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Objectives
• List benign neoplasms of the vagina, cervix, uterus, and
ovaries.
Chapter 8
Benign Disease of the Female
Pelvis
Susan Raatz Stephenson
• Summarize the results of surgery and trauma to the
uterus i.e synechiae, uteruine dehiscence.
• Distinguish extrauterine masses such as abscesses,
hematomas, lymphceles, and appendicitis from uterine
masses.
• List types of ovarian cysts, cause and their sonographic
appearance.
• Explain the results and imaging appearance of ovarian
torsion.
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Nabothian Cysts
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Nabothian Cysts
• Retention cyst of the nabothian gland
• Asymptomatic
• Common finding
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Endometrial Hyperplasia
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Endometrial Hyperplasia
• Excessive growth of the endomterium
• Due to
– High estrogen levels
– Hormone replacement therapy
– Tamoxaphin therapy
– Diabetes
– Obesity
– PCOD/anovulatory cycles
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
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Endometrial Hyperplasia
Endometrial Hyperplasia
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Asherman Syndrome / Synechaie
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Asherman Syndrome / Synechiae
• Adhesions of the endometrium
• Due to
– Trauma
– Surgery
• Cesarean section
•D&C
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Asherman Syndrome / Synechiae
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Uterine Diheiscence
• Rupture of a uterine scar
• Due to
– Myomectomies
– Instrument perforation
– Caesarian section
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Uterine Dehiscence
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Leiomyoma
Uterine Dehiscence
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Leiomyoma - Locations
• Most common pelvic tumor
• Benign tumor of the uterus
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Leiomyoma
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Leiomyoma – Degenerative Changes
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Leiomyoma – Pedunculated
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Leiomyoma – Calcified
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Ovaries – Functional Cysts
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Leiomyoma – Submucosal
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Ovaries – Functional Cysts
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Ovaries – Corpus Luteum
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Ovaries – Corpus Luteum
Ovaries – Theca Lutein
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Ovaries – Hemorrhagic Cysts
• Symptoms
– Acute onset of pain
• Differentials
– Ectopic pregnancy
– Tubal infection
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Ovaries – Hemorrhagic Cysts
• Appearance
dependent on age
– Acute
• Anechoic
– Late acute
• Solid mass
– Resolving
• Complex mass
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Ovaries – Torsion
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Ovaries – Torsion
• Partial or complete rotation of the ovary
• Due to
– Mass
– Cyst
– Hyperstimulation
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Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS)
• Complex process due to androgen disorder
• AKA Stein-Leventhal syndrome
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Polycystic Ovary Syndrome (PCOS)
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Polycystic Ovary Syndrome (PCOS)
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Polycystic Ovary Syndrome (PCOS)
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Cystic Teratoma
• Common germ cell
tumor
• Contains
• Symptoms
– Pain with torsion
– Mass on clinical
exam
– Hair
– Teeth
– Thyroid tissue
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Cystic Teratoma
Cystic Teratoma–Sonographic Appearance
• Predominately cystic mass
• Calcifiations
• Fat-fluid level
• Shadowing
• Echogenic foci
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Cystic Teratoma–Sonographic Appearance
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Serous Cystadenoma
• Mucinous secreting tumor
• Large
• Unilateral
• Fluid images with pinpoint echoes
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Serous Cystadenoma
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Serous Cystadenoma
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Meig’s Syndrome
• Triad of
• May image with
– Ovarian tumor
– Sertoli-Leydig Cell
– Ascites
– Gonadoblastoma
– Pleural effusion
– Granulosa Stromal
Cell Tumors
– Ovarian Sex CordStromal Tumors
– Brenner Tumors
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