Benign tumours,cysts

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Benign tumours,cysts

  1. 1. BENIGN TUMOURS,CYSTS & MALFORMATIONS OF THE GENITAL TRACT WAQAR SAEED 09-122
  2. 2. MALFORMATIONS OF THE GENITAL TRACT
  3. 3. I. THE MALFORMATIONS 1.Faliure of Recanalization: - Imperforate hymen or transverse septum - Cruciate Incision in the hymen 2.Failure of Ducts to form or fuse:
  4. 4. FAILURE OF DUCTS TO FUSE
  5. 5. BENIGN CYSTS OF VULVA - Bartholin cysts - Skene Gland cysts - Mucus inclusion cysts with or without vulval discomfort
  6. 6. BARTHOLIN CYSTS
  7. 7. MARSUPIALIZATION OF CYST
  8. 8. II. VULVAL CANCERS •VULVAL TUMORS: - Similar to those that arise in skin - Vulval varicosities
  9. 9. VAGINAL CANCER VAGINAL TUMORS: ( Rare) - Cysts - Gartner Duct Cyst - Urethral Diverticulum - Myoma
  10. 10. THE TUMORS… CERVICAL TUMORS:  Cervical Polyp: - Most common - Columnar to squamous metaplasia - May ulcerate - Intermittent/postcoital bleed - Remove by twisting pedicle
  11. 11. THE TUMORS…. Cervical Tumors:  Genital Papillomata  Fibroids
  12. 12. THE TUMORS… UTERINE TUMORS: 1.)Endometrial Polyps - Associated with endometrial hyperplasia - Abnormal uterine bleeding - Detected by curettage or by hysteroscopy.
  13. 13. THE TUMORS… 2.) Uterine Fibroids:  Gen. Considerations: - Most common tumor of the GT - Smooth muscle fibers interspersed with connective tissue - More common in nulliparous women - Etiology unclear - Post Menopausal Atrophy - Types
  14. 14.  Symptoms: - Depend on size and position of fibroid - Mostly asymptomatic - Abnormal uterine bleeding - Pelvic pressure and discomfort  Diagnosis: - On PA - Pelvic U/S
  15. 15. Management: i) Observe ii) Myomectomy iii) Hysterectomy iv) GnRH analogues
  16. 16. Effect of: i) Pregnancy on Fibroid: “ Red Degeneration” ii) Fibroid on Pregnancy: - Spontaneous Miscarriage - Large tumor malpresentation of fetus - Can Obstruct Labour - Bladder/Bowel Symptoms - PPH
  17. 17. Manage Fibroid in Pregnancy: - * AVOID Myomectomy - If labour obstructed go for CS
  18. 18. BENIGN OVARIAN CYSTS & TUMORS -Ovary consists of: - Coelomic Epithelium - Oocytes - Mesenchymal elements that form medulla
  19. 19. BENIGN OVARIAN CYSTS & TUMOURS  CLASSIFICATION: TUMOR Cell Origin Type Incidence Functional Cysts Normal Follicle Cystic 24 Serous Cystadenoma Coelomic Epitelium Cystic 20 Mucinous CYstadenoma Coelomic Epithelium Cystic 20 Teratoma (Dermoid Cyst) Oogonia Cystic 15 Endometrioma Ectopic Endometrium Cystic 10 Fibroma Mesenchyme Solid 5
  20. 20. BENIGN OVARIAN CYSTS & TUMOURS 1.) FUNCTIONAL CYST: - Enlargement of unruptured Graffian follicle - Unilat. < 5cm - May secrete estrogen resulting in menorrhagia - TVS for diagnosis
  21. 21. Rx: - Observe ( 2-3 months) - Aspirate under U/S & laproscopic guidance - If Blood stained aspirate  Laprotomy - Multilocular cyst  Surgical removal
  22. 22. BENIGN OVARIAN CYSTS & TUMOURS 2.) Mucinous Cystadenoma: - B/w age 35-55 - Usually unilat. - Lined by Columnar cells - Psuedomyxoma peritonei 3.) Serous Cystadenoma: - Age b/w 35-55 - Cuboidal Lining - 1/3 may have malignant change
  23. 23. BENIGN OVARIAN CYSTS & TUMOURS 4.) Endometrioma: - Chocolate Cyst - Rx as Endometriosis 5.) Benign Teratoma: ( Dermoid Cyst) - Age 20-40 - Epithelial,Endothelial, Mesothelial elements
  24. 24. BENIGN OVARIAN CYSTS & TUMOURS 6.) Connective Tissue Neoplasm: - Fibromas - 10% Bilateral - Meig’s Symdrome?? - Diagnosis by TVS
  25. 25. BENIGN OVARIAN CYSTS & TUMOURS Management: - Surgical - Young Cystectomy - BSO TAH

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