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Fibrocystic breast changes
Paget disease of the breast
Intrauterine growth restriction
Pelvic inflammatory disease
Gestational trophoblastic disease
Germ cell ovarian tumor
Polycystic ovary syndrome
Premature ovarian failure
Sex cord-gonadal stromal tumor
Surface epithelial-stromal tumor
Congenital cytomegalovirus (NORD)
Congenital rubella syndrome
Neonatal herpes simplex
Preeclampsia & eclampsia
Female sexual interest and arousal disorder
Genito-pelvic pain and penetration disorder
Fetal alcohol syndrome
Fetal hydantoin syndrome
Androgen insensitivity syndrome
Hypospadias and epispadias
Benign prostatic hyperplasia
Male hypoactive sexual desire disorder
Amenorrhea: Pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Cervical cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sex chromosomes: Pathology review
Disorders of sexual development and sex hormones: Pathology review
HIV and AIDS: Pathology review
Ovarian cysts and tumors: Pathology review
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Testicular and scrotal conditions: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Vaginal and vulvar disorders: Pathology review
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Granulosa Cell Tumor
Yolk Sac Tumor
65-year-old Rebecca presents to the clinic with several months of abdominal discomfort, bloating, and a change in bowel habits. Her past medical history is significant for endometriosis. Menarche was at age 10 and menopause at age 57. She has never been pregnant. On physical examination, a slightly painful nodule is palpated around the umbilicus. Transvaginal ultrasound showed a large, irregular cyst with heterogeneous fluid in her right ovary. Later that day, 6-year-old Gloriana is brought to the office by her mother, who is worried that her daughter is more “womanly” and taller than the other girls her age. Over the last few months, she has also occasionally complained of vague abdominal pain. Physical examination reveals coarse pubic hair and significant breast enlargement. The child’s height is also in the 96th percentile. Laboratory studies also showed increased inhibin b levels.
Based on the initial presentation, Rebecca and Gloriana’s symptoms are caused by some form of ovarian mass. Broadly speaking, ovarian masses include ovarian cysts and tumors. Starting with ovarian cysts, these are fluid-filled sacs on or in the ovaries and can be classified into simple and complex cysts.
Simple cysts are generally small, they contain a clear serous liquid, and have a smooth internal lining. The classic example is a follicular cyst which is a dominant follicle that fails to rupture before ovulation and keeps growing. This can happen, if say, the normal surge of LH that causes ovulation just doesn’t happen during a given menstrual cycle. In fact, follicular cysts are the most common type of ovarian mass in young individuals.
For your test, remember that if you encounter multiple follicular cysts, they are usually associated with polycystic ovary syndrome, or PCOS. This is caused by a dysfunction in the hypothalamic-pituitary-ovarian axis that causes chronic anovulation, which may lead to amenorrhea, or absent menstruation, and excess androgen production, which may lead to hirsutism.
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