to : Describe benign tumors of genital tract Identify clinical presentation...

Benign Tumor of female genital tract Dr. Alamin Babeker Mohamed Assistant professor of obstetrics &gynecology  OBJECTIVES By the end of this presentation you must be able to : Describe benign tumors of genital tract Identify clinical presentation and management Benign Ovarian cysts  Clinical presentation a pelvic/abdominal mass pelvic/abdominal pain due to pressure on bladder or bowel..torsion. Incidentally finding on ultrasound or during surgery. Differential diagnosis: 4. Uterine or ovarian tumors 1. Pregnancy. 5. fallopian tubes tumors 2. Appendicitis 6. bowel tumors 3. Tubo ovarian abcess. 7. Urinary bladder tumors.  Causes of benign ovarian cysts 1.Functional follicular cyst 4.Epithelial Corpus luteal cyst Serous cystadenoma Theca luteal cyst Mucinous cystadenoma 2.Inflammatory Brenner tumor Tubo-ovarian abscess 5.Sex cord stromal Endometrioma Fibroma 3.Germ cell Thecoma Benign teratoma  Investigations WBC CRP Ultrasound : transvaginal or abdominal. CT PELVIS MRI HCG to exclude pregnancy. Tumor markers like: CA 125, CAE, CA-19, AFP,B HCG, Inhibin.  Functional cysts Follicular ovulatory cyst is of average size 2.5 cm , can enlarge 3-10 cm. Corpus luteal cysts,, postovulatory, Theca luteal cysts,, associated with pregnancy. Follow up with U/S and analgesia. Rarely surgical or laparoscopical cystectomy.  Inflammatory ovarian cyst It is associated with PID., may involve ovaries , tubes even bowel. Tubo ovarian abscess. Diagnosed with symptoms and sins of PID& inflammatory markers. Treatment with analgesia and antibiotics. surgical excision.  Benign Germ cell tumor Dermoid cyst or mature teratoma is the commonest form. Manly among young females. 10% can be bilateral. It contains teeth , hair , fat Malignancy transformation is rare. MRI is the diagnostic modality. Management Cystectomy _+ovariectomy.  Benign Epithelial ovarian Peri menopausal women are the commonest age group. Serous cystadenoma ,Unilocular and unilateral. Mucinous cystadenoma are multilocular. Brenner tumors are small and may secrete estrogen.  Sex cord stromal ovarian tumors Common in postmenopausal age. Ovarian fibroma are solid benign tumors. Meigs syndrome is pleura effusion , ascites, and fibroma. Thecoma is estrogen secreting tumors , postmenopausal bleeding is their presentation, there is risk of endometrial cancer.  Benign Tumor of Uterus Uterine fibroid Endometrial and Cervical polyp  Uterine fibroids It is benign firm whorled tumors of uterine smooth muscle called leiomyoma. Estrogen dependent, rapid growth can occur in 2nd trimester. Red degeneration, hyaline, cystic, calcification , necrosis, inflammation. Sarcoma in 1:200. Clinical features: 1. Menorrhagia caused by submucous fibroid..anemia. 2. Pain caused by intramural one , red degeneration. 3. Subfertility caused by distortion of endometrial cavity and fallopian tubes  Types of fibroids: 1. Intrmural fibroids (Within the wall of uterus). 2. Subserosal fibroid (beneath serosa or peritoneum). 3. Submucosal fibroid (beneath the endometrium).  Investigation & management Hemoglobin level Ultrasound for fibroid site , size , urinary system. Management: conservative. Medical: tranexamic acid, mefenamic acid, combined oral contraceptive pill. gonadotrophin-releasing hormone agonist Surgical : myomectomy , hysterectomy. Uterine artery embolization (UAE)  Endometrial polyps Outgrowth of endometrium can be pedunculated or sessile, single or multiple treatment by removal if the symptom is persistent for at least three months or more. In 30% of tamoxifen therapy. It is of no significance in less than 40 years. Diagnosed by U/S or hysteroscope. In perimenopausal excisional biopsy should be done to exclude simple and atypical hyperplasia.  Cervical benign tumors Cervical polyp o Asymptomatic o PCB post coital bleeding o IMB inter menstrual bleeding o PV examination + speculum o Polypectomy is management  Nabothian follicles o mucus-filled cysts o No significance o No treatment o canbe drained if large  Vulval benign tumors Bartholin’s cyst inclusion cyst  Any question ?