What to do??
True or False, you should aspirate an ovarian cyst if concerned for malignancy
False
What is the most common imaging technique for adnexal masses?
transvaginal ultrasound
A "tubular-shaped sonolucent cyst" correlates with what diagnosis?
hydrosalpinx
True or False? CA-125 may be elevated in a normal pregnancy
True
What is the first line treatment for a tube-ovarian abscess?
Antibiotics
Name 3 GYN differential diagnoses for an adnexal mass
Endometrioma, Tubo-ovarian abscess, functional cyst, mature teratoma, hydrosalpinx, leiomyoma,
Name 2 characteristics of benign masses on US
thin smooth wall, absence of septations, internal flow, or solid components
What is the malignancy rate for a simple cyst? (regardless of menopausal status or size)
0-1%
What ovarian cyst size is an indication for surgery? (regardless of menopausal status)
10cm
Most common pathologic diagnoses of an adnexal mass in pregnant women is?
Mature teratoma OR paraovarian cyst OR corpus luteal cyst
Granulose cell tumors are associated with what 2 hormones?
estrogen and inhibin
Which genetic predisposition increases your lifetime risk of ovarian cancer the most?
BRCA1
60yo w/ a 7cm simple cyst. Management?
Expectant, repeat US
Name 2 ultrasound characteristics concerning for malignancy
> 10cm, papillary or solid components, irregularity, ascites, high doppler flow
A "hypoechoic attenuating component with multiple small homogeneous interfaces" on US is?
A mature teratoma
Endometriomas of what size are associated with lower follicle density?
5cm
Ovarian function is preserved in what percent of cases where necrosis or ischemia is seen at time of surgical exploration?
90% (at 3 months)
What percent of stage 1 epithelial ovarian carcinomas have an elevated CA-125?
50% (80% of all epithelial cell cancers)
What is the upper limit of normal for a CA-125 in a postmenopausal woman?
35
In pregnancy, what 2 ultrasonographic traits are predictors for persistence
Size > 5cm and complex morphology