1. Lectures on Gynecology
Dr Magda Helmi

2. Causes of benign ovarian cysts
Functional
Inflammatory
Germ cell
Epithelial
Sex cord stromal
Follicular cyst
Corpus Luteal cyst
Theca Luteal cyst
Tubo-ovarian abscess
Endometrioma
Benign teratoma
Serous cyst adenoma
Mucinous cyst adenoma
Brenner tumour
Fibroma
thecoma

3. Functional
Follicular cyst
Graafian follicle cyst or follicular cyst
is a type of functional simple cyst,
and is the most common type of
ovarian cyst
This type can form when ovulation
doesn't occur,
Usually, these cysts produce no
symptoms and disappear by
themselves , Its rupture can create
sharp, severe pain on the side of the
ovary . On a sonogram, simple
ovarian cysts have a uniformly thin,
rounded wall and a unilocular
appearance that is either hypoechoic
or anechoic. They usually measure
2.5-15 cm in diameter

4. Functional
Corpus Luteal cyst
Corpus Luteal cysts
occur following ovulation
and may present with
pain due to rupture and
or hemorrhage, typically
late in the menstrual
cycle.
Treatment is expectant,
with analgesia.
Occasionally, surgery
may be necessary to
wash out the pelvis and
perform an ovarian
cystectomy.

5. Functional
Theca Luteal cyst
Theca Luteal cysts are
associated with
pregnancy, particularly
multiple pregnancies,
and are often
diagnosed incidentally
at routine USS.
Most resolve
spontaneously during
pregnancy.

6. Inflammatory
ovarian cysts Tubo-ovarian
abscess
Are present in 14-38% of
patients hospitalized with pelvic
inflammatory disease (PID) .
Commonly seen in patients with
poor access to routine
gynecologic care.
The traditional criteria for the
diagnosis of PID include
subjective bilateral abdominal
pain per patient report and
positive physical examination
findings for bilateral adnexal
tenderness at palpation and
cervical motion tenderness.
A hydrosalpinx is generally
anechoic, whereas a pyosalpinx
may have increased echoes
within the fluid.

7. Germ cell
Benign teratoma
These are the most common
ovarian tumours in young
women, peak incidence is in
the early 20s accounting for
more than 50 per cent of
ovarian tumours in this age
group.
Dermoid cysts are a
combination of all tissue
types (mesenchymal,
epithelial and stroma).
Diagnosis may be incidental,
although 15 per cent present
acutely with torsion .
Treatment is often surgical
excision.

8. Benign Epithelial Ovarian
Cysts
Epithelial cystic tumors account for about
60% of all true ovarian neoplasm. One third
of all ovarian tumors are serous, and two
thirds of these serous tumors are benign. By
definition, serous tumors are characterized
by a proliferation of epithelium resembling
that lining the fallopian tubes.
Mucinous cysts are usually smooth-walled;
compared with the serous variety; they rarely
are associated with true papillae.
Treatment
For women of childbearing age, simple
unilateral oophorectomy via laparoscopy or
laparotomy is adequate
Mucinous
cyst
Serous
cyst

9. Benign Solid Ovarian
Tumors
Brenner tumors are usually found
incidentally at pathologic evaluation,
often in conjunction with a mucinous
cystadenoma or dermoid cyst. They
are relatively rare tumors and are
most common in the fifth to sixth
decades of life.
Solid mature teratomas are tumors
consisting of differentiated tissue
from all 3 germ layers. Benign
teratomas
Treatment
In most instances, simple excision of
the solid tumors is adequate therapy,
particularly for women of
reproductive age.

10. Fibroma
The most common benign solid tumor of the
ovary is the fibroma
It is derived from connective tissue and arise
from the solid ovarian cortical stroma.
Histologically, spindle cells are seen.
Ultrasonographically, these tumors appear
hypoechoic with attenuation of the ultrasound
beam.
On magnetic resonance imaging (MRI), it
demonstrate low-signal intensity.
These tumors may undergo calcification and
degeneration. Approximately 10-15% are
found in association with ascites.
Fewer than 1% undergo malignant
transformation to fibrosarcomas. About 1% of
cases are associated with Meigs syndrome,
characterized by ovarian fibroma, ascites, and
pleural effusion.