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SEMINAR 4 :   OVARIAN TUMORS
A.  B1.  B2.  B3.  C.  D.  E.  F.  F1. 

Case History- Ovarian Enlargement

Patient 1. Welcome to the gynecology clinic. Your first patient is a 21 year old GOPO with her LMP 6 weeks ago. She is noted to have ovarian enlargement (7cm) on pelvic exam. She has no pelvic pain or tenderness. You should:


Click on your choice:
 A. reexamine in a month

 B. get an ultrasound

 C. schedule surgery

 D. perform culdocentesis



This patient most likely has a benign ovarian tumor. Common findings include:

Follicular cyst
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Follicular cyst. Here is a benign cyst in an ovary. This is probably a follicular cyst. Occasionally such cysts may reach several centimeters in size and, if they rupture, can cause abdominal pain.
Credits: C. Matthew Peterson, M.D.

Corpus luteum cyst
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Corpus luteum cyst. The corpus luteum secretes progesterone which induces a secretory endometrium. It normally regresses in 14 days unless it is rescued by increasing concentrations of human chorionic gonadotropin from a pregnancy.
Credits: Alan B.P. Ng

Endometrioma
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Endometrioma. This is a section through an ovary to demonstrate several irregular hemorrhagic areas of endometriosis. Sometimes the blood is darker and gives the foci of endometriosis the gross appearance of "powder burns". Typical locations for endometriosis include: ovaries, uterine ligaments, rectovaginal septum, pelvic peritoneum, and laparotomy scars. Endometriosis may even be found at more distant locations such as appendix and vagina.
Credits: C. Matthew Peterson, M.D.

Mature cystic teratoma
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Mature cystic teratoma. Teratomas, often called dermoid tumors, represent 25% of all benign neoplasms. The most common elements are components of stratified squamous epithelium, hence their name: dermoid tumor.
Credits: Alan B.P. Ng

Serous cystadenoma
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Serous cystadenoma. These tumors comprise 20% of all ovarian neoplasms. The epithelium is a single layer of regular cuboidal epithelium, with basal nuclei and rare mitoses.
Credits: Alan B.P. Ng

Mucinous cystadenoma
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Mucinous cystadenoma. These tumors comprise 20% of all neoplasms, and 50% of ovarian neoplasms found in women less than 20 years of age. They are frequently multiloculated. The favored hypothesis for their origin is metaplastic surface epithelium as they have a predominance of endocervical gland type epithelium.
Credits: Alan B.P. Ng

An ultrasound study may further clarify the diagnostic possibilities.


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