Module 3 PowerPoints Things to Know

vaginal cuff

vaginal cuff

area left at end of vagina after hysterectomy

2.1

upper limit of normal of a mass in the vaginal cuff is ______________ cm

Gartner duct cyst

most common cystic mass of the vagina

malignant

most solid masses of the vagina are _______________

leiomyoma (fibroid)

most common gynecologic tumor

subserosal fibroid

• located just below outer membrane covering of uterus

• cause most obvious disturbance of uterine contour

pedunculated fibroid

• type of subserosal fibroid that is on a stalk

• may be mistaken for extrauterine mass

intramural fibroid

• most common type of fibroid and least disruptive

• located within myometrium, but does not disturb endometrium or serosal layer of uterus

submucosal fibroid

• most disruptive type of fibroid

• located just deep to endometrium and disturb the endometrial surface

• can cause infertility problems

fever

symptoms of endometritis include _____________

estrogens

ovaries actually make androgens and then convert them to _______________

functional ovarian cysts

most common cause of ovarian enlargement in young women

theca-lutein cyst

• largest functional cyst

• occur in presence of elevated hCG

• bilateral

• thick, irregular walls

• thick septations

• mural nodules

• presence of ascities

suspicious characteristics of ovarian cysts include:

normal physiologic findings; do not need a follow-up

a simple cyst ≤3 cm indicates:

should be described in the imaging report with a statement that they are almost certainly benign; do not need a follow-up

simple cysts >3 and ≤5 cm:

should be described in the imaging report with a statement that they are almost certainly benign; yearly follow-up with US recommended

simple cysts >5 and ≤7 cm:

further imaging with MRI or surgical evaluation should be considered

simple cysts >7 cm:

mature cystic teratoma

most common germ cell tumor

tip of the iceburg

• sonographic appearance of mature cystic teratoma (dermoid)

• anterior very echogenic area with posterior shadowing that prevents visualization of the posterior border

estrogens

thecomas secrete _____________

androgens

Sertoli Leydig cell tumors secrete ____________

Sertoli-Leydig cell tumor

the sonographic appearance of a _____________ is hypervascularity and low resistance flow within the tumor

mucinous cystadenomas

__________________ are usually much larger than serous cystadenomas at diagnosis

mucinous cystadenomas

______________ are usually multiloculated with thin walls and septations

Brenner tumor

• usually benign

• usually occur in postmenopausal women

• usually unilateral

• like to exist with other tumors (groupies😎)

gas or feces

teratomas/dermoids can mimic _______________

4

endometrial thickness of _____________ mm excludes abnormality

Meig’s syndrome

fibromas are associated with _______________ —massive ascites and pleural effusion with ovarian neoplasm

epithelial inclusion cyst

a Nabothian cysts is also known as an _______________

hemorrhagic cyst

most common source of complex ovarian mass in premenopausal women

germ cell tumors

• usually occur in adolescents

• associated with elevated AFP and hCG levels

• 85% are complex (mostly solid)

premenopausal

ovarian tumors are more commonly seen in ___________ patients

postmenopausal

large endometrial fluid collections are a suspicious finding in _______________ women

hematometra

blood in the endometrial canal

pyometra

pus in the endometrial canal

early proliferative phase

ovarian follicles begin to respond to FSH from the pituitary gland and several follicles begin to develop

late proliferative phase

• LH begins to rise & dominant follicle develops

• Graafian follicle ruptures around day 14 (ovulation)

secretory phase

ruptured Graafian follicle forms a corpus luteum

follicular cyst

• Graafian follicle fails to rupture

• immature follicle does not regress

• will continue to secrete estrogen

3 cm

a corpus luteum cyst must be ≥ ______________ to be considered a corpus luteum cyst

corpus luteum cyst

a _______________ may cause delay of menses because it keeps secreting progesterone

ectopic pregnancy

a corpus luteum can be mistaken for an ______________ during early pregnancy

paraovarian cyst (aka peritoneal inclusion cyst)

• have soft, deformable walls

• do not arise from the ovary—no ovarian tissue around them

ovarian torsion

• usually occurs in women under 30

• right ovary affected slightly more often than left

ovarian torsion

• sonographic appearance: ovarian enlargement, heterogenous

• Doppler: whirlpool sign, 75% absent arterial flow, more than 90% absent/decreased venous flow

PCOS

most common androgen disorder

Stein-Leventhal syndrome

• infertility

• obesity

• oligomenorrhea

• hirituism

string of pearls

on ultrasound, the classic appearance of PCOS is the _____________

benign

80% of all ovarian tumors are _______________

mature cystic teratoma

most commonly seen in women from 20s to 40s

dermoid

germ cell tumors that only contain ectoderm-derived tissues

dermoid plug

a Rokitansky nodule is also known as a ______________

fibroma

on ultrasound, a ________________ appears as a very hypoechoic adnexal mass with poor through transmission

fibroma

a ____________ is associated with chromosome 12 abnormality

estrogens

a granulosa cell tumor secretes _____________

endometrial carcinoma

patients with a granulosa cell tumor are at an increased risk of _________________ due to increased estrogen production

Sertoli-Leydig cell tumor

associated with Cushing disease