Benign Tumors

Benign Tumors

Benign Tumors

Cystic Tumors Of Vulva

Bartholins duct cyst
The most common large cyst of vulva Caused by inflammatory reaction with scaring and occlusion, or by trauma Asymptomatic, abscess Marsupialization, excision

Sebaceous cyst
The most common small cyst of vulva Resulting from inflammatory blockage of sebaceous duct Excision, heat, incision and drainage

Benign Tumors

Solid Tumors Of Vulva

Fibroma
The most common benign tumor of vulva Most commonly originate from labium major Pedunculated Asymptomatic, pain, pressure symptoms Surgical removal

Lipoma
Circumscribed tumor of fat cells Arising from the subcutaneous tissue of vulva Labium major Excision

Benign Tumors

Cystic Tumors Of Vagina

Inclusion cyst
The most common cyst of vagina Posterior or lateral wall of the lower third of vagina Resulting from laceration or episiotomy Asymptomatic, pain, dyspareunia excision

Gartners duct cyst

Anteriolateral aspect of upper vagina Remain of the mesonephric duct Asymptomatic, pain, dyspareunia excision

Benign Tumors

Solid Tumors Of Vagina

Fibroma
Arising from connective tissue and smooth muscle Dyspareunia Excision

Benign Tumors

Cystic Tumors Of Cervix

Nabothian cyst (Retention cyst)
Obstruction of the mouth of endocervical gland Caused by squamous metaplasia Asymptomatic No treatment is necessary

Benign Tumors

Solid Tumors Of Cervix

Polyps
The most common lesions of cervix Arising from the endocervix Aymptomatic, bleeding (contact bleeding) Excision, curettage

Cervical myoma
Smooth, firm mass Pressure symptoms (dysuria, urgency,) Dyspareunia Myomectomy,

hysterectomy

Benign Tumors

Endometrial Polyps
Sessile or pedunculated projection of endometrium Localized overgrowth of endometrial glands and stroma Single or multiple, most polyps arise from fundus Asymtomatic, bleeding Tip may be necrotic and inflamed or squamous metaplasia Removed by curettage or via hysteroscopy

Benign Tumors

Uterine Leiomyoma - General Consideration

Tumor of myometrium Well-circumscribed, noncapsulated Smooth muscle and fibrous connective tissue Myoma, fibromyoma, fibroma, fibroid The most common pelvic tumor Intramural, submucous, subserous, parasitic, intraligamentous

Benign Tumors

Uterine Leiomyoma - Degeneration

Resulting from alteration in the blood supply of myoma Hyaline, myxomatous, calcific, cystic, fatty, red or carneous, necrotic, sarcomatous May produce symptoms and signs that require treatment May be confused with sarcoma

Benign Tumors

Uterine Leiomyoma - Symptoms

Abnormal uterine bleeding
Excess or prolonged menses, spotting

Pressure
On bladder: urinary frequency, urgency On rectum: constipation On ureter: hydroureter, hydronephrosis

Pain
Dysmenorrhea, Pelvic heaviness or bearing down

Benign Tumors

Uterine Leiomyoma - Myoma In Pregnancy

Infertility, abortion, preterm labor, preterm rupture of membrane Red degeneration, increased pressure symptoms Fetal malpresentation, mechanical dystocia Diminished uterine contractility, postpartum hemorrhage

Benign Tumors

Uterine Leiomyoma - Diagnosis And Treatment

Diagnosis
Pelvic examination Ultrasonography

Treatment
Observation
Asymptomatic, small, postmenopausal

Medical
Symptoms treatment Reduce estrogen level GnRH analogues

Surgery
Myomectomy, hysterectomy Age, parity, future reproductive plans

Tumor embolization, RF, FUS

Benign Tumors

Functional Ovarian Cyst

Follicular cyst
Mature or atretic follicles that become distended with fluid Failure of ovulation with continued growth of the follicle Hyperstimulation from exogenous gonadotropins used to induce ovulation Asymptomatic, rupture or hemorrhage Observation, puncture, excision A result of either unusual continued growth or of hemorrhage into the luteum Torsion, rupture or hemorrhage It can simulate ectopic pregnancy excision

Corpus luteum cyst

Benign Tumors

Endometrioma Of Ovary
Small, superficial blue-black implants Large hemorrhagic cyst (chocolate cyst) Pelvic pain, dyspareunia, infertility Medical or surgical treatment

Benign Tumors

Epithelial Tumor Of Ovary

Serous cystadenoma
15-25% of all benign ovarian tumor 20-50 years old Bilateral in 12-50% 5-15cm Clear, yellow fluid No specific symptoms surgery 16-30% of all benign ovarian tumor Bilateral in 5-7% Endocervical type, intestinal type 15-30cm Sticky, slimy, or viscid material surgery

Mucinous cystadenoma

Benign Tumors

Gonadal Stromal Tumor Of Ovary

Granulosa cell tumor
Menometrorrhagia, postmenopausal bleeding TAH+BSO

Thecoma
Unilateral, encapsulated Postmenopausal bleeding TAH+BSO

Benign Tumors

Germ Cell Tumor Of Ovary

Benign cystic teratoma (mature teratoma, dermoid cyst)
Any combination of welldifferentiated ectodermal, mesodermal and endodermal elements Bilateral in 10-15%, 5-10cm Skin and skin appendages, sebaceous glands, sweat glands, hair follicles, muscle fibers, cartilage, bone, teeth, respiratory epithelium, gastrointestinal epithelium 50% asymptomatic Torsion, rupture, hemorrhage, malignant transformation

Benign Tumors

Connective Tissue Tumor Of Ovary

Fibroma
Middle age, bilateral in 2-10%, 6cm Firm, hard, smooth tumor Meigs syndrome
Fibroma Ascites Hydrothorax

Excision or TAH+BSO