what are common types of cysts from the cortex?
simple cysts
corpus luteum
endometrioma
what is a type of cysts that arises from the germ cells of the ovary?
teratomas (dermoid)
what is a functional cyst?
a cyst that arises from normal ovarian function and it resolves spontaneously
what is another name for an endometrioma?
chocolate cysts
which complex cyst type has an elevated tumor marker - CA-125?
endometrioma
which complex cyst is rare?
theca lutein cyst
what’s the problem with surgical excision of an ovarian cyst?
it cuts into the cortex, where the follicles come from
what are the characteristics of theca lutein cysts?
bilateral
large, multinodular (10-15 cm)
seen in the presence of HCG - resolves with removal of HCG
what signs and symptoms can a theca lutein cyst cause?
hyperemesis gravidarum
preeclampsia
thyroid dysfunction
maternal virilization
what are 70% of neoplasms in the ovary in women 10-30 years old?
mature cystic teratoma (aka dermoid cyst)
what are the major ways to manage benign cysts?
symptomatic (NSAIDs, heat)
hormonal (OCPs - prevents new cysts from forming; lupron causes endometriomas to shrink)
surgical (cyst aspiration, laproscopy)
ovarian cancer is the ___ most common gyn malignancy and the ____ cause of death
2nd, leading
what are the increased risks for ovarian cancer?
family hx
genetic syndrome (Lynch, BRCA1, BRCA2)
delayed childbearing, nulliparous
early menarche
late menopause
endometriosis
obesity
E2 replacement therapy >5 years
what is a common cause of ovarian torsion?
very large cysts
what is Stein-Leventhal syndrome?
PCOS
what percentage of women are affected by PCOS?
6.5-8%
what are the signs/symptoms of PCOS?
12+ peripheral follicles on imaging
oligomenorrhea (<9 months/year)
amenorrhea (no period > 3months
obesity
hyperandrogenism (hirsutism, acne, male-pattern hair loss, increased testosterone)
infertility
insulin resistance (acanthosis nigricans)
do women with PCOS really have cysts?
No, they are not usually ovulating, so they are antral follicles
what are the Rotterdam criteria (at least 2 required for diagnosis)
oligomenorrhea and anovulation
clincial and or biochemical signs of hyperandrogenism
polycystic ovaries - string of pearls
what’s on the ddx for PCOS?
hyperprolactinemia
Cushing
Thyroid disease
Congenital adrenal hyperplasia
androgren producing tumors
functional hypothalamic amenorrhea (Joan of Arc)