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Hydatidiform mole
- Caused by fertilization of an egg with extra sperm
- Can be complete (46XX) or partial (69XXY)
- Increased hCG, abnormal vaginal bleeding
- Precursor of choriocarcinomaPartial moles present with fetal parts and snowstorm appearance on US
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Bicornate uterus
- Results from incomplete fusion of paramesonephric ducts
- Causes recurrent miscarriages in second trimester
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Eclampsia
- Hypertension, proteinuria, edema ("preeclampsia") and seizuresBegins after GW 20
- Caused by placental ischemia, due to impaired vasodilation of spiral arteries
- Treat with Mg sulfate and diazepam, to prevent seizures
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Abruptio placenta
- Premature detachment of placenta
- Presents with painful bleeding in 3rd trimester
- Associated with DIC, smoking, cocaine use
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Placenta accreta
- Placenta is attached to myometrium
- Massive bleeding after delivery
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Placenta previa
- Placenta is attached to lower part of uterus
- May obstruct os
- Causes painless bleeding in any trimester
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Ectopic pregnancy
- Most common site is ampulla of fallopian tube
- Presents with adnexal mass, abdominal pain, and increased hCG
- Can be mistaked for appendicitis
- PID predisposes
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Polyhydramnios
Esophageal or duodenal atresia
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Oligohydramnios
- Placental insufficiency or renal agenesis
- Can give rise to Potter's syndrome
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Cervical squamous cell carcinoma
- Associated with HPV 16 or 18 infection
- Can catch at early stages with koilocytes on Pap smear
- Renal failure is the most common cause of death
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Endometriosis
- Abnormal location of endometrial tissue, with cyclic bleeding from ectopic tissue
- Bloody chocolate cysts, especially in ovaries
- Chronic endometriosis is associated with IUD use and actinomyces infection
- Acute endometriosis is associated with retained products of conception
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Adenomyosis
Endometrial tissue found within myometrium
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Endometrial carcinoma
- Most common gynecological malignancy
- Presents at 55-65 y/o with vaginal bleeding
- Associated with increased estrogen (obesity, PCO, granulosa cell tumor, nulliparity)
- Diagnose on Pap smear
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Leiomyoma
- Most common tumor in women
- Benign SM tumor
- Gives rise to circumscribed masses with a whorled pattern
- Does NOT progress to leiomyosarcoma
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Leiomyosarcoma
- Bulky and irregular shape
- Hemorrhage and necrosis
- Very aggressive, can recur
- Spindle cells on histology
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PCO
- Increased LH leads to anovulation
- Ovaries are bilaterally enlarged and cystic
- Amenorrhea, infertility, obesity, hirsutism
- Increased risk of endometrial cancer
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Germinoma
- Malignant ovarian tumor
- Sheets of uniform cells
- High hCG
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Choriocarcinoma
- Can develop during pregnancy
- Characterized by large, hyperchromatic, synctiotrophoblastic cells
- Increased hCG
- Associated with hydatidiform moles
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Yolk sac tumor
- Aggressive childhood malignancy
- Yellow, friable masses
- Schiller-Duval bodies, look like glomeruli
- Increased AFP
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Mature teratoma/dermoid cyst
- Most common benign ovarian tumor
- Younger patients
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Immature teratoma
Aggressive behavior
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Struma ovarii
- Ovarian tumor that contains thyroid tissue
- Symptoms of hyperthyroidism
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CA-125
Marker of ovarian cancer
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Cystadenomas (benign)
- Serous--frequently bilateral
- Mucinous--cysts, lined by mucus-secreting epithelium
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Cystadenocarcinomas (malignant)
- Serous--bilateral, has psammoma bodies
- Mucinous--associated with pseudomyxoma peritonei
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Pseudomyxoma peritonei
Intrabdominal accumulation of mucinous material from an ovarian (mucinous cystadenocarcinoma) or appendiceal tumor
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Brenner tumor
Composed of transitional epithelium (like bladder)
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Meig's syndrome
- Triad of ovarian fibromas, ascites, and hydrothorax
- Presents with a pulling sensation in the groin
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Granulosa cell tumor
- Secretes estrogen, associated with precocious puberty and endometrial cancer
- Call-Exner bodies (small, eosinophilic follicles)
- Can cause abnormal uterine bleeding
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Krukenberg tumor
- GI malignancy that metastasizes to ovaries
- Characterized by mucin-secreting signet ring cells
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DES exposure in utero
Vaginal clear cell adenocarcinoma
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Sarcoma botryoides
- Affects young girls, presents as a grape-like mass
- Spindle-shaped tumor cells are desmin +
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