ovarian cyst

in this presentation we wrote about phases of ovarian cysts and how it form in the ovary and its symptoms management .

1. By : AMEER AZEEZ :HAYDER AMMAR ovarian cyst 13:03:18 gynecology course

2. ovarian cyst Ovarian  cysts  are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance Ovarian cysts are very common. They can occur during the childbearing years or after menopause . Most ovarian cysts are benign (not cancer) and go away on their own without treatment. Rarely, a cyst may be malignant

3. What are the different types of ovarian cysts? functional cysts Follicle cysts. In a normal menstrual cycle, the egg grows inside a tiny sac called a follicle. When the egg matures, the follicle breaks open to release the egg. Follicle cysts form when the follicle doesn’t break open to release the egg. This causes the follicle to continue growing into a cyst. These cysts often have no symptoms and go away in one to three months. Corpus luteum cysts. Once the follicle breaks open and releases the egg, the empty follicle sac shrinks into a mass of cells called corpus luteum . Corpus luteum makes hormones to prepare for the next egg for the next menstrual cycle. Corpus luteum cysts form if the sac doesn’t shrink. Instead, the sac reseals itself after the egg is released. Then fluid builds up inside. Most corpus luteum cysts go away after a few weeks, but they can grow to almost four inches wide. They also may bleed or twist the ovary and cause pain . And they are most commonly ruptured.

4. Follicle cysts.

5. Corpus luteum cysts.

6. Pathological ovarian cyst dermoid cysts: sac-like growths on the ovaries that can contain hair, fat, and other tissue cystadenomas : noncancerous growths that can develop on the outer surface of the ovaries endometriomas : tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst

7. Symptoms of an ovarian cyst Often times, ovarian cysts do not cause any symptoms. However, symptoms can appear as the cyst grows. Symptoms may include: abdominal bloating  or swelling painful bowel movements pelvic pain before or during the  menstrual cycle painful intercourse pain in the  lower back  or thighs breast tenderness nausea and vomiting Severe symptoms of an ovarian cyst that require immediate medical attention include: severe or sharp pelvic pain fever faintness  or  dizziness rapid breathing

8. Diagnosing an ovarian cyst the following tests may be recommended to find out more information: Ultrasound exam

9. Medical management

10. Surgical management

11. Cont..

12. Complication

13. Which of the following types of cysts most commonly ruptures ? Endometriomas Corpus luteum cysts Dermoid cysts Cystadenomas

14. Corpus luteum cysts tend to be larger and more symptomatic than follicular cysts and are more prone to hemorrhage and rupture. Follicular cysts are usually smaller, with internal hemorrhage being relatively uncommon.

15. Which of the following is  not  associated with symptoms of ovarian cyst rupture? Abdominal distention Unilateral pelvic pain Amenorrhea Peritoneal signs

16. Cyst rupture is characterized by sudden, unilateral, sharp pelvic pain. This can be associated with trauma, exercise, or coitus. In addition, cyst rupture can lead to peritoneal signs, abdominal distention, and bleeding that is usually self-limited.

17. Which of the following is the preferred imaging modality for assessing ovarian cysts with or without rupture? CT MRI Ultrasonography Radiography

18. Ultrasonography is the preferred imaging modality for assessing gynecologic structures, given its low cost, availability, and sensitivity in recognizing adnexal cysts and hemoperitoneum . Despite this, ultrasound findings are nonspecific in some instances, particularly after rupture and decompression of a cyst in the setting of apparent physiologic levels of fluid in the pelvis. If ultrasound yields ambiguous results in a patient with significant pain, CT of the pelvis with contrast should be performed.

19. Cancer is always a concern with ovarian cysts, and cancer antigen 125 (CA-125) testing is often used to investigate for ovarian cancer. Which of the following is a contraindication to CA-125 testing? Age 20-30 years Anemia Pregnancy Postmenopause

20. Keep in mind the possibility of cancer when managing an ovarian cyst.  [29]  Cancer antigen 125 (CA125) is a protein expressed on the cell membrane of normal ovarian tissue and ovarian carcinomas. A serum level of less than 35U/ mL is considered normal, although in some laboratories, the upper limit of normal may be lower than this . CA-125 testing should not be done in pregnant patients with ovarian cysts because levels are significantly higher, especially during the first trimester. CA-125 testing should also not be done in the acute setting of ovarian cyst accidents, as this marker is raised in peritonitis, hemorrhage, cyst rupture, and infection, as well as in menstruation, fibroids, and endometriosis.