ovarian cyst and tumor

1. OVARIAN CYST AND TUMOR
PRESENTED BY
ABHILASHA VERMA
LECTURER ( OBG. GYNAE)
JHALAWAR NURSING COLLEGE

2. NORMAL OVARY
 Measurement -
• Reproductive = 4cm × 2 cm× 3 cm
• Menopause = 2 cm × 1.5 cm × 0.5 cm
 Ovary are paired sex glands or gonads in female , pinkish grey
in color which are concerned with-
• Germ cell maturation, storage and release.
• Steroidogenesis.

3. OVARIAN ENLARGEMENTS
NON-NEOPLASTIC
(Functional cyst)
NEOPLASTIC
( Pathologic cyst)

6. NON-NEOPLASTIC ENLARGEMENT
 Non-neoplastic enlargement of ovary is usually due to
accumulation of fluid inside functional unit of ovary.
 These are more common than neoplastic ones.
 They develops as a part of menstrual cycle and short lived.
 They usually cause no problem , rare they may rupture and
cause acute pain and intra-abdominal haemorrhage.
 Non-neoplastic cyst are as follows-
• Foliicular cysts
• Carpus leutium cysts.
• Theca leutin cyst.
• Endometriotic cyst / chocolate cysts.

7. 1) Follicular cyst-
• Arise from ovarian follicles are due to distension of
unruptured graffian follicles.
2) Carpus leutium cysts-
• It results from haemorrhage in persistent mature carpus
leutium.
3) Theca leutin cysts-
• Thin walled cysts lined by leutinised theca cells. They are
associated with high level of circulating gonadotropines (
pregnancy, hydatiform mole)
4) Endometriotic cysts-
• Ovary is the most common site of endometriosis and
chochlate cyst is the blood filled cysts of ovary. It is due to
endometriosis in ovary with haemorrhage.

8. FOLLICULAR CYST
ENDOMETRIOTIC CYST

10. NEOPLASTIC CYST
OR
PATHOLOGIC CYST
• Cysts that occur due to abnormal cell growth, thsese are less
common.
 Incidence –
• It varies from 1 to 3 % among gynaecologic admissions.
• 75% of these are benign in nature.
 Classification-
• Dermoid cyst
• Serous cyst adenoma
• Endometirod tumours
• Granulosa cell tumours
• Androblastoma
• Lipid cell tumour
• Germ cell tumour
• Gestational trophoblastic diasease.
• Gonadoblastoma.
• Secondary metastasis.

11. DERMOID CYST

12. CLINICAL FEATURES OF NEOPLASTIC CYSTS
 Most benign tumors are asymptomatic ,they generally detected as
lump during abdominal palpation.
 Symptoms may be-
– Heaviness in lower abdomen
– Gradual increase mass in lower abdomen.
– Dull aching pain in lower abdomen.
– Painful bowel movement.
– Pelvic pain before & during menstrual cycle.
– Dyspareunia
– In few cases tumor big enough to fill whole abdomen causing cardio-resp.
and GIT symptoms ( Nausea, indigestion)
– Menstrual pattern remain unaffected unless associated with hormone
producing tumor.
 Signs may be-
– Pitting edema my be present when tumor in great veins.
– Bulging of lower abdomen.
– On percussion dull in center & hyper resonant in flanks
– On auscultaion friction rub over tumor

13.  When cyst ruptured –
• Severe or sharp pelvic pain in lower abdomen in oneside.
• Fever, faintness, dizziness.
• Rapid breathing.

14. INVESTIGATIONS
• Doppler USG ( cyst, ascites, blood flow etc)
• CT-scan( Adenaxal mass, calcification)
• MRI ( Benign or malignant)
• Serum Ca 125 marker
• Laparotomy & laparoscopy
• Cytology.

15. DIFFRENCIAL DIAGNOSIS
• Pregnancy
• Full bladder
• Fibroid
• Encysted perotinitis
• Ascites
• Pregnancy with fibroid.

16. COMPLICATIONS
• Torsion of pedicles. (Axial rotation)
• Intracystic haemorrhage
• Infection
• Rupture
• Malignancy.

17. MEDICAL MANAGEMENT
1. Watchful waiting.( Observation)
2. Hormone birth control pill , it prevent development of new
cysts.
3. Analgesics ( NSAIDs, opioid analgesics)

18. SURGICAL MANAGEMENT
• Ovarian cystectomy
• Oviriotomy
• Hystrectomy
• Laparotomy