1 / 39

Benign Ovarian Tumors

Benign Ovarian Tumors. Dr.Pravin Mhatre Associate Professor and Unit incharge, Nowrosjee Wadia Maternity Hospital and G.S. Medical College, Parel, Mumbai. Solid Ovarian Tumors. Child Germ cell Post pub. Germ cell , Dysgerminoma 20-35 Germ cel l, Dysgerminoma

deron
Download Presentation

Benign Ovarian Tumors

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Benign Ovarian Tumors

  2. Dr.Pravin Mhatre Associate Professor and Unit incharge, Nowrosjee Wadia Maternity Hospital and G.S. Medical College, Parel, Mumbai

  3. Solid Ovarian Tumors • Child Germ cell • Post pub. Germ cell,Dysgerminoma • 20-35 Germ cell, Dysgerminoma • 35-45 Thecoma,Metastatic • Post meno. Thecoma,Metastatic Fibroma

  4. Solid Ovarian Tumors • SMALL • Brenner • Fibroma • Theca cell tumor • Arrhenoblastoma • Dysgerminoma

  5. Solid Ovarian Tumors • MEDIUM SIZE • Brenner • Fibroma (Capsule) • Granulosa cell tumor • Teratoma • Dysgerminoma (Capsule) • Sarcoma

  6. Solid Ovarian Tumors • LARGE SIZE • Brenner • Fibroma (Capsule-Pedicle) • Krukenberg (Capsule-Pedicle) • Carcinomata

  7. Cystic Ovarian Tumors • Child Terratoma, Granulosa cell • Post pub. Terrato, FOLL. • 20-35 Terrato,FOLL.Epith(B/M) • 35-45 Terrato,FOLL. • Post meno. Epith(B/M)

  8. Cystic Ovarian Tumors • SMALL SIZE • Follicular cyst • Follicular hematoma • Corpus Luteual cyst • Corpus Luteual hematoma • Dermoid (ped. Capsulated)

  9. Cystic Ovarian Tumors • MEDIUM SIZE • Cystoma simplex • Granulosa &Theca leutin cyst • Papillary serous cystadenoma • Granulosa • Dermoid (ped. Capsulated)

  10. Cystic Ovarian Tumors • LARGE SIZE • Mucinous cystadenoma • Serous cystadenoma

  11. Pedunculated Ovarian Tumors • Child Teratoma • Post pub. Teratoma • 20-35 Teratoma, Mucinous • 35-45 Teratoma,Mucinous • Post meno.Krukenberg (long pedicle) Fibroma

  12. Capsulated Ovarian Tumors • Child Terato, Granulosa cell. • Post pub. Terato, GR. • 20-35 Terato, GR.,Mucin/Serous • 35-45 Terato, GR.,Mucin/serous • Post meno. GR.,Krukenberg, Sertoli.

  13. Unilateral Ovarian Tumors • Child Terratoma • Post pub. Terrato, FOLL. • 20-35 Terrato,FOLL.Epith(B) Germ cell • 35-45 Terrato,FOLL.Epith(B) Germ cell • Post meno. Epith(B/M)

  14. Bilateral Ovarian Tumors • Child Terratoma • Post pub. Terrato, • 20-35 Terrato,Epith(B) • 35-45 Terrato,Epith(B) • Post meno. Epith(B/M)

  15. Ovarian Tumors • Ascites and Metastesis • Child • Post pub. Germ cell (M) • 20-35 Epith(M) • 35-45 Epith(M) • Post meno. Epith(M)

  16. Ovarian Tumors Associations • Mucinous + Fibroma • Mucinous + Terratoma (same/opp) • Mucinous + Brenner

  17. Ovarian Tumors Associations • Brenner + Terratoma Granulosa cell tumor Mucinous cystadenoma

  18. Ovarian Tumors Associations • Granulosa cell tumor + Brenner Fibroma Terratoma Fibroid Endometrial hyperplasia Hyperthecosis

  19. Ovarian Tumors Associations • Dermoid (Benign cystic terratoma) Granulosa cell tumor Thecoma Androblastoma

  20. SPECIMENS • Dermoid • Mucinous cystadenoma • Meigs syndrome • Dysgerminoma • Granulosa cell Tumor • Arrhenoblastoma • Theca cell Tumor • Brenner • Krukenbergh • fibroma

  21. Dermoid ( Benign cystic terratoma ) • 10% of all cystic swellings • 12% bilateral • Pedunculated • Well capsulated • 15 cm • Common on Right side • Multicentric

  22. Dermoid ( Benign cystic terratoma ) • Ectoderm + Mesoderm + Endoderm • Supradiaphramatic structures • Teeth permanent never deciduous • Teeth canines,molars,incisors but never premolars • No Gonadal tissue • But assoc. with Granulosa Theca Androblastoma

  23. Dermoid ( Benign cystic terratoma ) Complications • Torsion 10% • Rupture 1% • Infection • Hemolytic anemia-splenomegaly • Malignancy

  24. Dermoid ( Benign cystic terratoma ) Radiological Signs • Presence of teeth and bone • Halo sign due to thick capsule • Calcification in capsule • Commonest tumor _ pregnancy

  25. Dermoid ( Benign cystic terratoma ) • Dale’s sign • Kustner’s sign

  26. Mucinous Cystadenoma • 10% Bilat, 6% malignant • Pedicle & large size = Complications • Pseudomyxoma Peritonei -2-5% • Mucin- ppt by alcohol • Pesudomucin-sol in water & dil acid - stained by Hematoxyline. - high con of neutral polysaccharide. • Silomucin res. to sialase = Malign. • Enzymes-Hyal, tryp, amyl, pep, peroxidase

  27. Meig’s Syndrome • Demons (Fra) & Lawson Tait (Briton) • Criteria for Meig’s Syndrome (3) • Psuedo-Meig’s • Theca/Granulosa Tumor • Hyperstimulaion • Ovarian malig. • Struma ovari 10% • Serous/Mucinous

  28. Dysgerminoma • 1906-Chevassu Dis = neutral/disgermal • 1911-Chenot Dys = primitive germ cell yolk sac – gonadal ridge same sex as host • Japan &India high incidence • Age 20 • 50% unilateral Rt sided, 20% bilateral • Size 3-50 cm ,common size 15cm. • Intersex-xo,xy,xxx Fathalla /Mayers • Teratoma, Gonadoblastoma, End.sinus

  29. Dysgerminoma Precos puberty • Hirsut/virilisation due to Exosteroid • Common assoc. with Pregnancy • +ve pregnancy test • LDH monitoring • Spread 20-30%locally • Lymphatic –main • Hematogenous -late

  30. Dysgerminoma Gresham’s criteria conservative treat. • Unilat.,non adherent, Encapsulated • Less than 10 cm • Pure • No ascities / Lymph node / spread • No dysgenetic gonads / 46 xy • Desired Fertility • Close follow up

  31. Dysgerminoma • Brody’s survival Encapsulated 95% Adherent 75% Rupture 60% Metastasis 33% • Recurrence Con. Surg. 22% + Radiation 18% Rad. Surg. 10%

  32. Granulosa Cell Tumor • Age 2% prepubertal 37% childbearing 61% postmenopausal • Test /dhea /Andro–d5-estrone, estradiol • Pregnanolone/progest-absent • 50% malig. Granulosa cell carcinoma

  33. Granulosa Cell Tumor Poor Prognosis • Age >40 • Size >15cm • Abd. Symptoms • Palpable mass • Bilat. Tumor • Solid tumor • Extraovarian spread • Neumerous mitotic figure

  34. Arrenhoblastoma • SertoliLeydigMixed • Rare rare rare • 5cm <5cm >5cm • Capsule no capsule • 3&7 decade 3&4 decade • Lob/solid/elastic fleshy / soft • Peripheral hilar hilar • Benign benign benign

  35. Arrenhoblastoma • SertoliLeydigMixed • Hormone • 70% estr 80%andr. 75%andr. • 20%andr. 10%estr. • Assoc. • Ut.anomstreak gonad cort. hyper. • End.hyp. Br+gr+muci. Adenocar.

  36. Theca cell tumor • Rare • After menopause • Always unilat. • Benign • Non capsulated • 8cm • Oestradiol secretion • Assoc- der / fibroid / fibroma

  37. Brenner Tumor • Rare • Solid • Postmenopausal • Benign , ?malignant • 99%unilateral • Walthard inclu. (origin)Werth1887, walthard1903 • Area of central liquif.,resembels Graff. foll. Oophoroma folli. • Similar to theca cell, Estrogenic • Lined by transitional cells.

  38. Krukenberg Tumor • Large ,solid, long pedicle, capsulated. • Waxy, ovarian shape, signet ring, • Usually sec. Stomach 70% Large bowel 18% Breast 6% • Prim. Kruken. 5yr. Survival Autopsy no primary. 18 cases • Retrograde spread.

  39. Fibroma • Commonest solid benign ov. Tumor • 15cm • Torsion • 3 Types - Surface pappillary growth - Small encap.Normal ov. Tissue - Fibroma replaces ovary

More Related