Endometrial and Ovarian Conditions: Symptoms, Diagnosis, Treatment

Classification

• Without Atypia
• Atypical Hyperplasia (Precancerous)

Symptoms

• Postmenopausal bleeding (often prolonged)
• Irregular bleeding while on Hormone Replacement Therapy (HRT)
• No symptoms (asymptomatic)

Diagnosis

• History and Clinical Findings
• Transvaginal Ultrasound (TVUS)
• Endometrial Sampling Biopsy (Pipelle biopsy)
• Dilation and Curettage (D&C)
• Hysteroscopy with Biopsy

Treatment (Without Atypia)

• May resolve without treatment
• Progestin therapy
• Hysterectomy (if symptoms persist or recur)

Most common gynecological cancer in women.

• Primarily affects postmenopausal women.
• Often caused by unopposed estrogen exposure.
• Risk Factors: Obesity, Polycystic Ovary Syndrome (PCOS), late menopause, nulliparity.

Symptoms

• Postmenopausal vaginal bleeding (a critical symptom).

Types of Endometrial Cancer

Diagnosis

• Gynecological Exam and History
• Transvaginal Ultrasound (TVUS)
• Endometrial Biopsy (definitive diagnosis)
• Abdominal Ultrasound, CT Scan, and Chest X-ray for staging

Treatment

• Surgery: Total Hysterectomy with Bilateral Salpingo-oophorectomy
• Radiotherapy
• Chemotherapy
• Hormonal Therapy (e.g., progesterone)

Types of Ovarian Cysts

• Follicular Cyst: Forms when a follicle fails to rupture and release an egg, continuing to grow.
• Corpus Luteum Cyst: Occurs when the corpus luteum fills with fluid or blood after ovulation.

Symptoms

• Asymptomatic (often)
• Lower Abdominal Pain
• Menstrual Cycle Disorders

Complications

• Severe Lower Abdominal Pain
• Menstrual Cycle Disorders
• Hemorrhagic Shock (due to cyst rupture and internal bleeding)
• Ovarian Torsion

Diagnosis

• Ultrasound Scan (assessing chamber, size, transparency)

Treatment

• Often resolve spontaneously within 2-3 months
• Medical Management: Combined Oral Contraceptives (COCs) or Progestins
• Surgical Intervention: Cystectomy or Adnexectomy
• Indicated if symptoms increase or complications arise

Types

• Serous and Mucinous Cystadenoma
• Mature Teratoma (Dermoid Cyst)

Symptoms

• Asymptomatic (often)
• May cause lower abdominal pain
• Pelvic Pressure
• Changes in Bowel Habits

Diagnosis

• Gynecological Exam: Palpation of tumor
• Ultrasound
• Laboratory Tests: CA-125 markers (though not specific for benign tumors)

Treatment

• Asymptomatic cases: Monitoring
• Surgical Intervention: Cystectomy (cyst removal)

General Characteristics

• 90% are epithelial cancers
• 10% are Germ Cell tumors
• Highest mortality rate among all gynecological cancers

Symptoms

• Asymptomatic initially
• Often an accidental finding
• Abdominal pain, increased abdominal girth
• Weight loss
• Changes in bowel habits
• Pelvic pressure

Types of Ovarian Epithelial Tumors

• Serous Cystadenocarcinoma
• Mucinous Cystadenocarcinoma
• Endometrioid Carcinoma
• Clear Cell Carcinoma

Diagnosis and Staging

Treatment

• Hysterectomy with Bilateral Salpingo-oophorectomy
• Peritoneal Biopsy
• Lymph Node Biopsy
• Cytoreductive Surgery (to reduce tumor size)
• Chemotherapy: Carboplatin + Paclitaxel
• Regular follow-up examinations: every 3 months for 2 years, then every 5-6 months thereafter.