Benign Tumors

Benign Tumors

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

Benign Tumors

• 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

Benign Tumors

• 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

• Gartner’s 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

Benign Tumors

• 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

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

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

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

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

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

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 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

Benign Tumors

Dermoid cyst

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