Benign ovarian tumour

Benign ovarian tumour-
80%of ovarian tumour are benign.They can become secondary malignant however.
symptoms_1 abdominal swelling upto 50 kg ovarian tomour hv been noted. 2 irregular menstrual cycle-theca granulosa cell tumour_oestrogen secretion which cause menorrhagia..
Musculizing tumour_amenorrhoe and virilization.
Brenner tumour_postmemopausal bleeding.
3 pressure symptoms-frequency of micturation,retention,pressure on rectum,dyspnoa,palpitation,bialateral pitting oedema of foot.
4 normally there is no pain but acute abdominal pain may occure if ovarian tumour undergoes torsion or rupture.
Physical sign-
inrpectiön-abdominal swelling formed by abdominal cyst.Abdominal wall moves with deep inspiration.Symmetrical position of tumour in abdomen.
Palpation-upper and lateral limit of tumour can b defind.Sooth surface. Small cyst.,tense and cystic.Large tumour is fixed. Fluid thrill can b illiciated.
dull over centre of tumour.Resonat over flank.
 Bimannual examinatiön-
small tumour-uterus can b identified without difficulty.Cyst usually displace uterus to opposite side..If there is hard nodule it indicate malignancy.
1 full bladder. 2 pregnant uterus
3 myoma 4 ascites
1 Radiograph of abdomen and pelvis-soft tissue shadow,teeth in dermoid.
2 Diagnostic laparoscopic examination,iv pyelography excledes hydronephrosis.
3 Breast examinatiön to exclue pregnancy.
4 ultrasönograqy.
Benign cyst shows these features-unilateral,unilocular/multilocular with thin wall non-echogenic cavity,tumour marker CA 125 <35 unite/ml.
5 colour flow doppler-
neovascularization in malignant form.
6 CT MRI to identify dermoid cyst,haemorrhage cyst.
7 tissue marker CA 125 >35 unit/ml
CEA >5 mg/lit in mucinous ovarian tumour.
8 cytological study of ascitic fluid or aspirated cystic fluid.
laparotomy is needed.
Abdominal hysterctomy and bilateral salpingo-oophorectomy in perimenausal women.
Histological specimen may discover microscopic evidence of malignancy and thereby need of secondary surgery is avoided.
conserve healthy overy in young pt.
Clamp infudibulo pelvic ligament laterally mesovarian in middle,fallopian tuae ,overian liagment medially.
Laperoscopic cystectomy/ovariotomy_ minimal invasive surgery in vague for small cyst.
First aspirate cystic fluid,then dissect cyst wall.

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