Benign Tumors Obsgin
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Benign Tumors
Benign Tumors
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Benign Tumors
Cystic Tumors Of Vulva
• Bartholin’s duct cyst– The most common
large cyst of vulva– Caused by
inflammatory reaction with scaring and occlusion, or by trauma
– Asymptomatic, abscess– Marsupialization,
excision
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Benign Tumors
• Sebaceous cyst– The most common small
cyst of vulva– Resulting from
inflammatory blockage of sebaceous duct
– Excision, heat, incision and drainage
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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
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Benign Tumors
• Lipoma– Circumscribed tumor
of fat cells– Arising from the
subcutaneous tissue of vulva
– Labium major– Excision
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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
• Gartner’s duct cyst– Anteriolateral aspect of upper
vagina– Remain of the mesonephric duct– Asymptomatic, pain, dyspareunia– excision
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Benign Tumors
Solid Tumors Of Vagina
• Fibroma– Arising from
connective tissue and smooth muscle
– Dyspareunia
– Excision
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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
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Benign Tumors
Solid Tumors Of Cervix
• Polyps– The most common
lesions of cervix
– Arising from the endocervix
– Aymptomatic, bleeding (contact bleeding)
– Excision, curettage
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Benign Tumors
• Cervical myoma– Smooth, firm mass
– Pressure symptoms (dysuria, urgency,)
– Dyspareunia
– Myomectomy, hysterectomy
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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
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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
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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
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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
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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
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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
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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
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Benign Tumors
• Corpus luteum cyst– A result of either unusual
continued growth or of hemorrhage into the luteum
– Torsion, rupture or hemorrhage
– It can simulate ectopic pregnancy
– excision
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Benign Tumors
Endometrioma Of Ovary(kista endometriosis)
• Small, superficial blue-black implants
• Large hemorrhagic cyst (chocolate cyst)
• Pelvic pain, dyspareunia, infertility
• Medical or surgical treatment
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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
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Benign Tumors
• Mucinous cystadenoma– 16-30% of all benign ovarian
tumor
– Bilateral in 5-7%
– Endocervical type, intestinal type
– 15-30cm
– Sticky, slimy, or viscid material
– surgery
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Benign Tumors
Gonadal Stromal Tumor Of Ovary
• Granulosa cell tumor– Menometrorrhagia,
postmenopausal bleeding
– TAH+BSO
• Thecoma– Unilateral, encapsulated
– Postmenopausal bleeding
– TAH+BSO
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Benign Tumors
Germ Cell Tumor Of Ovary
• Benign cystic teratoma (mature teratoma, dermoid cyst)– Any combination of well-differentiated 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
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Benign Tumors
Dermoid cyst
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Benign Tumors
Connective Tissue Tumor Of Ovary
• Fibroma– Middle age, bilateral in
2-10%, 6cm
– Firm, hard, smooth tumor
– Meig’s syndrome• Fibroma
• Ascites
• Hydrothorax
– Excision or TAH+BSO