Table of contents
- 1. Cervical Cancer
- 2. Ovarian Cysts
- 3. Fibroids
Cervical Cancer
Pathology:
Ovarian Cysts
- Usually benign
- Do not cause pain, unless extremely large, or there is torsion, or hemorrhage
- Investigate with U/S; (i.e. hemorrhagic cyst, may be causing pain).
- Can decrease in size with OCP?
Table 1: The risk of malignancy index (RMI) scoring system
| Feature | RMI 1 Score | RMI 2 Score |
| Ultrasound features:
| 0= none
| 0= none
|
| Premenopausal | 1 | 1 |
| Postmenopausal | 3 | 4 |
| CA125 | U/ml | U/ml |
| RMI score = ultrasound score x menopausal score x CA125 level in U/ml. | ||
Four cohort studies exploring the role of RMI scores were identified. Three of these studies compared the two RMI scores using cut-off values above 200 to indicate malignancy. The RMI 2 score was more sensitive than the RMI 1 system with results of 74 to 80% at a specificity of 89 to 92% and positive predictive values around 80%. Evidence level 2+
Fibroids
- Aka leiomyoma
- Usually beign
- Pain: usually no pain Except:
- submucosal or pedunculated and undergoing torsion
- undergoing "Red Degeneration" - fast growth in high-estrogen environment (i.e. pregnancy), and outgrowing blood supply.
- Usually present with bleeding (especially if submucosal) and may cause infertility.
- Often co-exist with endometriosis.
- Can decrease in size or limit growth and bleeding with OCP.
...end of document
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