Adnexal Mass Evaluation Guide

Adnexal Masses Todd D. Tillmanns MD Associate Professor Division of Gynecologic Oncology University of Tennessee And West Clinic

Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epithelial Ovarian Carcinoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ovarian Serous Cystadenocarcinoma ,[object Object],[object Object],[object Object]

Ovarian Papillary Serous Cystadenocarcinoma ,[object Object]

Ovarian Mucinous Cystadenocarcinoma ,[object Object],[object Object],[object Object]

Endometrioid Adenocarcinoma ,[object Object],[object Object],[object Object],[object Object]

Sex Cord Stromal Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Granulosa Cell Tumor ,[object Object],[object Object],[object Object]

Germ Cell Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sertoli Leydig Tumor ,[object Object],[object Object],[object Object]

Benign Adnexal Masses ,[object Object],[object Object],[object Object],[object Object]

Simple follicular cyst ,[object Object]

Corpus Luteum Cyst ,[object Object],[object Object]

Paratubal Cyst ,[object Object],[object Object],[object Object]

Mature Cystic Teratomas ,[object Object],[object Object],[object Object],[object Object]

Ovarian Fibroma ,[object Object]

Endometrioma ,[object Object],[object Object],[object Object],[object Object],[object Object]

Leiomyomata ,[object Object],[object Object]

Tuboovarian Abscess ,[object Object],[object Object]

Screening Guidelines ,[object Object],[object Object]

Screening Guidelines ,[object Object],[object Object],[object Object],[object Object]

Screening Guidelines ,[object Object],[object Object],[object Object]

Ovarian Cancer Screening Trials ,[object Object],[object Object],[object Object]

GOG-199 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Screening Recomendations ,[object Object]

Who Should be Referred According to ACOG ,[object Object],[object Object],[object Object],[object Object],[object Object]

OVA1 ,[object Object],[object Object]

Hereditary Risk ,[object Object],[object Object],[object Object],[object Object],[object Object]

Conditions found in association with increased CA-125 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Morphology Index for Tumors ,[object Object],De Priest et al. Gynecol Oncol 1993;51:7-11 Predom Solid Solid area > 10 mm Thick Septa 3 mm-10 mm Thin septa < 3mm No Septa Septa Structure Predom solid Papillary Projection > 3 mm Papillary Projections < 3 mm Smooth >3 mm thickness Smooth <3 mm thickness Cyst Wall Structure >500 cm 3 >200-500 cm 3 >50-200 cm 3 10-50 cm 3 <10 cm3 Volume 4 3 2 1 0

Morphology Index in Premenopausal Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],De Priest et al. Gynecol Oncol 1993;51:7-11

U/S Scoring System to Differentiate Benign from Malignant ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Alcazar JL et al. Am J Obstet Gynecol 2003;188:685-692

Multivariate Significant Parameters on U/S ,[object Object],[object Object],[object Object],[object Object],[object Object],Alcazar JL et al. Am J Obstet Gynecol 2003;188:685-692

Prospective U/S Studies with Scoring Systems in use ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Sassone AM et al. Obstet Gynecol 1991;78:70-6 // De Priest et al. Gynecol Oncol 1993;51:7-11 // Ferazzi E et al. Ultrasound Obstet Gynecol 1997;10:192-7 // Alcazar JL et al. Am J Obstet Gynecol 2003;188:685-692

Ultrasound / CT ,[object Object],[object Object],Ultrasound

CT –vs- U/S to diagnose Premenopausal Adnexal Masses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Mallarini GS.etal. Ultra Obstet Gynecol 1997;9:339

U/S Adnexal Mass > 3 cm ,[object Object],[object Object],[object Object],[object Object],[object Object],Osmers RGW et al. Obstet Gynecol 1996;175:428-434

1072 Consecutive Ovarian tumors in Premenopausal Women ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Functional Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Osmers RGW et al. Obstet Gynecol 1996;175:428-434

Ovarian Cancer and Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Smith LH et al. Obstet Gynecol 2003;189:1128-1135

Adnexal Masses in Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Sherard GB et al. Obstet Gynecol 2003;189:358-362

Ovarian Conservation -vs- Oophorectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Parker, WH et al. Ovarian Conservation at the time of hysterectomy and long term Health Outcomes in the Nurses’ Health Study. Obstet Gynecol 2009;113:1027-1037

Specific Guide Line Work Up History & Physical CXR, abd/pelvic CT scan or U/S Obtain family cancer history CA 125, CBC, Chem Profile, BE/colonoscopy if symptomatic Adnexal Mass Surgical Candidate? Counsel Patient on Risks of Pregnancy Loss, Preterm Delivery, Fetal Morbidity, Torsion, Possibility of benign disease –vs- LMPT –vs- Malignancy

Questions / Comments Even my family has stopped listening to me! Love is unconditional with Nora

Adnexal Mass Evaluation Guide

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Andere mochten auch

Andere mochten auch (6)

Ähnlich wie Adnexal Mass Evaluation Guide

Ähnlich wie Adnexal Mass Evaluation Guide (20)

Mehr von University of Tennessee Memphis Obstetrics and Gyncology

Mehr von University of Tennessee Memphis Obstetrics and Gyncology (8)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Adnexal Mass Evaluation Guide