#Ultrasound in #Pcos
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This document discusses the use of transvaginal ultrasound (TVS) to diagnose Polycystic Ovarian Syndrome (PCOS). It states that TVS can identify PCOS in approximately 75% of clinically diagnosed cases. Key ultrasound criteria for diagnosing PCOS include an antral follicle count (AFC) of more than 12 follicles sized 2-9mm in one or both ovaries, or an ovarian volume greater than 10cm3 with no follicles over 10mm. Recent guidelines consider an AFC over 25 as meeting the ultrasound criteria for a PCOS diagnosis. The document provides references and information for patients on infertility and contacting a doctor for related queries.
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2. Etiological factors for ovarian tumours include nulliparity, heredity such as BRCA gene mutations, and genetic syndromes like Lynch syndrome.
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- Common benign adnexal masses include physiologic cysts, peritoneal inclusion cysts, and masses related to conditions like ovarian hyperstimulation syndrome or polycystic ovary syndrome. Masses may also be due to endometriosis.
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The document provides information on normal ovaries and ovarian masses. It discusses:
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2. Risks of ovarian neoplasms - a woman has a 5-10% lifetime risk of surgery for a suspected ovarian mass, of which 13-21% will be malignant.
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Pelvic mass of ovarian/adenexal origin
A pelvic mass of ovarian or adnexal origin can have several potential causes including ovarian tumors, which can be benign cysts, physiological cysts, or malignant neoplasms. Other possible causes are adnexal masses such as endometriomas, hydrosalpinges, or tubo-ovarian abscesses. A thorough differential diagnosis and examination is required to determine the origin and characteristics of the pelvic mass.
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Ovarian cysts are fluid-filled sacs that can form in the ovaries. They are common and usually harmless but can sometimes be cancerous. Malignant ovarian cysts are diagnosed using ultrasound imaging to check for characteristics like solid areas, thick septations, and ascites. Treatment for malignant cysts involves surgical removal of the ovaries and nearby lymph nodes, followed by chemotherapy.
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This document discusses ovarian tumours, including their epidemiology, embryology, risk factors, classification, staging, pathology, screening, management, and various treatment options. It addresses how ovarian cancer accounts for nearly 4% of cancers in women and is a leading cause of death from female genital tract malignancies. Various types of ovarian tumours are described, such as epithelial tumours including serous, mucinous and endometrioid tumours, as well as sex cord-stromal tumours and germ cell tumours. Risk factors, prevention strategies, and challenges with screening for early detection are also summarized.
Adnexal masses
- An adnexal mass refers to a lump near the uterus, ovaries, fallopian tubes, or surrounding tissue. Imaging can help determine if a mass is benign or cancerous.
- Common benign adnexal masses include physiologic cysts, peritoneal inclusion cysts, and masses related to conditions like ovarian hyperstimulation syndrome or polycystic ovary syndrome. Masses may also be due to endometriosis.
- Potentially cancerous masses include various epithelial tumors of the ovaries, such as serous or mucinous tumors. Other ovarian cancers include clear cell carcinoma and germ cell tumors. Imaging can help identify features suggesting malignancy.
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This document discusses benign ovarian tumors, including functional ovarian cysts and benign neoplastic ovarian tumors. It describes the main types of functional cysts such as follicular, lutein and hemorrhagic cysts. It also outlines the main types of benign neoplastic ovarian tumors, including epithelial tumors, sex cord-stromal tumors, germ cell tumors and mixed tumors. The diagnosis, management and treatment options for different types of benign ovarian tumors are provided.
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This document provides information about ovarian tumors, including their anatomy, classifications of benign and malignant tumors, FIGO staging of ovarian cancer, and principles of treatment. It describes the different types of benign cysts and tumors, as well as classifications for malignant ovarian cancer stages I through IV. The staging system considers factors such as tumor size, organ extension, and distant metastases. Principles of treatment include surgical staging and debulking followed by intensive chemotherapy using platinum-based drugs, with CA-125 used to assess response.
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An apporach to ovarian pathology
1. Ovarian cancer is the seventh most common malignancy among women worldwide and the most lethal gynecologic malignancy in developed nations. Late detection is common, with 67% of patients presenting with advanced disease.
2. Imaging plays a crucial role in detecting adnexal lesions, characterizing masses, and determining likelihood of malignancy to guide treatment planning. Ultrasound is the first-line imaging modality for evaluating adnexal masses.
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The document provides information on normal ovaries and ovarian masses. It discusses:
1. The typical size of normal ovaries and factors that can affect size.
2. Risks of ovarian neoplasms - a woman has a 5-10% lifetime risk of surgery for a suspected ovarian mass, of which 13-21% will be malignant.
3. Differential diagnosis of adnexal masses varies with age, with masses in pre-menarchal/post-menopausal women considered highly abnormal.
Malignant Mixed Mullerian Tumor – Case Reports and Review Article
Malignant mixed mullerian tumors are very rare genital tumors. They are biphasic neoplasms composed of an admixture of malignant epithelial and mesenchymal elements. In descending order of frequency they originate in the uterus, ovaries, fallopian tubes, cervix and vagina. Also they arise denovo from peritoneum. They are highly aggressive and tend to occur in postmenopausal low parity women. Because of rarity, there is as such no treatment guidelines available. Multimodality treatment in the form of radical surgery followed by adjuvant chemotherapy or radiotherapy or combined chemoradiation gives a better prognosis & outcome. Two case reports of such tumors, one from ovary and other from penitoneum are presented along with the review of literature.
Benign ovarian tumours
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
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The document provides guidelines for pelvic ultrasound examination. It describes evaluating the ovaries and using them as reference points. If pathology is seen, its size and sonographic features should be documented. Spectral Doppler should be performed to examine vessels. The fallopian tubes and other structures should also be examined. Characteristics of different types of ovarian cysts and masses are outlined. The document also discusses features suggestive of malignancy on ultrasound and risk of malignancy indices.
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This document discusses benign tumors of the ovaries and fallopian tubes. It describes various types of functional cysts such as follicular cysts, lutein cysts, and theca-lutein cysts. It also discusses inflammatory conditions, metaplastic conditions like endometriosis, and various neoplastic tumors including epithelial, sex cord-stromal, and germ cell tumors. Diagnosis and management are discussed for different types of ovarian tumors based on factors like size, symptoms, and patient's desire for future fertility. Surgical exploration and microscopic examination are usually needed for definitive diagnosis and treatment.
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This document discusses the evaluation and classification of adnexal masses. It defines the adnexa as the region adjoining the uterus, and describes adnexal masses as masses arising from the ovaries, fallopian tubes, or surrounding tissues. Non-neoplastic adnexal masses include follicular cysts, corpus luteum cysts, theca lutein cysts, polycystic ovarian syndrome, endometriomas, and inflammatory masses. Neoplastic ovarian masses are further classified as epithelial, germ cell, or sex-cord stromal tumors. The document outlines the diagnostic evaluation of adnexal masses, including ultrasound characteristics, tumor markers like CA-125, and referral indications. It also describes
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1. Ovarian cysts and tumors can be non-neoplastic (functional cysts) or neoplastic (pathologic cysts). Non-neoplastic cysts are more common and include follicular cysts, corpus luteum cysts, and endometriotic cysts.
2. Neoplastic cysts are less common and include dermoid cysts, serous cyst adenomas, and various germ cell tumors. They may be asymptomatic but can also cause abdominal pain, bloating, or a visible abdominal mass.
3. Investigations include ultrasound, CT, MRI, and tumor markers. Management involves watchful waiting for small asymptomatic cysts, while symptomatic or
Mucinous cystadenoma case presentation
A case of an ovarian tumour pre-operatively thought to be malignant, which was per-operatively diagnosed as benign and later confirmed as a mucinous cystadenoma.
Ob-Gyn Department, BIRDEM-2 General Hospital, Shegunbagicha, Dhaka, Bangladesh
Lect 3- overy cancer
Ovarian neoplasms can be cystic, solid, or mixed tumors. The three main types are epithelial tumors (70-80% of ovarian cancers), germ cell tumors (15% of ovarian cancers), and stromal/sex cord tumors (5-10% of ovarian cancers). Epithelial tumors arise from the ovarian surface epithelium and include serous and mucinous tumors, which can be benign, borderline, or malignant. Serous tumors are the most common ovarian cancer.
Endometriosis & Adenomyosis
Endometriosis is the presence of endometrial tissue outside the uterus, most commonly found on the ovaries, pelvic peritoneum, and ligaments. It affects 6-10% of women and is a common cause of infertility and pelvic pain. Diagnosis is typically made by laparoscopy where lesions are visualized and biopsied. Treatment aims to reduce pain and fertility issues through hormonal suppression or surgery to remove lesions. Complications can include infertility, pregnancy issues, intestinal obstruction, and in rare cases, malignant transformation of lesions.
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- Ovarian cysts are a common finding and are usually benign functional cysts.
- Evaluation involves ultrasound, tumor markers like CA-125 and HE4, and risk of malignancy algorithms.
- Management depends on factors like size, symptoms, and patient age/menopausal status.
- Ovarian neoplasms include functional, inflammatory, and neoplastic tumors and are classified based on histology.
- Borderline ovarian tumors have
MALE INFERTILITY AND ERECTILE DYSFUNCTION
This document discusses male infertility and erectile dysfunction. It begins by defining infertility and discussing the prevalence of male factor infertility. The initial diagnostic workup is outlined, including medical history, physical exam, semen analysis, and imaging. Common causes of male infertility are then reviewed, including varicocele, testicular atrophy, orchitis, testicular microlithiasis, cryptorchidism, and various obstructive causes. Specific imaging findings of these conditions on ultrasound, MRI, and other modalities are presented.
Manegement of adenexal masses in pregnancy
Over the last 20 years, the use of ultrasound in pregnancy has dramatically increased the numbers of ovarian cysts diagnosed.
The majority of these ovarian cysts in pregnancy either resolve spontaneously or are due to benign conditions.
Ovarian cancer is extremely rare in women of childbearing age and thus most of these cysts can be managed conservatively.
In terms of malignancy potential, those that are malignant are likely to be borderline.
Unless there is a suspicion of malignancy or there is a significant cyst complication, such as torsion, surgery is not indicated.
MRI is a safe and useful tool to help evaluate cysts in more detail in situations where ultrasound provides an inconclusive answer.
If surgery is planned, this should take place during the second trimester to minimise the risk of miscarriage.
Whether surgery is done laparoscopically or using a traditional open approach, it is largely dependent on operator experience and patient preference.
Aspiration of ovarian cysts is only indicated where they appear simple on ultrasound and where they are causing pain or are thought to be obstructing the birth canal.
If surgery does not take place, then ultrasound follow-up during and after pregnancy may be advised accordingly.
Are You Having Infertility ?
Ultrasound is done to look for any diseases in the uterus, ovaries, tubes and pelvis that may cause infertility. It assesses the uterus for size, position, endometrial thickness and myometrium. In the ovaries it looks at size, volume and follicular number. It also checks for any fluid in the pelvis which could indicate infection or tuberculosis. Ultrasound can be done via transabdominal scan (TAS) with a full bladder or transvaginal scan (TVS) after emptying the bladder by inserting a probe into the vagina. TVS provides a clearer view of the pelvic structures. Ultrasound is commonly done on day 2, 9 and 21 of the
Git j club panc cysts.
This document discusses pancreatic cysts and cystic neoplasms. It provides information on different types of cysts including pseudocysts, serous cystic neoplasms, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms. Key points include that pancreatic cysts are increasingly detected due to improved imaging but can be challenging to diagnose definitively. Endoscopic ultrasound with potential fluid sampling is often needed to characterize cysts, though accuracy depends on experience. Malignant potential varies between cyst types and certain features like size, wall thickness, and presence of nodules impact cancer risk assessment.
Ovarian Tumors 2.pptx gynecology lecture
Ovarian tumors are abnormal growths on the ovaries, the female reproductive organs that produce eggs. Ovarian tumors can be noncancerous (benign) or cancerous (malignant). Many things can make you more likely to develop an ovarian tumor.
Colon cancer in 2018
Colon cancer epidemiology, risk factors, and etiology, pathology, screening, diagnosis, workup, staging, treatment, chemotherapy and follow-up.
These slides are selections from the major references in surgery, oncology, and internal medicine. I have tried to gather the information from valid and recently-updated references such as NCCN guidelines and Cancer statistics. I hope it helps!
NB.pptx
This document provides information on neuroblastoma and Wilms' tumor, two common pediatric abdominal masses. Neuroblastoma arises from neural crest tissue and is the most common extracranial solid tumor in children. It typically presents as an abdominal mass and can metastasize. Treatment involves chemotherapy, surgery, and sometimes stem cell transplant depending on risk factors. Wilms' tumor arises from the kidneys and is also typically detected as an asymptomatic abdominal mass in young children. Staging involves evaluating the extent of the primary tumor and presence of metastases to determine the appropriate treatment, which usually involves surgery and chemotherapy. Both tumors require a multidisciplinary approach including imaging, biopsy, surgery, and chemotherapy.
Role of tvs in art
Ultrasound plays a key role in evaluating infertility by assessing ovarian reserve, endometrial thickness and blood flow, detecting uterine anomalies, guiding oocyte retrieval and embryo transfer. New markers of endometrial receptivity and follicle development aim to improve success with single embryo transfer. Three-dimensional ultrasound enhances detection of uterine anomalies and may improve embryo visualization during transfer.
tortion.pptx
Ovarian torsion is the fifth most common gynecological emergency. It occurs more commonly in women in their 20s and post-menopausal women. Malignancy may be associated with ovarian torsion in 1.1-2% of adult patients, but the risk is higher at 25% for women over 60. Diagnosis is difficult but ultrasound and Doppler analysis can help identify torsion. Early surgical intervention is important to detorse the ovary within 8 hours to prevent necrosis. Delayed diagnosis can lead to incorrect pathology calls. Frozen section during emergency surgery is important but may miss malignancies in necrotic tissues.
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O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
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#Ultrasound in #Pcos
- 1. · TVSisahighlysensi ve testforiden fica onofPolycys covaries. (PCOS). · Polycys covariesaredetectedbyTVS(Transvaginalsonography)inapproximately · Antral follicles are small follicles in the ovary ranging in size from 2-9 mm and grow over 10-12days in a menstrualcycletoselectonedominantfolliclewhichmaturesandreleasestheovum. 75%ofwomenwithclinicaldiagnosisofPCOS(1). · Ultrasoundisoneofthecriteriaforthediagnosisofpolycys covariansyndrome · An AFC(Antral follicular count) of more than 12 in one or both ovaries of size 2-9mm arranged either peripherallyordiffuselywithadenseincreasedVolumeofovarianstroma.(2) · RecentguidelinesayAFC>25inoneorbothovariesisconsideredasUSGcriteriaofPCOS.(3) 3 · Ovarian volume of greater than 10cm with no follicles measuring over 10mm in diameter is considered as PCOS. Ultrasound in PCOS 3. Human Reproduction update 2014; 20(3): 334-52 2. Clinical Endocrinology 1991 1. Gardener's Text Book of ART 5th Edition Page 676 References. Know Your Ultrasound Scan Series – 6 Are You Having Infertility ? Patient Information Fact Sheet For Infertility Related Queries, Contact Director - Dr (Col) Pankaj Talwar, VSM i - Consult, a Subsidary of ARTech +91 9810790063 +91 8287883005 pankaj_1310@yahoo.co. in www.drpankajtalwar.comManipal Hospital - Palam Vihar, Sector 6 Dwarka, New Delhi - 110075 visit