Unit 3 Ovarian Syndrome/Other Benign Cysts

What is Polycystic Ovarian Disease (PCOS)?

• Endocrinologic Disorder

• Hyperandrogenism- from ovary

• “Chronic Anovulation Syndrome”

What is Stein-Leventhal Syndrome?

• Infertility

• Oligomenorrhea

• Hirsutism

• Obesity

What is this image showing?

PCOS

What is the US appearance of PCOS?

• Bilaterally normal or enlarges ovaries

• Multiple small follicular cysts < 1cm

  • Periphery- “string of pearls”

  • General cystic pattern

• Echogenic stroma

What are these images showing?

PCOS

What is the sonographic criteria for PCOS?

• At least 12 follicles

  • 2-10mm in size

• Ovarian volume > 10 cc

What is this image showing?

PCOS

What are Peritoneal inclusion Cysts?

• Adhesions trap peritoneal fluid

  • Mesothelial cell lining

What are the symptoms/signs of a large adnexal mass?

• Pelvic Pain

• History of Surgery

• Pre-menopausal

What is the sonographic appearance of a Peritoneal Inclusion Cyst?

• Multiloculated

• Anechoic to hemorrhagic appearance

What is this image showing?

Peritoneal Inclusion Cysts

What are Paraovarian Cysts

Cystic structures arising from broad ligaments or adnexal structures

What percent of adnexal masses are paraovarian cysts?

10%

What are the symptoms of a paraovarian cyst?

• Asymptomatic

  • May bleed

  • May torse

What is the US appearance of a paraovarian cyst?

• Simple cyst appearance

• Vary in size

• Do not regress with hormone changes

What is this image showing?

Paraovarian Cyst

What is this image showing?

Paraovarian Cysts

What are benign cysts in a fetus/newborn from?

• Maternal hormone stimulation

What do benign cysts premenarchal usually do?

• Regress

• Normal physical growth

• Occasionally produce precocious puberty

What is a simple cyst in postmenopausal women caused by?

A cause of ovarian enlargement

What is the size of a simple cyst in postmenopausal women?

< 3 cm occurs in 15% of patients

Occurance of any ovarian cyst in postmenopausal women is a cause for ___________?

Investigation

Simple cysts are likely benign with what characteristics?

• < 5 cm

• RI- >.4

What is the cancer marker for a simple cyst in postmenopausal women?

• CA 125 screening

• 85-90% ovarian CA is epithelial origin causing cystic type appearance