chapter 18 OVARIES AND FALLOPIAN TUBES REGISTRY

HEMORRHAGIC CYST

A CYST THAT CONTAINS BLOOD

GESTATIONAL TROPHOBLASTIC DISEASE

A DISEASE ASSOCIATED WITH AN ABNORMAL PROLIFERATION OF THE TROPHOBLASTIC CELLS DURING PREGNANCY; REFERRED AS [MOLAR] [PREGNANCY]

SEPTATIONS

A PARTITION SEPARATING TWO OR MORE CAVITIES

PAPILLARY PROJECTIONS

A SMALL PROTRUSION OF TISSUE

OVARIAN HYPERSTIMULATION SYNDROME

A SYNDROME RESULTING FROM HYPERSTIMULATION OF THE OVARIES BY FERTILITY DRUGS; RESULTS IN THE DEVELOPMENT OF MULTIPLE, ENLARGED FOLLICULAR OVARIAN CYSTS

GERM CELL TUMOR

A TYPE OF NEOPLASM DERIVED FROM GERM CELLS OF THE GONADS; MAY ALSO BE FOUND OUTSIDE OF THE REPRODUCTIVE TRACT

MENORRHAGIA

ABNORMALLY HEAVE AND PROLONG MENSTRUATION

OVARIAN TORSION

AN ABNORMALITY THAT RESULTS FROM THE OVARY TWISTING ON ITS MESENTERIC CONNECTION, CONSEQUENTLY CUTTING OFF THE BLOOD SUPPLY TO THE OVARY

SEBUM

AN OILY SUBSTANCE SECRETED BY THE SEBACEOUS GLANDS

FIBROMA

AN OVARIAN SEX-CORD STROMAL TUMOR FOUND IN MIDDLE-AGE WOMEN

MEIGS SYNDROME

ASCITES AND PLEURAL EFFUSION IN THE PRESENCEC OF A BENIGN OVARIAN TUMOR

CLINICAL FINDINGS OF A CYSTIC TERATOMA

ASYMPTOMATIC ACUTE PELVIC PAIN IF RUPTURE OR TORSION OCCURS

CLINICAL FINDINGS OF FOLLICULAR CYSTS

ASYMPTOMATIC PAIN ASSOCIATED WITH HEMORRHAGE AND ENLARGEMENT OF CYST

WHEN DOES OVULATION OCCUR?

AT APROX DAY 14 OF THE MENSTRUAL CYCLE

Clinical findings of ovarian torsion

Acute unilateral abd or pelvic pain Nausea and vomiting

Clinical findings of gránulosa cell tumors

Adolescence - pseudoprecocious puberty Reproductive age & postmenopausal- abnormal vaginal bleeding

Sono findings of serous cystadenoma

Anechoic lesión that contains septations And or papillary projections

Where are endometriomas located?

Anywhere outside of the endometrial cavity, including on any other pelvic organ, such as bladder and bowel. [Most ][commonly ]on the[ ovaries. ]

Clinical findings of parovarian cyst?

Asymptomatic Lower abd girth and pelvic pain if cyst is large

Clinical findings of corpus luteum cysts

Asymptomatic Pain associated with hemorrhage and cyst enlargement

Clinical findings of krukenberg tumor

Asymptomatic Possible weight loss Pelvic pain

ENDOMETRIOMA

BENIGN BLOOD CONTAINING TUMOR THAT FORMS FROM THE IMPLANTATION OF ECTOPIC ENDOMETRIAL TISSUE; ASSOCIATED WITH ENDOMETRIOSIS

CYSTIC TERATOMA

BENIGN OVARIAN MASS THAT IS COMPOSED OF THE THREE GERM CELL LAYERS

THECOMA

BENIGN OVARIAN SEX-CORD STROMAL TUMOR THAT PRODUCES ESTROGEN IN OLDER WOMEN

HEMATOSALPINX

BLOOD WITHIN THE FALLOPIAN TUBE

Sono findings of krukenberg tumor

Bilateral, smooth walled, hypo ovarian mass May have ascites

Transitional cell tumor, small, unilateral, may contain calcifications. Almost always benign but can be malignant

Brenners tumor

By when do corpus luteum cysts usually resolve?

By 16 wk of pregnancy

SONO FINDINGS OF A CYSTIC TERATOMA

COMPLEX W ECHOGENIC STRUCTURES THAT MAY SHADOW TIP OF THE ICEBERG SIGN DERMOID PLUG- SHADOWING DERMOID MESH- PRODUCED BY HAIR LINEAR INTERFACES WITHIN THE CYST

PERISTALSIS

CONTRACTIONS THAT MOVE IN A WAVELIKE PATTERN TO PROPEL A SUBSTANCE

ONCE THE GRAAFIAN FOLLICLE RUPTURES IT BECOMES?

CORPUS LUTEUM

MOST COMMON BENIGN OVARIAN TUMOR, RESULTS FROM THE RETENTION OF AN UNFERTILIZED OVUM, COMPOSED OF ECTODERM, MESODERM, AND ENDODERM.

CYSTIC TERATOMA

Clinical findings of dysgerminoma

Children- precocious puberty Elevated serum lactate dehydrogenase Possible elevated hCG

What are the most common pelvic masses seen during a first trimester sono exam?

Corpus luteum cyst

Sono findings of parovarian cyst

Cyst located adjacent but not attached to the ovary If hemorrhagic, will appear complex

Usually benign tumor, usually large and found bilateral on females between 40-50's or during pregnancy

Cystadenomas

Sono findings of endometriomas

Cystic mass with low-level internal echoes Anechoic or complex Cystic mass with posterior enhancement

LYSIS

DESTRUCTION OR BREAKING DOWN

MALIGNANT DEGENERATION

DEVELOPING INTO CANCER

Stage 4 ovarian cancer

Distant mets beyond peritoneal cavity

Most common malignant germ cell tumor of the ovary, often in patients younger than 30 and may be found in pregnancy. Elevation of serum lactate dehydrogenase.

Dysgerminoma

CHOCOLATE CYSTS

ENDOMETRIOMAS (MASS THAT CONSISTS OF ENDOMETRIAL TISSUE)

AS ENDOCRINE GLANDS, THE OVARIES ARE RESPONSIBLE FOR THE RELEASE OF?

ESTROGEN and PROGESTERONE

HYPEREMESIS

EXCESSIVE VOMITING

Clinical findings of yolk sac tumor?

Elevated AFP

Clinical findings of theca lutein cysts

Elevated levels of hCG Nausea & vomiting Pain associated w/ rupture, hemorrhage or ovarian torsion

Because of estrogen stimulation, postmenopausal women with gránulosa cell tumors have approx 10 to 15% chance of developing?

Endometrial carcinoma

Benign, blood containing tumor, that forms from implanted ectopic endometrial tissue.

Endometrioma or chocolate cyst

Sono findings of ovarian torsion

Enlarged ovary Multifollicular development Lack of or diminished flow patterns compared with the non affected ovary

VIRILIZATION

FEMALE CHANGES CAUSED BY INCREASED ANDROGENS; DEEPING OF THE VOICE AND HIRTUISM

THE OVARIES ARE STIMULATED TO DEVELOP MULTIPLE FOLLICLES DURING THE FIRST HALF OF THE MESTRUAL CYCLE BY?

FOLLICLE-STIMULATING HORMONE RELEASED BY [ANTERIOR] [PITUATARY] [GLAND]

PHASE OF THE FIRST HALF OF THE MENSTRUAL CYCLE ?

FOLLICULAR PHASE

ENDOMETRIOSIS

FUNCTIONAL ECTOPIC ENDOMETRIAL TISSUE LOCATED OUTSIDE OF THE UTERUS

THECA LUTEIN CYSTS

FUNCTIONAL OVARIAN CYSTS THAT ARE FOUND IN THE PRESENCE OF ELEVATED LEVELS OF hCG ALSO REFFERED TO AS THECA LUTEAL CYST

Sex cord-stromal tumor, benign ovarian masses, found in middle age women, may be complicated by Meigs syndrome

Fibroma

Sex-cord- stromal, [Most ][common][ estrogenic] tumor, can reach 40cm, have [malignant][ potential], most often found in [postmenopausal] females.

Granulosa cell tumor

CILIA

HAIRLIKE PROJECTIONS WITHIN THE FALLOPIAN TUBES

MULTILOCULATED

HAVING MORE THAN ONE INTERNAL CAVITY

UNICOLAR

HAVING ONLY ONE INTERNAL CAVITY

WHAT IS THE TYPICAL FLOW DURING MENSTRUAL AND PROLEFEREATIVE PHASES?

HIGH RESISTANCE

WHAT IS THE NORMAL SONO APPEREANCE OF THE OVARIES?

HOMOGENOUS WITH MEDIUM LEVEL TO LOW LEVEL ECHOGENICITY.

FOLLICLE-STIMULATING HORMONE

HORMONE OF THE ANTERIOR PITUITARY GLAND THAT CAUSES THE DEVELOPMENT OF MULTIPLE FOLLICLES ON THE OVARIES

Sono findings of fibroma

Hypoechoic, solid mass with posterior attenuation If large may mimic a pedunculated leiomyoma

Sono findings of thecoma

Hypoechoic, solid mass with posterior attenuation No posterior enhancement If large may mimic a pedunculated leiomyoma

PELVIC INFLAMMATORY DISEASE

INFECTION OF THE FEMALE GENITAL TRACT THAT MAY INVOLVE THE OVARIES, UTERUS, AND OR THE FALLOPIAN TUBES

TRUE PELVIS

INFERIOR PORTION OF THE PELVIS THAT CONTAINS THE UTERUS, OVARIES, FALLOPIAN TUBES, URINARY BLADDER, SMALL BOWEL, SIGMOID COLON AND RECTUM

SALPINGITIS

INFLAMMATION OF THE FALLOPIAN TUBES

PERITONITIS

INFLAMMATION OF THE PERITONEAL LINING

PSEUDOMYXOMA PERITONEI

INTRAPERITONEAL EXTENSION OF MUCIN-SECRETING CELLS THAT RESULT FROM THE RUPTURE OF A MALIGNANT MUCINOUS OVARIAN TUMOR OR POSSIBLY A MALIGNANT TUMOR OF THE APPENDIX

WHAT HAPPENS WHEN GRAAFIAN FOLLICLES FAIL TO OVUALTE?

IT CAN CONTINUE TO ENLARGE AND BECOME A [FOLLICULAR] [CYST]

WHAT HAPPENS TO THE CORPUS LUTEUM IF FERTILIZATION DOES [NOT] OCCUR?

IT REGRESSES AND IT BECOMES [CORPUS] [ALBICANS]

WHAT HAPPENS TO THE CORPUS LUTEUM IF FERTILIZATION OCCURS?

ITS MAINTAINED AND BECOMES CORPUS LUTEUM OF PREGNANCY

Malignant ovarian tumor that metastasized from the GI tract most frequently the stomach

Krukenberg tumor

PEDUNCULATED UTERINE LEIOMYOMA

LEIOMYOMA THAT EXTENDS FROM THE UTERUS ON A STALK

WHAHT IS THE TYPICAL FLOW AT MIDCYCLE?

LOW RESISTANCE

PAHSE OF THE SECOND HALF OF THE MENSTRUAL CYCLE ?

LUTEAL PHASE

Sono findings of mucinous cystadenoma

Large anechoic lesión that contains septations and or papillary projections May contain recognizable internal debris

Sono findings of mucinous cystadenocarcinoma

Large multilocular cystic mass Papillary projections and septations Echogenic material within Pseudomyxoma peritonei

Sono findings of serous cystadenocarcinoma

Large multilocular cystic masses Papillary projections and septations Ascites

Sonó findings of theca lutein cyst

Large, bilateral, multiloculated ovarian cystic masses May contain hemorrhagic components

What is the formula to calculate ovarian volume?

Lenght x width x height x 0.5233

KRUKENBERG TUMOR

MALIGNANT OVARIAN TUMOR THAT METASTASIZES FROM THE GI TRACT

SERTOLI-LEYDIG CELL TUMOR

MALIGNANT SEX-CORD STROMAL OVARIAN NEOPLASM THAT IS ASSOCIATED WITH VIRILIZATION

DERMOID MESH

MASS OF HAIR WITHIN A CYSTIC TERATOMA

THE OVARIES CONSISTS OF?

MEDULLA- W/ VASCULATURE & LYMPHATICS CORTEX- MASS OF THE OVARIE

Clinical findings of a thecoma

May be Asymptomatic Postmenopausal bleeding or abnormal vaginal bleeding secondary to estrogen stimulation Meigs syndrome (ascites and PE)

Clinical findings of a brenner tumor

May be asymptomatic Meigs syndrome

Clinical findings of fibroma

May be asymptomatic Meigs syndrome

Malignant ovarian tumor, associated with pseudomyxoma peritonei

Mucinous cystadenocarcinoma

Ovarian serous cystadenoma

Multiloculated cystic mass with septations

WHERE IS THE SITE FOR OOGENESIS (CREATION OF OVUM)

OVARIAN CORTEX

FOLLICULAR CYST

OVARIAN CYST THAT FORMS FROM THE FAILURE OF THE GRAAFIAN FOLLICLES TO OVULATE

YOLK SAC TUMOR

OVARIAN MALIGNANT GERM CELL TUMOR

SEX-CORD STROMAL TUMORS

OVARIAN TUMORS THAT ARISE FROM THE GONADAL RIDGES

PAIRED, OVAL SHAPED [INTRAPERITONEAL] ORGANS THAT HAVE DUAL BLOOD SUPPLY FORM OVARIAN ARTERY AND OVARIAN BRANCHES FROM THE UTERINE ARTERIES ?

OVARIES

Clinical findings of serous cystadenoma

Often asymptomatic

What is the most common cause of ovarian torsion?

Ovarian cyst or mass

The Fallopian tubes may be referred to as?

Oviducts, Uterine tubes Salpinges

Sono appearance of dysgerminoma

Ovoid solid echogenic mass of the ovary May contain cystic components

MITTELSCHMERZ

PAIN AT THE TIME OF OVULATION

DERMOID PLUG

PART OF A DERMOID TUMOR THAT CONTAINS VARIOUS TISSUES AND MAY PRODUCE A POSTERIOR SHADOWING DURING SONO EXAM

CORPUS LUTEUM CYST

PHYSIOLOGIC CYST THAT DEVELOPS AFTER OVULATION HAS OCCURRED

THE CORPUS LUTEUM PRODUCES WHAT HORMONES?

PROGESTERONE AND ESTROGEN IN SMALL AMOUNTS

Small cysts located adjacent to the ovaries. Range from 1.5 to 19cm

Parovarian cyst

Clinical findings of endometriomas

Patient may be asymptomatic Middle aged females Pelvic pain [infertility] Dysmenorrhea Menorrhagia Dyspareunia Painful bowel movements

Clinical findings of mucinous cystadenoma

Pelvic pressure and swelling

The corpus luteum is responsible for?

Producing progesterone, thereby maintaining the endometrium during an early pregnancy in preparation for implantation

WHICH IS THE MOST DEPENDENT PORTION OF THE PERITONEAL CAVITY?

RECTOUTERINE POUCH

Ovarian torsion usually occurs in which side?

Right side

PSEUDOPRECOCIOUS PUBERTY

SECONDARY SEXUAL DEVELOPMENT INDUCED BY SEX STEROIDS OR FROM OTHER SOURCES LIKE OVARIAN TUMORS, ADRENAL TUMORS, OR STEROID USE

ISTHMUS

SEGMENT OF THE FALLOPIAN TUBE THAT IS LOCATED BETWEEN THE INTERSTITIAL AND AMPULLA

SONO FINDINGS OF FOLLICULAR CYST

SIMPLE CYST- ANECHOIC, THIN WALL, UMILOCULAR, ROUND, POSTERIOR ENHANCEMENT HEMORRHAGIC CYST- COMPLEX COMPONENTS, OR ENTIRELY ECHOGENIC 3-8cm

BRENNERS TUMOR

SMALL BENIGN OVARIAN TUMORS

DAUGHTER CYST

SMALL CYST WITHIN A LARGE CYST

TIP OF THE ICEBERG SIGN

SONO APPEARANCE OF A CYSTIC TERATOMA (DERMOID) WHEN ONLY THE ANTERIOR ELEMENT OF THE MASS IS SEEN, WHILE THE GREATER PART OF THE MASS IS OBSCURED BY SHADOWING

CUMULUS OOPHORUS

STRUCTURE THAT CONTAINS THE DEVELOPING OOCYTE

Most common malignancy of the ovary, frequently bilateral

Serous cystadenocarcinoma

,sex cord-stromal ovarian neoplasm associated with virilization. Patients may present with abnormal menstruation and hirsutism, found in women younger than 30.

Sertoli-leydig cell tumor [androblastoma]

Sono findings of corpus luteum cysts

Simple cyst appearance Hemorrhagic cyst appearance

corpus luteum cysts

Size up to 8-10cm

Sono findings of brenners tumor

Small, solid, hypoechoic mass May contain calcifications

Sono findings of gránulosa cell tumor

Solid hypoechoic mass Complex or partially cystic mass

Sono findings of sertoli-leydig cell tumor

Solid, hypoechoic ovarian mass Complex or partially cystic mass

CORPUS LUTEUM

TEMPORARY ENDOCRINE GLAND THAT RESULTS FROM THE RUPTURE OF THE GRAFFIAN FOLLICLE AFTER OVULATION

HYDROSALPINX

THE ABNORMAL ACCUMULATION OF FLUID WITHIN THE FALLOPIAN TUBE

CORPUS LUTEUM OF PREGNANCY

THE CORPUS LUTEUM THAT IS MAINTAIN DURING AN EARLY PREGNANCY FOR THE PURPOSE OF PRODUCING ESTROGEN AND PROGESTERONE

OOGENESIS

THE CREATION OF AN OVUM

INFUNDIBULUM

THE DISTAL SEGMENT OF THE FALLOPIAN TUBE

THE CELLS SURROUNDING THE TINY FOLLICLES PRODUCE [ESTROGEN] WHICH STIMULUTES WHAT?

THE ENDOMETRIUM TO THICKEN

FIMBRIA

THE FINGERLIKE EXTENSION OF THE FALLOPIAN TUBE LOCATED ON THE INFUNDIBULUM

ENDODERM

THE GERM CELL LAYER OF THE EMBRYO THAT DEVELOPS INTO THE [GI] [RESPIRATORY] [TRACTS]

MESODERM

THE GERM CELL LAYER OF THE EMBRYO THAT DEVELOPS INTO [CIRCULATORY] [SYSTEM], [MUSCLES], [REPRODUCTIVE] [SYSTEM], AND OTHER STRUCTURES

GRAAFIAN FOLLICLE

THE NAME FOR THE [DOMINANT] [FOLLICLE] PRIOR TO OVULATION

ECTODERM

THE OUTER GERM CELL LAYER OF THE EMBRYO THAT DEVELOPS INTO [SKIN] [HAIR] AND [NAILS] AND OTHER STRUCTURES.

PYOSALPINX

THE PRESENCE OF PUS WITHIN THE FALLOPIAN TUBE

OVULATION

THE RELEASE OF THE MATURE EGG FROM THE OVARY

CORPUS ALBICANS

THE REMAINING STRUCTURE OF THE CORPUS LUTEUM AFTER ITS DETERIORATION

INTERSTITIAL

THE SEGMENT OF THE FALLOPIAN THAT LIES WITHIN THE UTERINE HORN (CORNU)

OVARIAN CYSTECTOMY

THE SURGICAL REMOCAL OF AN OVARIAN CYST

[BENIGN], OVARIAN [SEX][-CORD-][STROMAL] AND ESTROGEN PRODUCING TUMOR, MOST OFTEN FOUND IN [POSTMENOPAUSAL] WOMEN, MAY BE ASSOCIATED WITH [MEIGS][ SYNDROME].

THECOMA

AMPULLA

THEH LONGEST AND MOST TORTUOUS SEGMENT OF THE FALLOPIAN TUBE

TERATOMAS CAN CONTAIN WHAT KIND OF ELEMENTS?

THYROID TISSUE, BONE, HAIR, TEETH, SEBUM, FAT, CARTILAGE, AND DIGESTIVE ELEMENTS

SERUM LACTATE DEHYDROGENASE

TUMOR MARKER THAT IS ELEVATED IN THE PRESENCE OF AN OVARIAN DYSGERMINOMA AND OTHER ABDOMINAL ABNORMALITIES

Largest, least common functional cysts. Found with elevated hCG. Usually bilateral and multiloculated may reach up to 15cm

Theca lutein cyst

What is the primary function of the Fallopian tubes?

To provide an area of fertilization and transport the products of conception to the uterus

Stage 3 ovarian cancer

Tumor involves one or both ovaries with confirmed peritoneal mets outside the pelvis and or regional Lymph node involvement

Stage 2 ovarian cancer

Tumor involves one or both ovaries with pelvic extension

Stage 1 ovarian carcinoma

Tumor is confined to the ovary

Sono findings of yolk sac tumor

Varying appearances

Clinical findings of sertoli-leydig cell tumor

Virilization Abnormal menstruation Hirsutism

Clinical findings of serous and mucinous cystadenocarcinoma

Weight loss Pelvic pressure and swelling Abnormal vaginal bleeding GI symptoms Acute Abd pain Elevated CA-125

Second most common malignant germ cell tumor, characterized by rapid growth. In females younger than 20, highly malignant

Yolk sac tumor or endodermal sinus tumor