Keterangan
Benign ovarian masses are relatively common, and they encompass a variety of non-cancerous growths in the ovaries.Common benign ovarian masses include functional cysts, dermoid cysts, cystadenomas, and fibromas, each with distinctive features. Symptoms can range from asymptomatic cases to pelvic pain, bloating, and irregular menstrual cycles, often leading to their discovery during routine gynecological examinations. Transvaginal ultrasound is a key diagnostic tool for identifying and characterizing ovarian masses, providing valuable information on size, composition, and location. While most benign ovarian masses occur spontaneously, factors such as hormonal imbalances, genetic predisposition, and reproductive history may contribute to their development. Treatment options vary based on the type and size of the mass, with some resolving on their own and others requiring medical intervention, such as hormonal therapy or surgical removal. Benign ovarian masses can impact fertility, particularly when they interfere with normal ovarian function. In such cases, a multidisciplinary approach involving gynecologists and fertility specialists may be beneficial.
Ringkasan
- Ovarian masses are encountered throughout a woman's reproductive life, from childhood to post-menopause. Differentiating between fallopian and ovarian masses via scanning or clinical examination is challenging, leading to the term "adnexal mass." These masses are categorized as ovarian or other types. Ovarian types include functional cysts, functional tumors, neoplastic tumors, and borderline tumors.
- Common ovarian tumors vary by age group. Infancy and prepubertal age see functional cysts or germ cell tumors. Adolescence witnesses a rise in epithelial tumors, while reproductive age groups often have dermoid and epithelial tumors. Perimenopausal ages may experience epithelial ovarian tumors, functional cysts, or metastasis.
- Functional cysts are further divided into follicular, corpus luteal, and theca lutein cysts. Follicular cysts are the most common, resulting from hormonal dysfunction prior to ovulation. Corpus luteal cysts persist after ovulation, and can be hemorrhagic. Theca lutein cysts involve luteinization and hypertrophy of the theca interna layer, often due to elevated beta-hCG levels in pregnancy or molar pregnancies.
- Benign ovarian tumors include serous cystadenomas, mucinous cystadenomas, dermoid cysts, and fibromas. Serous cystadenomas are typically benign but can be bilateral and have a risk of malignancy. Mucinous cystadenomas can be large and also have a malignancy risk. Dermoid cysts contain various tissue elements and have a small risk of malignant transformation. Fibromas are solid masses and can be associated with Meigs' syndrome (ascites and hydrothorax).
- Clinical presentations of benign ovarian tumors vary. Symptoms can range from unrecognized masses to chronic pain, increased abdominal girth, and menstrual disturbances. Torsion, intracystic hemorrhage, infection, and rupture can lead to acute symptoms. Palpation findings for benign tumors typically reveal smooth, mobile masses.
- Investigations include routine tests along with ultrasonography, CT scans, MRI, and tumor markers. Transvaginal ultrasonography is preferred for reproductive-age women. The IOTA classification helps distinguish between benign and malignant masses based on ultrasound features. Tumor markers like CA-125, CEA, CA 19-9, and HE4 are used to assess malignancy risk.
- Management strategies vary based on age and tumor size. In neonates and infants, small cysts often regress spontaneously. Children require similar management. In reproductive-age women, observation, aspiration, or surgical excision with ovarian tissue preservation may be appropriate. Postmenopausal women require careful assessment for malignancy risk, employing scoring systems like RMI and ROMA.
Contoh Sertifikat
Tentang Pembicara
Dr. Aruna Reddy
HOD of OBG & GYN Department St Theresa’s Multy Specialty Hospital,Hyderabad
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