Benign Tumors

Benign Tumors

Benign Tumors

Cystic Tumors Of Vulva

Bartholins duct cyst

The most common large cyst of
vulva
Caused by inflammatory reaction
with scaring and occlusion, or by
trauma
Asymptomatic, abscess
Marsupialization, excision

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

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

Gartners 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

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, RF, FUS

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

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
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

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 welldifferentiated 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

Connective Tissue Tumor Of

Ovary
Fibroma
Middle age, bilateral in
2-10%, 6cm
Firm, hard, smooth
tumor
Meigs syndrome
Fibroma
Ascites
Hydrothorax

Excision or TAH+BSO