Test 2- Uterine and Ovarian Pathology

Which "sign" is a common indication of a benign cystic teratoma?

"Tip of the iceberg" sign

What may be seen when adenomyosis is present?

-Enlarged uterus -Myometrial cysts -Hypoechoic areas adjacent to the endometrium -Will cause pain and irregular bleeding

Ovarian torsion is most commonly seen in ages ________ or less.

10

What is Meig's syndrome associated with?

Ascites Pleural effusion Fibrous ovarian mass

This acquired condition will cause adhesions or synechiae within the endometrium. This can cause miscarriage.

Asherman's syndrome

Longstanding, PID can result in ________.

Infertility, with a much greater risk of ectopic pregnancy

Which type of fibroid is within the myometrium?

Intramural / interstitial

Which type of tumor spreads to the ovaries from a G.I. cancer (usually)?

Krukenberg tumor (Solid, most often bilateral. If unilateral, it will be on the right).

What is the most common benign pelvis pathology of the uterus/female pelvic organs?

Leiomyoma (aka fibroid)

What is a malignant tumor that resembles a fibroid, has rapid growth, and most commonly occurs in postmenopausal women?

Leiomyosarcoma

Ovarian blood flow during ovulation is (high/low) resistance.

Low

A fibroma is associated with ________.

Meig's syndrome

An insignificant cyst seen in the cervix is called a ________.

Nabothian cyst

What are the risk factors for cervical cancer?

Obesity and anovulatory cycles in premenopausal women, postmenopausal if on estrogen replacement therapy, history of atypical hyperplasia of the endometrium, history of tamoxifen therapy, strong family history of uterine cancer

The twisting of an ovary that will cause blood flow to cease is called ________.

Ovarian torsion

What is the most common complication of a benign cystic teratoma?

Ovarian torsion Dermoids may be found incidentally or they may cause pain.

This is a disorder of the endocrine system that is associated with anovulation, hirsutism, and often increased blood sugar. This will often have an appearance of peripheral follicles a.k.a. as a "string of pearls" sign.

PCOS

Which disorder will show a "string of pearls" sign?

PCOS

Fever, pain, and elevated WBC count is associated with which condition?

PID

________ is an infection and inflammation most commonly associated with the transmission of STDs. Will cause scarring and inflammation of the pelvic organs.

PID

What symptoms are associated with PID?

Pain Free fluid Fluid within the tubes Abscess (TOA- tube ovarian abscess)

What are possible symptoms of a leiomyoma?

Pain Menorrhagia Palpable mass Infertility (Can be asymptomatic)

Which type of fibroid is on a stalk, occurs with submucosal and subserosal, and can look like an adnexal mass?

Pedunculated

A thecoma may be confused with a ________.

Pedunculated fibroid

PID can lead to ________ and ________.

Peritonitis and perihepatitis

With adenomyosis, cysts may appear in the ________ portion of the myometrium.

Posterior

Adult granulosa cell tumors occur in ________ women.

Postmenopausal

A patient with endometrial cancer most commonly presents with ________.

Postmenopausal bleeding

Juvenile granulosa cell tumors result in ________.

Precocious puberty (less than 8 years old)

Both benign and malignant mucinous epithelial tumors are associated with ________.

Pseudomyxoma peritonei (jelly ascites)

Pyosalpinx

Pus in the fallopian tube

Pyometra

Pus in the uterus

Endometrial polyps are best imaged with the use of ________.

SIS - saline infused sonohysterography

________ is the second most common tumor of the ovary. It is large and may have thin wall septations. (Benign)

Serous

What are the five types of epithelial tumors?

Serous Mucinous Endometroid Clear cell Transitional cell (aka Brenner)

________ is the most common of all ovarian cancers. It is multilocular, has multiple papillary projections, and is associated with ascites.

Serous cystadenocarcinoma

Which unilateral tumor affects women under 30, is testosterone producing, and causes masculinization?

Sertoli-Leydig tumor

What is another term for PCOS?

Stein-Leventhal syndrome

Which type of fibroid is beneath the endometrial cavity and project into the uterine cavity?

Submucosal

Which type of fibroid is most likely to cause abnormal bleeding?

Submucosal

Which type of fibroid is beneath the perimetrium?

Subserosal

What is the male counterpart of a dysgerminoma?

Testicular seminoma

The largest functional cyst that tends to be bilateral, and is caused from the overstimulation of hormones (hcg) is called a ________.

Theca lutein cyst

________ is a solid ovarian tumor with shadowing. Occurs in postmenopausal women. Estrogen producing. May have a thick endometrium due to the estrogen.

Thecoma

Which tumors should come to mind when you know they are estrogen producing?

Thecoma Granulosa cell tumor

________ is the second most common malignant germ cell tumor. Found in women 20-30 years old. Highly malignant. Unilateral.

Endodermal sinus tumor (yolk sac tumor)

What is the most common reason for postmenopausal bleeding?

Endometrial atrophy

What is the most common GYN cancer that occurs in postmenopausal women?

Endometrial cancer

________ is a proliferation of the endometrium that can be caused from estrogen influence or hormonal imbalance. Will cause heavy bleeding.

Endometrial hyperplasia

________ are growths in the endometrium that can cause abnormal bleeding and miscarriage. These are benign and are overgrowths of endometrial tissue.

Endometrial polyps

________ is the presence of functional endometrial tissue outside of the uterus (that proliferates).

Endometriosis

________ will cause dysmenorrhea, dyspareunia, dysuria, and dyschezia.

Endometriosis

Which epithelial tumor may be associated with endometrial cancer?

Endometroid

________ epithelial tumor is very malignant but more easily cured than mucinous or serous. It has a mixed solid/cystic mass.

Endometroid

________ are the most common of all ovarian neoplasms.

Epithelial tumors

Endometrial cancer has a strong association with ________.

Estrogen replacement or unopposed estrogen

Peritonitis and perihepatitis is a syndrome called ________.

Fitz-Hugh-Curtis syndrome

Hydrosalpinx

Fluid in the fallopian tube

Hydrometra

Fluid in the uterus

An ovarian cyst formed when a dominant follicle fails to rupture is called a ________. Can measure 3-8 cm. Mainly clear without septations.

Follicular cyst

Theca lutein, follicular, corpus luteal, and hemorrhagic are all ________ cysts.

Functional

Most cysts present in the vaginal canal are ________.

Gartner's duct cysts

What type of tumors originate from primitive embryonal cells?

Germ cell tumors

What type of tumor is estrogen producing and has both an adult and juvenile type?

Granulosa cell tumor

A cyst that bleeds within itself is called a ________. Will cause pain. Will commonly resolve without intervention.

Hemorrhagic cyst

Ovarian blood flow during menstruation is (high/low) resistance.

High

The condition that is most commonly seen in postmenopausal women with a history of radiation or cervical stenosis with fluid in the endometrium is called ________.

Hydrometra

Malignant mucinous epithelial tumors are usually multiloculated with thick septations and thick fluid, they have papillary projections and measure ________ cm.

15-30 cm

Benign mucinous epithelial tumors are usually unilateral, have thick multiple septations with thicker fluid, and may be up to ________ cm.

50 cm

An abnormal connection between an artery and vein that may be the result of a biopsy is called an ________.

AV fistula (If congenital, it's called an AV malformation)

Hydrometrocolpos

Accumulation of secreted fluid (such as menstrual blood and vaginal secretions) resulting in distention of the uterus and vagina. This is due to obstruction.

Endometrial cancer is a form of ________ (type of cancer).

Adenocarcinoma

________ is the condition where the endometrium invades the myometrium in 30-50 year old women.

Adenomyosis

________ is the most common germ cell tumor. It occurs in reproductive aged women. It involves all three germ cell layers (endoderm, mesoderm, ectoderm.)

Benign cystic teratoma

What are the three types of germ cell tumors?

Benign cystic teratoma Dysgerminoma Endodermal sinus tumor (aka yolk sac tumor)

Hematosalpinx

Blood in the fallopian tube

________ is a blood test to check for elevated levels of markers associated with certain ovarian cancers.

CA-125

What is the second most common GYN cancer that occurs most commonly in women ages 20 to 30?

Cervical cancer

If endometriosis is isolated or self-contained, then an endometrioma may form. This is also called a ________.

Chocolate cyst

A cyst that occurs after ovulation and secretes progesterone is called a ________.

Corpus luteal cyst

Endometrial cancer can be definitively diagnosed with a ________.

D&C with biopsy

Asherman's syndrome may present in a patient with a history of ________.

D&C's Surgeries Infection

How is cervical cancer diagnosed and treated? What does it have a high association with?

Diagnosed: biopsy and PAP smear Treated: Leep procedure, cone procedure, and colposcopy High association with: HPV

Cancer spreads through:

Direct invasion Blood and lymph Peritoneal fluid

________ is the most common malignant germ cell tumor. Commonly found in women under 30. Appears as multilobulated and solid. Size varies.

Dysgerminoma

Which germ cell tumor presents with increased AFP and LDH?

Endodermal sinus tumor (yolk sac tumor)

With PID, infection will begin in the ________ and spread where?

Will begin in the endometrium and spread through the tubes and into the pelvic cavity.