Chapter 44 "Pathology of the Ovaries"

androgen

substance that stimulates the development of male characteristics; the ovaries will synthesize some of these substances and convert them to estrogens

cystadenocarcinoma

a malignant tumor that forms cysts

cystadenoma

benign adenoma containing cysts

estrogen

Female hormone produced by the ovaries

corpus luteum cyst

small endocrine structure that develops within a ruptured ovarian follicle and secretes progesterone and estrogen

dermoid tumor

benign tumor composed of hair, muscle, teeth, and fat

endometriosis

condition that occurs when functioning endometrial tissue invades sites outside the uterus

follicular cyst

benign cyst within the ovary that may occur and disappear on a cyclic basis

functional cyst

cyst that results from the normal function of the ovary

Meigs' syndrome

benign tumor of the ovary associated with ascites and pleural effusion

Mucinous cystadenocarcinoma

malignant tumor of the ovary with multilocular cysts

Mucinous cystadenoma

benign tumor of the ovary that contains thin-walled multilocular cysts

ovarian carcinoma

malignant tumor of the ovary that may spread beyond the ovary and metastasize to other organs via the peritoneal channels

ovarian torsion

partial or complete rotation of the ovarian pedicle on its axis

paraovarian cyst

cystic structure that lies adjacent to the ovary

polycystic ovary syndrome

endocrine disorder associated with chronic anovulation

serous cystadenocarcinoma

most common type of ovarian carcinoma; may be bilateral with multilocular cysts

serous cystadenoma

second most common benign tumor of the ovary; unilocular or multilocular

simple ovarian cyst

smooth, well-defined cystic structure that is filled completely with fluid

surface epithelial-stromal tumors

gynecologic tumors that arise from the surface epithelium and cover the ovary and the underlying stroma

theca-lutein cysts

multilocular cysts that occur in patients with hyperstimulation

laterally, posterolaterally

In anteflexed midline uterus, ovaries are usually identified _______ or _________.

medially

Following hysterectomy, the ovaries tend to be located more ________ and directly superior to the vaginal cuff.

homogeneous

the normal ovary has a(n) ________ echotexture, which may exhibit a central, more echogenic medulla with small anechoic or cyst follicles seen in the cortex

peripherally

Small anechoic or cystic follicles may be seen ______ in the cortex.

proliferative

During early ________ phase, many follicles develop and increase in size until about day 8 or 9 of the menstrual cycle.

cumulus oophorus

the ______ may occasionally be detected as an eccentrically located, cystlike 1-mm internal mural protrusion

follicular

If the fluid in the nondominant follicles is not reabsorbed, a(n) ___________ cyst develops.

luteal

The occurrence of fluid in the cul-de-sac is commonly seen after ovulation and peaks in the early ___________ phase

corpus luteum

following ovulation in the luteal phase, a mature ______ develops and may be identified sonographically as a small hypoechoic or isoechoic structure peripherally within the ovary

cyst

any simple ______ that hemorrhages may appear as a complex mass

malignant

the more sonographically complex the tumor, the more likely it is to be ______, especially if associated with ascites

ten

patients with normal menstrual cycles are best scanned in the first ______ days of the cycle; this prevents confusion with normal changes in intraovarian blood flow because high diagnostic flow occurs in the luteal phase

benign

a mass showing complete absence of or very little diastolic flow (very elevated resistive index and pulsatility index values) is usually _____

diastolic

duplex doppler reveals prominent ______ flow in corpus luteum cysts. This low-velocity waveform is present throughout the luteal phase of the cycle

ruptured

Echogenic, free intraperitoneal fluid in the cul-de-sac can help confirm the diagnosis of a ________ or leaking hemorrhagic cyst.

theca-lutein cysts

the largest of the functional cysts are ______ and appear as very large, bilateral, multiloculated cystic masses. This mass is associated with high levels of human chorionic gonadotropin (hCG) and is seen most frequently in association with gestational trophoblastic disease

Ovarian hyperstimulation syndrome

A frequent iatrogenic complication of ovulation induction is ________________. The ovaries are enlarged but measure less than 5 cm in diameter.

polycystic ovary syndrome

an endocrinologic disorder associated with chronic anovulation with an imbalance of luteinizing hormone and follicle-stimulating hormone resulting in abnormal estrogen and androgen production is ______

broad

parapovarian cysts account for approximately 10% of adnexal masses; they arise from the ______ ligament and usually are of mesothelial or paramesonephric origin

endometrial

Endometriosis is a common condition in which functioning ________ tissue is present outside the uterus.

chocolate cyst

The localized form consists of a discrete mass called an endometrioma, or _________.

blood

endometriosis may appear as bilateral or unilateral ovarian cysts with patterns ranging from anechoic to solid, depending on the amount of _____ and its organization

complete

torsion of the ovary is caused by partial or ______ rotation of the ovarian pedicle on its axis

edematous

Ovarian torsion produces an enlarged _____ ovary, usually greater than 4 cm in diameter.

benign

unilocular or thinly septated cysts are more likely ______

malignant

multilocular thickly separated masses and masses with solid nodules are more likely ______

cystic

Ovarian cancer can present as a complex, cystic, or solid mass, but it is more likely preponderantly ______.

increased

The incidence of ovarian cancer is greatly ________ in women who have had breast and colon cancer.

angiogensesis

malignant tumor growth is dependent on _______ with the development of abnormal tumor vessels, This leads to decreased vascular resistance and higher diastolic flow velocity

"dermoid plug", fat-fluid, shadowing, internal

sonography may demonstrate one of several patterns: (1) a completely cystic mass; (2) a cystic mass with a very echogenic nodule along the mural wall representing a(n) _______; (3) a(n) ______ level; (4) high-amplitude echoes with ______ (e.g., teeth or bone); or (5) a complex mass with ______ septations

ovaries

the ______ are more involved with metastatic disease than any other pelvic organ