The primary role of Sonography in the evaluation of ovarian masses:
To indicate the need for surgical or medical intervention
The majority of ovarian masses are:
Of the epithelial ovarian tumors that occur before menopause, _____ are malignant.
Of the epithelial ovarian tumors that occur after menopause, _____ are malignant.
The more complex the ovarian tumor is sonographically, the ______ likely it is to be malignant.
The presence of ascites with an ovarian tumor_____ the likelihood of malignancy.
Serous ovarian tumors are typically _____.
___% of serous ovarian tumors are bilateral.
When one ovary is _____ than the other one, it is considered abnormal.
Two times larger
Ovarian masses can be differentiated from pedunculated fibroids by:
Identifying a connection to the uterus
Doppler of the ovaries should be preformed:
On every exam
The normal ovarian artery should have an RI of _____.
_____ are the most common cause of ovarian enlargement in premenopausal women.
_____ occurs when the follicle fails to rupture or degenerate.
_____ are usually simple cysts.
_____ occur when the corpus luteum fails to degenerate or has excessive bleeding.
Corpus Luteum Cyst
_____ are common during the 1st trimester of pregnancy.
Corpus Luteum Cysts
Follicular cysts are usually _____.
_____ is sometimes used to encourage regression of follicular cysts.
Resolution of a corpus luteum cyst usually occurs by the _____ week of pregnancy.
Doppler flow to a corpus luteum cyst is _____.
Polycystic ovarian disease is a _____ disorder.
Polycystic ovarian disease is associated with _____.
_____ arise from the broad ligament and account for about 10% of adenexal masses.
The size of a _____ does not change with the ovarian cycle.
_____ are more likely to have their shape changed by adjacent structures because they are not surrounded by ovarian tissue.
_____ are bilateral, large, complex ovarian masses that are associated with molar pregnancies.
An increased incidence of _____ is associated with the use of Pergonal for infertility.
Odd shaped fluid collections in the abdomen may be created by _____.
Small simple ovarian cysts occur in female fetuses and newborns due to _____.
Simple ovarian cysts in postmenopausal women that measure _____ are not likely to be malignant.
_____ is a blood test that may be used to help screen for ovarian cancer.
_____ often makes ovaries difficult to see due to blurring of tissue planes & adhesions.
The term adenoma refers to a _____ tumor.
The term adenocarcinoma refers to a _____ tumor.
_____ is a benign tumor that is quite large and is lined with mucinous elements from the cervix and/or bowel.
_____ tumors often appear sonographically as a multiloculated tumor with differing echogenicities within the different compartments of the tumor.
Mucinous Cystadenoma is usually _____.
Mucinous Cystadenocarcinoma is usually _____.
Mucinous Cystadenoma are prone to rupture, causing _____.
_____ are the second most common benign ovarian tumor and are usually unilateral.
Which is larger?
a. Serous Cystadenoma
b. Mucinous Cystadenoma
_____ is made up of septated cysts with nodules along the walls and irregular borders.
_____ is the most common ovarian cancer.
In cases of serous ovarian tumors, bilateral tumors suggest _____.
In cases of serous ovarian tumors, ascites develops due to _____.
Peritoneal Tumor Implants
_____ is a rare, malignant tumor of the ovary that is resistant to chemotherapy.
Clear Cell Carcinoma
The majority of germ cell tumors are _____.
_____ are germ cell tumors that arise from a single oocyte.
_____ are the most common tumor of the ovary.
About 80% of Dermoids are found in women of ____-____ age.
_____ is another name for dermoid.
_____ of Dermoids have cystic component.
_____ is a very rare Teratoma made up of thyroid tissue.
Teratomas are more likely to become malignant in women who are ____.
Over 40 years old
_____ often contain fat, teeth, and hair.
_____ is a malignant tumor that usually occurs in women less than 30 years old.
_____ are malignant, fast-growing tumors that occur in women 10-20 years of age.
_____ tumors are usually very hypoechoic, solid, adnexal masses that occur in middle-aged women.
_____ is a complication of fibroma tumor involving massive ascites and pleural effusion.
_____ is a rare ovarian tumor that secretes estrogen.
_____ is usually unilateral and may resemble endometrioma.
_____ is an ovarian tumor that secretes androgens.
_____ is the leading cause of death from gynecologic malignancy in the U.S.
About _____ of patients suffering from ovarian carcinoma are over 50 years old.
Ovarian cancer is easily detectable in the early stages because of early onset of symptoms. T or F
The five-year survival rate for Stage I ovarian cancer is:
The five-year survival rate for Stage IV ovarian cancer is:
The strongest risk factor for ovarian cancer is:
Family history of ovarian or breast cancer
Over _____ of women are in advanced stages of ovarian cancer by the time they see their doctor.
_____ is caused by rotation of the ovary, twisting the blood vessels closed.
Ovarian Torsion (ovary will be enlarged)
Ultrasound of the ovaries is used throughout the menstrual cycle to help with _____ of medication and/or insemination of infertility patients.
Transvaginal sonography is used to _____ oocyte harvest and placement of embryos into the endometrial cavity during in-vitro fertilization.
_____ refers to a group of tumors that arise from the chorionic villi of the placenta.
Gestational Trophoblastic Disease
Abnormal proliferation of the trophoblast leads to _____.
_____ refers to a pregnancy in which no fetal pole develops. A gestational sac is seen and sometimes a yolk sac is seen.
_____ is another name for an embryonic pregnancy.
_____ is the most common form of trophoblastic disease and is benign.
Increased maternal age leads to a/an _____ risk for molar pregnancy.
Previous history of molar pregnancy leads to a/an _____ risk for molar pregnancy.
A _____ has only trophoblastic material and no fetal parts.
Complete Molar Pregnancy
_____ occurs when a sperm fertilizes an ovum that contains no chromosomes.
Complete Molar Pregnancy
_____ occurs when two sperm fertilize an ovum.
Partial Molar Pregnancy
_____ has an abnormal placenta and an abnormal fetus.
Partial Molar Pregnancy
When the mother has vaginal bleeding and is in danger of losing the pregnancy, but the fetus is still alive and in the uterus, it is referred to as:
When the mother has vaginal bleeding and the sonogram demonstrates no fetal heart beat and a flattened gestational sac on its way out of the uterus, it is called:
When the mother has a vaginal bleeding and the sonogram demonstrates an empty uterus and normal adnexa, it is called:
If a complex mass in a gestational sac is seen within the uterus and the HCG levels are falling, it is consistent with:
If a complex mass in a gestational sac is seen within the uterus and the HCG levels are very high, it is consistent with:
Patients with _____ typically present with severe nausea and vomiting and abnormally high HCG levels.
In a molar pregnancy, the Doppler waveform in the mass will be _____.
Molar pregnancy is said to look like _____ on ultrasound.
Bunches of grapes
_____ are locally invasive but do not metastasize.
Invasive Molar Pregnancies
_____ is both locally invasive and will develop distant mets.
What characteristics help the sonographer distinguish between hydropic degeneration of the placenta and molar pregnancy?
• Increased HCG levels
• Normal fetus
Mrs. Smith went to the doctor because her abdomen was becoming more and more distended. Sonography demonstrated a large, septated, vascular ovarian mass, ascites, and three hypoechoic masses in the liver. What is the probable diagnosis? What stage is it?
Ovarian Serous Cystadenocarcinoma
Mrs. Johnson went to the doctor complaining of pelvic fullness. Sonography demonstrated a large, septated ovarian mass and mild ascites. CT demonstrated no lymph node involvement, uterine involvement or distant mets. Her diagnosis was ovarian cancer. What stage was it?
What are the three main sonographic categories of ovarian mass?
What characteristics must be present to classify an ovarian cyst as a simple cyst?
• Smooth walled
• Posterior enhancement
Abnormal Doppler waveforms of ovarian vessels can be seen in what conditions besides cancer?
• Ectopic pregnancy
• Corpus luteum cysts
Describe the two possible explanations for how endometriosis happens:
• Reflux out of tubes and implants in pelvis
• Stem cells develop into endometrial tissue due to hormonal stimulus causing irritation
What lab values need to be investigated when there is a suspected germ cell tumor of the ovary?
Sally went to the emergency room with extreme pain in the right side of her pelvis. Sonography demonstrated a large, hypoechoic right ovary with no Doppler signal. What was the probable diagnosis?