Synonyms/Description Early menopause Ovarian insufficiency Etiology Premature ovarian failure (POF) occurs in women under the age of 40 and is characterized by amenorrhea, hypoestrogenism, and elevated gonadotropins. It affects an estimated 1% of women, including 0.1% under age 30. Most cases of POF are idiopathic. There are theories that POF is the result of follicular depletion, accelerated follicular atresia, or other follicular dysfunction. There are rare…

Synonyms/Description None Etiology Endometrial polyps are relatively common intrauterine lesions that are typically benign and often asymptomatic. Hyperplastic/proliferative polyp is the most common type of polyp; it represents overgrowth of endometrial glands and stroma. Clinically they can be associated with postmenopausal and abnormal uterine bleeding as well as infertility. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become…

Synonyms/Description Polycystic ovarian syndrome (PCOS) Stein-Leventhal syndrome Etiology Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, occurring in 4% to 6% of the female population. PCOS is a complex of symptoms often associated with obesity, type 2 diabetes, metabolic syndrome, and infertility. Historically there had been a lack of consensus regarding the features that define PCOS. In 2003 a…

Synonyms/Description Ectopic location of kidney—normal variant Etiology The incidence of pelvic kidney is reported as being between 1 in 2200 and 1 in 3000. The normal human kidney migrates to the renal fossa from a pelvic location early in embryonic development, typically before the 10th week of gestation. The congenital failure of this migration results in a pelvic kidney. Although a pelvic kidney is defined as…

Synonyms/Description Varicose veins of the pelvis Etiology Although the etiology of pelvic congestion syndrome is unclear, it appears that gross dilatation, valve incompetence, and reflux of the ovarian veins may be causal. Anatomic and/or hormonal factors may lead to insufficiency of the ovarian and/or internal iliac veins, resulting in peri-ovarian pelvic varicosities. Such tubo-ovarian varicoceles may be the female equivalent of testicular varicoceles. You’re Reading a…

Synonyms/Description Adnexal cyst, mesothelial or paramesonephric cyst Etiology Paratubal and paraovarian cysts arise from the broad ligament. They constitute 10% of adnexal masses. They are usually benign but may rarely (reportedly 2%) contain malignant or borderline elements. Etiologies for paratubal cysts include mesosalpingeal cysts, hydatid cysts of Morgagni, and paratubal subserosal cysts arising from Müllerian duct remnants, as opposed to paraovarian cysts, which arise from mesonephric…

Synonyms/Description Septic pelvic thrombophlebitis (SPT) Etiology Ovarian vein thrombosis is a rare but potentially severe postpartum complication, occurring 80% to 90% of the time on the right side, and with a reported incidence of 1:600 to 1:2000 deliveries. Ovarian vein thrombosis can also occur in the immediate postoperative period after pelvic surgery or in conjunction with pelvic infection or thrombophilias such as factor V Leiden mutation.…

Synonyms/Description Adnexal torsion Etiology Torsion is defined as the twisting by at least one complete turn of the adnexa, ovary, or (rarely) the tube only around the infundibulo-pelvic and tubo-ovarian ligament, resulting in ischemia. It occurs more frequently on the right side (70%), perhaps because of a longer tubo-ovarian ligament on the right. Approximately 15% of ovarian torsions occur in children. An increase in weight of…

Synonyms/Description Ovarian carcinoma or adenocarcinoma Etiology Ovarian cancer is the second most common (endometrial is number one) genital tract malignancy (1% to 2% lifetime risk) and the most deadly (overall 5-year survival of 45%). Familial predisposition accounts for 5% to 10% of women who develop ovarian cancer and is typically associated with BRCA1 and BRCA2 gene mutations. Ovarian cancer is more prevalent with increasing age, usually…

Synonyms/Description Echogenic foci or “bright spots” of the ovary Most commonly thought to represent calcified corpora albicans Etiology In a study by Brown and colleagues, small ovarian calcifications (1 to 3 mm) were found in more than half of women examined with transvaginal ultrasound who were scheduled to undergo oophorectomy for unrelated diagnoses. The mean number of echogenic foci per ovary was 8.7 (range, 1 to…

Synonyms/Description Congenital uterine anomalies Etiology Congenital anomalies of uterine shape occur in 3% to 4% of all women. The prevalence in women with infertility and early miscarriage is up to 10%, and as high as 25% in those with midtrimester pregnancy losses. Patients with uterine shape abnormalities have an increased incidence of congenital renal anomalies such as unilateral renal agenesis. The American Society for Reproductive Medicine…

Synonyms/Description One of the epithelial-stromal tumors containing mucoid material Etiology Most mucinous cystadenomas are benign tumors, although 20% can be borderline (low malignant potential) or malignant. Benign mucinous cystadenomas represent 20% to 25% of all benign ovarian tumors and occur mostly during the third to fifth decades. These mucinous tumors are comprised most often of the mucin-producing cell type similar to a cell type that lines…

Synonyms/Description Secondary ovarian tumor Krukenberg tumor (originating mostly from the gastrointestinal tract) Etiology Metastatic tumors to the ovary account for approximately 20% of ovarian malignancies. The most common primary origins for metastatic disease to the ovary include colon, stomach, breast, and the genitourinary tract, and less commonly, lymphoma and leukemia. Krukenberg tumor is a specific term, characteristically used to describe metastatic colon or stomach adenocarcinoma to…

Synonyms/Description Lymphadenopathy Etiology Lymph nodes are common sites of metastatic disease in gynecologic tumors and are an important prognostic factor in these malignancies. For example, the 5-year survival for a patient with vulvar cancer and normal nodes is 90%, compared with a patient with nodal disease, whose 5-year survival rate is 50%. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy…

Synonyms/Description Benign metastasizing leiomyoma Etiology This is caused by intravascular proliferation of a smooth muscle, leiomyoma-like tumor, which is noninvading locally, but grows within venous channels of the uterus and pelvis as serpiginous tubular masses. This growth can be extensive and occasionally even reach the inferior vena cava and the right atrium, causing cardiac symptoms. In one study, 56% of patients with this condition had previously…

Synonyms/Description Mirena ParaGard IUD IUCD (intrauterine contraceptive device) LARC (long-acting reversible contraception) Etiology The uterus may be too small to accommodate an intrauterine device (IUD) or the IUD may not open normally because of placement or anatomic abnormalities or it may become lodged in the lower uterine segment The IUD may become embedded in the myometrium. You’re Reading a Preview Become a Clinical Tree membership for…

Synonyms/Description Fluid-filled, distended fallopian tube Etiology A hydrosalpinx is a dilated fallopian tube filled with fluid. A normal tube is not visible sonographically; however, when a tube becomes obstructed, it distends and fills with fluid, giving it a sausage-like appearance. Infection is a major cause of hydrosalpinx, also called pelvic inflammatory disease (PID), in which the tube fills with pus in the acute phase of the…

Synonyms/Description Hydrometra and hydrocolpos Pyometra and pyocolpos Etiology The most common etiology is cervical or vaginal obstruction, resulting in a collection of blood, pus, or fluid that distends the uterus or vagina. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Synonyms/Description Granulosa-theca cell tumor Sex cord–gonadal stromal tumor Etiology Granulosa cell tumors (GCTs) are relatively rare malignant neoplasms representing 3% of all ovarian cancers and 70% of tumors in the category of ovarian sex cord-stromal tumors. Granulosa cell tumors arise from a hormonally active component of the ovarian stroma that is responsible for estradiol production and hence represents 80% of hormone-producing ovarian tumors. Granulosa cell tumor…

Synonyms/Description Thecoma, fibroma, and fibrothecoma are all tumors belonging to the thecoma-fibroma group of stromal tumors (per the World Health Organization classification of ovarian sex cord–stromal tumors). Etiology Thecoma-fibroma tumors are a closely related group of benign tumors that arise from ovarian stroma and are often difficult for the imager and even pathologist to distinguish. The fibroma contains spindle cells, and is the most common type…