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14.tumor of reproductive organs

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14.tumor of reproductive organs

  1. 1. Tumor of reproductive organs Benign tumor Malignant tumor
  2. 2. Uterine myoma(fibroid) • One of most common(80%) benign gynecologic tumors(fibroid tumor); muscle and connective fibrous tissue. • Etiology: unknown • Asymtomatic, uterus to enlarge depend on size of tumor • Fibroids are classified according to location; subserosal, intramural, submucosal
  3. 3. Uterine myoma(fibroid)
  4. 4. Uterine myoma(fibroid) • Sx & symptoms: menorrhagia(heavy prolonged vaginal bleeding) and frequent bleeding anemia (submucosal) • Dysmenorrhea, dyspareunia, expansion of the low abdomen(large tumor), pelvic pressure, abdominal discomfort. • Depend on ovarian hormones because they grow during the reproductive years and atrophy during menopause • Tx: Depend on symptoms, supportive care, laparoscopic myomectomy, hysterectomy • Side effects of hysterectomy; depression, loss of sexual pleasure, urinary tract injury or infection
  5. 5. Endometrial hyperplasia • Benign condition in which the cell lining the uterus grow too much. • Women old than 40 yrs some times developed cancer • Sign & symptoms: heavy menstrual period • Dx: Physical & pelvic examination, D&C endomaterial biopsy • Tx: hormonal therapy(progesterone), D&C hysterectomy to prevent developing cancer
  6. 6. Benign cervical polyps • • • • • Growth and develop endocervical canal. Discovered during a speculum examination. Bright red, small single or multiple 30-40 age women common Asymptomatic, occasionally spotting, leukorrhea(profuse thick vaginal discharge), menorrhagia, postmenopausal bleeding • Tx: surgical remove and cauterization biopsy and endometrial sampling • Avoid sexual intercourse at least 24hrs to prevent irritation and bleeding
  7. 7. Benign cervical polyps
  8. 8. Benign ovarian cyst • • • • • • • • Ovarian cysts are fluid-filled benign growth, various size, single and multiple. Many kind of cyst which include ,follicular, luteal, epithelial, dermoid Follicular cyst is most common, ovum does not release the egg Luteal(hemorrhagic)cyst: bleeding from the ovulation site enters the ovarian capsule Epithelial cyst: from epithelium of the ovary Dermoid cyst: contain fat, hair, teeth, mature form one of teratoma, easily change to malignant Post menopausal women with ovarian cyst are increased risk for ovarian cancer. Sx & symptom: no symptoms if large, pelvic discomfort and pain - Rupture of cyst; severe and sharp pain - Torsion; Twisted and cut off the blood vessel supplying the cyst and ovary; nausea, fever, severe abdominal pain
  9. 9. Benign ovarian cyst
  10. 10. Benign ovarian cyst • Tx: Wait and see; most of ovarian cyst shrink and resolve on their own. Follow up exam 2-3month • Surgical remove by laparoscope • Standard pre and postoperative nursing care
  11. 11. Uterine cancer • • • - Endometrial cancer is common, Malignant tumor Etiology & pathology: 55-70yrs of age at highest risk Risk factors: early menarche(before 12yrs) Older than 50 yrs Delayed menopause Endometrial hyperplasia Hormone replacement therapy Obesity Infertility or nulliparity White race Family history
  12. 12. Uterine cancer • Sign & symptoms: abnormal bleeding, unusual discharge, painful urination, pelvic pain • Dx: D&C and endometrial biopsy • TX: Depend on stage of the disease Radical hysterectomy(TAH+BSO total abdominal hysterectomy and both Salpingo oopohrectomy) NG care: Nurse can provide emotional support and reassurance as well as education. Preventive life style practices
  13. 13. Uterine cancer • 5yr survival rate - Stage I: 90-95% - Stage II: 75% - Stage III: 60% - Stage IV 15-26% Prognosis is good because this cancer often detected early(stage I and II)
  14. 14. Cervical cancer • • • • Before cancer, cervical dysplasia If not treat dysplasia, develop cervical cancer Cervical cancer is third most common cancer in US Prevalence site; squamo-columminal junction(cell lining the cervix); squamo-epitherial cell carcinoma • Regular Pap smear through early detect and prevent from invasive cervical cancer risk of death • Cervical cancer is classified using stage system from stage 0(carcinoma in situ) to stage IV(invasive cervical cancer)
  15. 15. Cervical cancer staging • Stage 0; carcinoma in situ; cancer is found in the first layer of cell lining the Cx only • Stage I; cancer is found in the Cx only • Stage II; cancer has spread beyond the Cx upper vagina but not in to the pelvic wall • Stage III; cancer has spread to the lower third of vagina and have spread to the pelvic wall and lymph nodes. • Stage IV; cancer has spread to the bladder, rectum, or other parts of body
  16. 16. Etiology and pathophysiology • Human papiloma virus(HPV type 16, 18) • Risk factors: long term persistent HPV infection and STI • Smoking • Weakened immune system • Multiple sex partners • First intercourse in an early age • First childbirth before 20yrs • Low socioeconomic status • Diet lacking in Vit. A and C • Oral contraceptive use
  17. 17. • Sx and symptoms: asymptomatic in the early stage. • Vaginal bleeding, Unusual vaginal discharge, pelvic pain during intercourse • Tx: Pap smear colposcopybiopsy, endocervical curettage • Cryosurgery, Loop Electrosurgical Excision Procedure(LEEP) • Invasive cervical cancer; radical hysterectomy(remove TAH+BSO+lympnode) • Radiation, chemotherapy depend on stage
  18. 18. Carcinoma of cervix survival at 5yrs • Stage I 100% closed 100% • Stage II 60% • Stage III 25% • Stage IV 5-10% • All stage 60%
  19. 19. Ovarian cancer • Ovarian cancer is the fifth most common cancer in U. S. • Fourth leading cause of death. 78% of women diagnosed with ovarian cancer survive 1 yr after diagnosis • 50% survive longer than 5yrs • 29% of cases found during early stage
  20. 20. Ovarian cancer staging stage • Stage I • Stage II • Stafe III • Stage IV characteristics • Ovaries only • To pelvis • Abdomen, inguinal node • Distant metastasis, lung liver etc
  21. 21. Etiology and pathophysiology • Risk Factors - 55-65yrs age more likely than young women, after menopause - Family history( mother, sister, daughter) - Obesity - Reproductive history; menses before 12, no children, first child after 30yrs, do not become pregnant. - Infertility drug for long period - Hormonal replacement and estrogen therapy more than 10 yrs - Breast cancer
  22. 22. Sign & symptoms • Asymtomatic, usually vague and similar to other disorder, thus delaying accurate identification • Initial symptoms are abdominal swelling or bloating, fatigue and abdominal pain, constipation and urinary frequency. • If torsion or tumor ruptures, sudden sharp abdominal pain • Dx: pelvic examination, ultrasound, Ca125(blood test), Laparoscopy with biopsy will be done confirm diagnosis
  23. 23. Ovarian cancer 5 yr survival • • • • • • Stage IA 82% Stage IB 75% Stage IC 68% Stage IIA 60% Stage IIB+c 54% Stage III 23% Stage IV 8% • Overall survival 32%
  24. 24. Treatment & management • Depend on stage and women’s general health • Surgery, chemotherapy, and radiation • Nurse provide preoperative and postoperative complication and side effects from chemotherapy and radiation • Nursing support and client to client network(support group) can help improve quality of life • Nug care: teaching counseling, giving support, physical care, hospice care if need.
  25. 25. Vulva cancer • Cancer of the vulva is rare • Risk factor: vulvitis, vulvar dermatosis, STIS, cervical cancer, Diabetes • Sign & symptoms: vulva itching, burning, pain, • Clinical exam, scaly lesion that present as red or white irregular pigmentation • Lesions can vary in size and shape and can be raised or flat small or large • Dx : biopsy and pathologic analysis • Tx: surgery remove the tissue or tumor • Complication from radical vulvactomy can include scarring and wound breakdown skin graft required or hemivulvactomy

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