Adnexal Pathology

Based on the images of the right ovary in a patient experiencing acute pelvic pain, how is the study to be interpreted?

Ovarian torsion

-The images show an enlarged ovary with a heterogeneous texture and absent internal vascularity=torsion

Pseudomyxoma peritonei is associated with which of the following masses?

Mucinous cystadenocarcinoma

-Pseudomyxoma peritonei is complex ascites caused by mucinous cystadenocarcinoma

Which of the following is most likely to be associated with Meigs syndrome?

Fibroma

-Meigs syndrome=pleural effusion, ascites, and benign ovarian tumor (most often fibroma)

What abnormality is most likely demonstrated in the image below?

Endometrioma

-A mass with low level echoes, smooth walls and posterior enhancement indicates an endometrioma or chocolate cyst

What usually occurs secondary to PCOS?

Endometrial hyperplasia

-PCOS is associated with chronic anovulation. It's like constantly being stuck in follicular phase when estrogen is the dominant hormone. Constant estrogen stimulation causes endometrial thickening

A large adnexal cyst with thick septations and papillary projections is documented. This finding most likely corresponds with what diagnosis?

Serous cystadenocarcinoma

-Thick septations and papillary projections are findings suggestive of malignancy. Serous cystadenocarcinoma is the best choice because it is the most common

What would be most likely be related to infertility?

Chocolate cyst

-Causes for infertility are either functional (PCOS) or conditions that damage the ovaries, tubes, or endometrium such as endometriosis, PID, polyps

What mass is related to estrogen production?

Granulosa cell tumor

-Thecoma and granulosa cell tumor are the 2 estrogen producing ovarian tumors

The following image taken from the adnexa most likely represents what pathology?

Cystic teratoma

-The appearance is consistent with a dermoid or cystic teratoma

Which of the following could possibly related to post-menopausal bleeding?

Thecoma

-Thecoma and granulosa cell tumor are estrogen producing ovarian tumors. Both can be related to endometrial thickening and bleeding

The images of the ovary is consistent with what diagnosis?

Polycystic ovarian disease

-This ovary has the string of pearls appearance consistent with PCOS

What ovarian mass is the related to elevated levels of hCG in the non-pregnant female?

Dysgerminoma

-Dysgerminoma is associated with hCG in a non-gravid female

-Yolk sac tumor is associated with AFP in a non-gravid female

What adnexal abnormality is associated with gastric cancer?

Krukenberg tumor

-Krukenberg tumor is metastasis to the ovaries from a GI cancer, usually stomach (gastric) cancer