FEMALE GENITAL

NEOPLASM
DR. DIAN YULIARTHA LESTARI, SPPA
 VULVA
• BENIGN EXOPHYTIC LESION
• CONDYLOMA ACUMINATE
• STD
• HPV 6&11
• MAKROS : VERRUCOUS, MULTIFOCAL,
SOLITER
• MIKROS : TREELIKE CORES, SEL
KOILOSITOSIS (+)
• SQUAMOUS NEOPLASTIC LESION
• VULVAR INTRAEPITHELIAL NEOPLASIA (VIN)
• VULVAR CARCINOMA
• 3%
• > 60 TH
• 2 GROUP :
1. BASALOID & WARTY CA  HPV (+) (30%)
2. KERATINIZING SCC  HPV (-) (70%)
• GLANDULAR NEOPLASTIC LESION
• PAPILLARY HIDRADENOMA
• MAKROS: NODUL BERBATAS JELAS
• LOKASI LABIA MAYORA/INTRALABIAL FOLDS
• MIKROS : MIRIP INTRADUCTAL PAPILOMA BREAST
 VAGINA

• VAGINAL INTRAEPITHELIAL NEOPLASIA

• SQUAMOUS CELL CARCINOMA
• 1%
• HIGH ONCOGENIC HPV (+)
 EMBRYONAL RHABDOMYOSARCOMA

• SARCOMA BOTRYOIDES
• < 5 TH
• MAKROS : POLYPOID, ROUNDED, BILKY MASSES
PROJECT OUT OF THE VAGINA
(GRAPE LIKE)
 CERVIX

• ENDOCERVICAL POLYPS
• BENIGN EXOPHYTIC
• 2-5% ADULT
• KLINIS : IRREGULAR VAGINAL SPOTTNG
 PREMALIGNANT AND MALIGNANT
NEOPLASMA
• ETIOLOGI : HPV 16&18
• RISK FACTOR:
• MULTIPLE SEXUAL PARTNERS
• MALE PARTNER WITH MULTIPLE PREVIOUS
• YOUNG AGE AT 1ST INTERCOURSE
• HIGH PARITY
• PERSISTEN HPV
• IMUNOSUPRESION
• CERTAIN HLA SUBTYPES
• ORAL CONTRACEPTIVES
• NICOTINE
CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN)
CERVICAL CANCER SCREENING
 CERVICAL CARCINOMA
• 1ST WOMEN CANCER IN INDONESIA
• MEDIAN AGED : 55 TH
• CLINICAL:
• ASYMPTOMATIC
• VAGINAL BLEEDING
• PELVIC PAIN/DYSURIA

• MAKROSKOPIS:
• MASSA EXOPHYTIC BERDUNGKUL
• ATAU ULCERASI, MERAH,
• MUDAH BERDARAH
 UTERUS - ENDOMETRIUM

• CARCINOMA OF THE ENDOMETRIUM

• 7%
• POSTMENOPAUSE WOMEN (55-65 TH)
• KX : POSTMENOPAUSE BLEEDING
• KLASIFIKASI:
• TYPE I
• TYPE II
 MALIGNANT MIXED MULLERIAN TUMORS
• = CARCINOSARCOMA
• EPITEL  ENDOMETRIAL ADENOCARCINOMA
• STROMA  MALIGNANT MESODERMAL COMPONENT (MUSCLE, CARTILAGE, OSTEOID)
• POSTMENOPAUSE WOMEN + BLEEDING
• MAKROS:
• FLESHIER
• BULKY, POLYPOID

• MIKROS
• ADENOCARCINOMA  ENDOMETRIOID, SEROUS/CLEAR CELL
• SARCOMA
 UTERUS - MYOMETRIUM

• LEIOMYOMAS
• MOST COMMON
• SINGLY/MULTIPLE
• LOKASI : INTRAMURAL, SUBMUCOSA, SUBSEROUS
• KLINIS :
• ASYMPTOMATIC
• ABNORMAL BLEEDING
• COMPRESSION OF BLADDER
• INFERTILITY
• MAKROS:
• BATAS JELAS
• BULAT, PADAT KENYAL
• PUTIH KEABUAN
• PUSARAN AIR (WHORLED PATTERN)
• MIKROS
• PROLIFERASI SEL-SEL OTOT POLOS YANG SALING BERPOTONGAN
• LEIOMYOSARCOMA
• ATYPIA (+)
• MITOSIS >10/10 HPF
• NECROSIS (+)
OVARIES
 SEROUS TUMOR
• NEOPLASMA KISTIK
• DILAPISI EPITHEL SILINDRIS/COLUMNAR – KUBOID
• SILIA (+)/(-)
• ISI : BAHAN SEROUS
• TIPE :
• BENIGN  SEROUS CYST ADENOMA
• BORDERLINE  SEROUS BORDERLINE TUMOR
• MALIGNANT  SEROUS CYST ADENOCARCINOMA

• 40% OVARIAN TUMOR

• 20-45 TH
 MUCINOUS TUMOR
• 30% OF ALL OVARIAN TUMOR
• MIDDLE ADULT LIFE
• 80% BENIGN/BORDERLINE; 15% MALIGNANT
• MAKROS :
• 5% BILATERAL
• BESAR HINGGA 25 KG
• MULTILOCULATED
• BERISI BAHAN MUCIN
PSEUDOMYXOMA PERITONII
ENDOMETRIOID TUMORS
CLEAR CELL TUMOR
BRENNER TUMOR
GERM CELL TUMOR
TERATOMA
DYSGERMINOMA
ENDODERMAL SINUS (YOLK SAC) TUMOR
SEX CORD-STROMAL
TUMOR
GRANULOSA CELL
TUMOR
THECOMA-FIBROMA
SERTOLI-LEYDIC TUMOR (ANDROBLASTOMA)
 PLACENTA - CHORIOCARCINOMA
• 1 : 20.000
• 50% BERASAL DARI MOLA HIDATIDOSA
• 25% BERASAL DARI ABORTUS
• 22 % BERASAL DARI KET
• TRIAS SUTOMO :
• PERDARAHAN
• NEKROSIS
• SEL RADANG
TERIMA KASIH