{"id":203,"date":"2020-08-13T16:17:17","date_gmt":"2020-08-13T16:17:17","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=203"},"modified":"2023-09-30T10:38:59","modified_gmt":"2023-09-30T10:38:59","slug":"55-ovarian-neoplasms","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/basic_obgyn\/overview\/55-ovarian-neoplasms\/","title":{"rendered":"55. Ovarian Neoplasms"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/TJNktNrRJd0\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Duration = 6:06<\/p>\n<input type='hidden' bg_collapse_expand='69e9dc98b40207047902690' value='69e9dc98b40207047902690'><input type='hidden' id='bg-show-more-text-69e9dc98b40207047902690' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9dc98b40207047902690' value='Hide Transcript'><button id='bg-showmore-action-69e9dc98b40207047902690' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9dc98b40207047902690' ><\/p>\n<p>00:00<br \/>\nAPGO educational topic number 55<br \/>\n00:02<br \/>\novarian neoplasms ovarian cancer is the<br \/>\n00:05<br \/>\nfifth most common cause of cancer death<br \/>\n00:07<br \/>\nin women in the United States ovarian<br \/>\n00:10<br \/>\ncancer has the highest mortality rate<br \/>\n00:11<br \/>\namong gynecologic malignancies<br \/>\n00:13<br \/>\napproximately 55% of patients will die<br \/>\n00:15<br \/>\nwithin five years of diagnosis the<br \/>\n00:18<br \/>\nobjectives of this video are to describe<br \/>\n00:19<br \/>\nthe initial management of a patient<br \/>\n00:21<br \/>\nwithin an X amass compare the<br \/>\n00:23<br \/>\ncharacteristics of functional cysts<br \/>\n00:25<br \/>\nbenign ovarian neoplasms and ovarian<br \/>\n00:27<br \/>\ncancers list the risk factors and<br \/>\n00:29<br \/>\nprotective factors for ovarian cancer<br \/>\n00:31<br \/>\ndescribe the symptoms and physical<br \/>\n00:33<br \/>\nfindings associated with ovarian cancer<br \/>\n00:35<br \/>\nand lastly describe the three<br \/>\n00:37<br \/>\nhistological categories of a very<br \/>\n00:39<br \/>\nneoplasm what is an in Exel mass and<br \/>\n00:43<br \/>\ngynecology it refers to anything next to<br \/>\n00:45<br \/>\nthe uterus usually involving the<br \/>\n00:47<br \/>\nfallopian tube or ovary the term adnexal<br \/>\n00:50<br \/>\nmass is often used interchangeably with<br \/>\n00:52<br \/>\nthe term mass when a patient presents<br \/>\n00:54<br \/>\nwith an x amass it is important to<br \/>\n00:56<br \/>\nperform a thorough pelvic examination<br \/>\n00:58<br \/>\nfor preman Arkell girls the ovary should<br \/>\n01:01<br \/>\nnot be palpable for reproductive age<br \/>\n01:03<br \/>\ngroup women a normal ovary is palpable<br \/>\n01:06<br \/>\nabout half of the time and for<br \/>\n01:07<br \/>\npostmenopausal women the ovaries are<br \/>\n01:09<br \/>\nusually not palpable 25% of ovarian<br \/>\n01:12<br \/>\ntumors in postmenopausal women are<br \/>\n01:14<br \/>\nmalignant whereas 10% of our variant<br \/>\n01:17<br \/>\ntumors in reproductive age women are<br \/>\n01:18<br \/>\nmalignant pelvic ultrasound is the<br \/>\n01:21<br \/>\nprimary component of evaluation of an<br \/>\n01:23<br \/>\nannexe amass the three main<br \/>\n01:25<br \/>\nclassifications of an exhalation Allah<br \/>\n01:28<br \/>\ncysts number two benign ovarian<br \/>\n01:30<br \/>\nneoplasms and number three malignant<br \/>\n01:32<br \/>\novarian neoplasms functional cysts are<br \/>\n01:35<br \/>\nphysiologic and formed from normal<br \/>\n01:37<br \/>\novulatory function they are composed of<br \/>\n01:40<br \/>\nfollicular cyst and corpus luteum cysts<br \/>\n01:42<br \/>\nand they will spontaneously resolve<br \/>\n01:44<br \/>\nfunctional cysts require surgical<br \/>\n01:45<br \/>\nintervention only if they become<br \/>\n01:47<br \/>\nsymptomatic for instance if the size<br \/>\n01:49<br \/>\nbecomes large if there&#8217;s torsion or if<br \/>\n01:51<br \/>\nthere&#8217;s uncontrolled bleeding into the<br \/>\n01:53<br \/>\ncysts which is known as a hemorrhagic<br \/>\n01:54<br \/>\ncyst<br \/>\n01:55<br \/>\nthere are three histological cell types<br \/>\n01:57<br \/>\nthat give arised a benign and malignant<br \/>\n01:59<br \/>\novarian neoplasms let&#8217;s spend a moment<br \/>\n02:02<br \/>\nto discuss these three cell types here<br \/>\n02:05<br \/>\nis the ovary and it is lined by<br \/>\n02:06<br \/>\nepithelial cells shown here in blue here<br \/>\n02:09<br \/>\nis a follicle and in the follicle there<br \/>\n02:12<br \/>\nare granulosus<br \/>\n02:13<br \/>\nand theca cells represented here in pink<br \/>\n02:16<br \/>\nthese cells are referred to as the<br \/>\n02:17<br \/>\nstromal cells the third type of cell in<br \/>\n02:20<br \/>\nthe ovary are the germ cells that are<br \/>\n02:21<br \/>\nthe precursor cells to gametes<br \/>\n02:23<br \/>\nrepresented here in purple so it is<br \/>\n02:25<br \/>\nthese three histological cell types<br \/>\n02:27<br \/>\nepithelial stromal and germ cell that<br \/>\n02:30<br \/>\ngive a rise to benign and malignant<br \/>\n02:31<br \/>\novarian neoplasms there are multiple<br \/>\n02:35<br \/>\nspecific benign and malignant tumors<br \/>\n02:37<br \/>\nwithin each of these three cell types we<br \/>\n02:40<br \/>\nwill start with benign ovarian neoplasms<br \/>\n02:42<br \/>\nabout 25% of an exome asses in<br \/>\n02:45<br \/>\nreproductive age women are benign<br \/>\n02:47<br \/>\nneoplasms the epithelial are the largest<br \/>\n02:50<br \/>\nclass of ovarian neoplasms serous<br \/>\n02:52<br \/>\nmucinous and endometrioid are the most<br \/>\n02:54<br \/>\ncommon benign epithelial neoplasms the<br \/>\n02:57<br \/>\ngerm cell type are derived from the<br \/>\n02:59<br \/>\nprimary germ cell and thus may contain<br \/>\n03:01<br \/>\nrelatively differentiated structures<br \/>\n03:03<br \/>\nsuch as hair and bone the mature cystic<br \/>\n03:05<br \/>\nteratoma known as a dermoid is the most<br \/>\n03:07<br \/>\ncommon tumor found in women of all ages<br \/>\n03:09<br \/>\nit is often in premenopausal women and<br \/>\n03:12<br \/>\ndemonstrate tissues of all three<br \/>\n03:13<br \/>\nembryologically cell types ectodermal<br \/>\n03:15<br \/>\nmesodermal and endodermal lastly the<br \/>\n03:18<br \/>\nstromal cell type benign ovarian<br \/>\n03:20<br \/>\nneoplasm is derived from specialized sex<br \/>\n03:22<br \/>\ncord stroma of the developing gonad two<br \/>\n03:25<br \/>\nexamples are fibromas or the&#8211; comas<br \/>\n03:27<br \/>\nManx syndrome is a benign ovarian<br \/>\n03:30<br \/>\nfibroma plus society&#8217;s plus a right<br \/>\n03:32<br \/>\npleural effusion let&#8217;s now move to<br \/>\n03:34<br \/>\nmalignant ovarian neoplasms epithelial<br \/>\n03:37<br \/>\ncell type consists of 90 percent of all<br \/>\n03:39<br \/>\novarian malignancies serous endometrial<br \/>\n03:43<br \/>\nmucinous and clear cell are all<br \/>\n03:45<br \/>\nepithelial malignant ovarian neoplasms<br \/>\n03:47<br \/>\nthe germ cell type is the most common<br \/>\n03:50<br \/>\novarian cancer in women less than 20<br \/>\n03:51<br \/>\nyears old<br \/>\n03:52<br \/>\nthese may be functional producing beta<br \/>\n03:54<br \/>\nHCG or alpha-fetoprotein dis German<br \/>\n03:57<br \/>\nOma&#8217;s endodermal sinus tumors and<br \/>\n03:59<br \/>\nimmature teratomas are examples of germ<br \/>\n04:02<br \/>\ncell malignant ovarian neoplasms and<br \/>\n04:04<br \/>\nlastly sex chord stromal type produce<br \/>\n04:07<br \/>\nhormones granulosa cells &#8211; MERS may<br \/>\n04:09<br \/>\nsecrete large amounts of estrogen and<br \/>\n04:10<br \/>\nsertoli related tumors may secrete large<br \/>\n04:13<br \/>\namounts of androgen these sex chord<br \/>\n04:15<br \/>\nstromal tumors are rare let&#8217;s move now<br \/>\n04:17<br \/>\nto patient presentation from malignant<br \/>\n04:19<br \/>\novarian neoplasms women most commonly<br \/>\n04:22<br \/>\npresent in their fifth decade of life<br \/>\n04:24<br \/>\nand they may present with abdominal<br \/>\n04:26<br \/>\nbloating<br \/>\n04:27<br \/>\ndistension abdominal or pelvic pain<br \/>\n04:29<br \/>\nearly satiety urinary urgency or<br \/>\n04:31<br \/>\ndecreased energy it is important to note<br \/>\n04:34<br \/>\nthat the most common symptoms are<br \/>\n04:35<br \/>\ngastrointestinal and not gynecological<br \/>\n04:38<br \/>\nsymptoms approximately one out of 70<br \/>\n04:40<br \/>\nwomen will develop ovarian cancer during<br \/>\n04:42<br \/>\nher lifetime and risk factors include<br \/>\n04:44<br \/>\nNullah parity primary and fertility<br \/>\n04:46<br \/>\nendometriosis and inherited mutations<br \/>\n04:48<br \/>\nsuch as BRCA and hnpcc protective<br \/>\n04:52<br \/>\nfactors on the other hand include taking<br \/>\n04:54<br \/>\noral contraception for at least five<br \/>\n04:56<br \/>\nyears having a history of a tubal<br \/>\n04:58<br \/>\nligation or history of a hysterectomy<br \/>\n05:00<br \/>\nmoving now to evaluation it is very<br \/>\n05:03<br \/>\nimportant for both the patient and her<br \/>\n05:04<br \/>\nclinician to be aware of early warning<br \/>\n05:06<br \/>\nsigns of ovarian cancer for radiological<br \/>\n05:09<br \/>\nimaging pelvic ultrasound is the best<br \/>\n05:12<br \/>\nfirst line test and a ca-125 is most<br \/>\n05:15<br \/>\nhelpful in postmenopausal woman with a<br \/>\n05:17<br \/>\npelvic mass this is because there are<br \/>\n05:19<br \/>\nmany cases of elevated ca-125 in<br \/>\n05:21<br \/>\npremenopausal women for reasons such as<br \/>\n05:23<br \/>\nfibroids PID and endometriosis that make<br \/>\n05:26<br \/>\nit less useful surgical exploration is a<br \/>\n05:29<br \/>\ndefinitive next step in the evaluation<br \/>\n05:31<br \/>\nwhen there is a high suspicion this<br \/>\n05:33<br \/>\nconcludes the aapko video on our variant<br \/>\n05:35<br \/>\nneoplasms we&#8217;ve discussed the<br \/>\n05:37<br \/>\ncharacteristics and management of<br \/>\n05:39<br \/>\nfunctional sister line ovarian neoplasms<br \/>\n05:41<br \/>\nand malignant ovarian neoplasms as well<br \/>\n05:43<br \/>\nas discussing the risk factors and<br \/>\n05:45<br \/>\nprotective factors for ovarian cancers<br \/>\n05:47<br \/>\nremember to always have a high clinical<br \/>\n05:49<br \/>\nsuspicion to rule out ovarian cancer<br \/>\n06:04<br \/>\nyou<\/p>\n<p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Duration = 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