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What is the most common benign gynecological tumor?
- Uterine fibroids
- SM tumor
- Seen in 40-50% of reproductive age women
- Tend to regress after menopause
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Which type of uterine leiomyoma is most likely to be symptomatic?
Submucosal--can cause bleeding and infertility
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4 approaches to management of uterine fibriods
- 1. Watchful waiting--asymptomatic, fibroids under 8 cm, not submucosal
- 2. Medical--antiprostaglandins or tranexamic acid
- 3. Interventional radiology--embolize uterine artery, shrinks fibroid and decreases bleeding
- 4. Surgical--myomectomy preserves fertility, hysterectomy can be used for giant fibroids
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Most common gyne cancer in North America?
Uterine (cervical is more common in some low socioeconomic areas)
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Risk factors for endometrial cancer
- 1. Unopposed estrogen (PCOS, obesity, HRT)
- 2. Nulliparity
- 3. Late menopause
- 4. Tamoxifen
- 5. Estrogen-producing ovarian tumor (e.g. granulosa cell)
- 6. HNPCC
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Categories of endometrial cancer
- 1. Adenocarcinoma (80%)
- 2. Adenosquamous (15%)
- 3. Papillary serious adenocarcinoma (4%)
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Most common clinical presentation in endometrial cancer
Post-menopausal bleeding
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Stage I endometrial cancer
Confined to uterine corpus
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Stage II endometrial cancer
Involves corpus and cervix
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Stage III endometrial cancer
Invades beyond uterus but is confined to pelvis
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Stage IV endometrial cancer
Mets outside of pelvis
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Most common site of distant mets for endometrial cancer
Lungs
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Uterine sarcoma
Rare uterine tumor of stromal origin. 5 year survival is 35%.
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Typical presentation of leiomyosarcoma
Rapidly enlarging uterus
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US characteristics of malignant ovarian tumors
- 1. Over 10 cm
- 2. Bilateral
- 3. Cystic and solid elements
- 4. Multiloculated
- 5. Thick septae
- 6. Ascites
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Most common solid ovarian neoplasm
- Benign cystic teratoma (dermoid tumor)
- 20% bilateral
- Increased risk of ovarian torsion
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What does a dysgerminoma produce?
Lactate dehydrogenase
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Most common malignant ovarian tumor
- Serous adenocarcinoma
- Contains psammoma bodies
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What ovarian tumor may be complicated by pseudomyxoma peritonei?
Mucinous adenocarcinoma
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Ovarian stromal tumors
- Benign ovarian fibroid
- Granulosa/theca cell tumor
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Tumor that metastasizes from the GI tract to the ovaries
- Krukenberg tumor
- Signet ring cells
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Triad associated with Meig's syndrome
- Ovarian fibromas
- Ascites
- Right pleural effusion
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Causes of elevated CA-125
- BenignBenign ovarian neoplasm
- Endometriosis
- Pregnancy
- Fibroids
- PID
- Cirrhosis
- Pancreatitis
- Renal failure
- MalignantTumors of the ovary, uterus, pancreas, stomach, colon, or rectum
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Stage I ovarian cancer
Tumor limited to ovaries
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Stage II ovarian cancer
Tumor involves one or both ovaries with extension into the pelvis
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Stage III ovarian cancer
Peritoneal implants
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