Dr. H. ASROL BYRIN, SpOG(K)

BENIGN TUMOR of THE REPRODUCTION ORGAN

A. Tumor KistikB. Tumor Solid

Tumor Kistik1. Inclution cyst Caused by laceration of episiotomy laceration or

tear, located beneath the epithel of vulva, vagina, or

perineum2. Gartner Cyst Came from the rest of mesonefric (Wolfii duct),

witth thin wall covered by cuboid or thorax epithelial, with

clear liquid3. Nuck cyst (Hidrocele of the Nuck cyst) Came from the rest of processus of peritonealis

vagina4. Bartholin cyst Caused of inflammation

5. Sebacea cyst from sebacea gland, mostly at labium mayora et

minora, epithelial wall, with cholesterol cystals inside

6. Hydradenoma Usually cyst, but could be solid, from the sweat

gland, in labia mayora et minora and perineum, similar to adenocarcinoma, rare become malignancy

7. Fox-Fordyce disease From the sweat gland, as retention cyst, located

in labia mayora and mons veneris, onset after the puberty, itchy

8. Paraurethralis cyst (Schene) Caused by inflammation, especially GO

A. Epithelial tumourTumor Epitel1. Acuminatum condilom Cauliflower, hyperkeratosis, soliter or grouping 2. Carunculae urethrae Came from the posterior wall of ectropin from the

distal urethrae3. Pigmented nevus 40% become malignancy (malignant melanom)

B. Mesodermal tissue tumour1. Fibroma connective tissue, located at the labia mayora, soft to

solid, greyish white2. Lipoma From the fat tissue, the progression was slowly

3. Leiomyoma From the element of the smooth muscle of

Round ligament4. Neurofibroma From the myelin, polypoid, colour like meat5. Hemangioma Not a real neoplasm, with blood inside and

endothel cell as the wall (cavernous hemangiona) 6. Limfangioma From the limph, no need for therapy

MESODERMAL TISSUE TUMOUR

A. Cyst tumour 1. Inclution csyt 2. Gartner cyst 3. EndometriosisB. Solid tumour 1. Acuminate condyloma 2. Fibroma 3. Leiomyoma 4. Fibroma 5. Hemangioma 6. Adenosis Vaginae

UTERUS

Polyp : 1-2 % Mostly 40-60 years old soliter Stalk Protruding from the OUE Flat surface Soft consistention Pink-maroon in colour Etiology not exactly knnown Sometimes leukorrhea, spotting

intramenstrualand postcoital bleeding

Gambar Polip Serviks Uteri

PolYp :1. Endometrial polyp2. From the uterine myoma3. Placental polyp

Endometrial polyp From the endommetrium pedunculated in the uterine cavity Have a conection with Malignancy was possibility : adaendometrial

hyperplasia

UTERINE BODY

Bening neoplasm from the uterine musccle Uterine Fibroma, uterine leiomyoma or

fibroid

Causa:“Theory of Estrogen Stimulation” Growing fast in pregnancy Never found before menarche Atrophy after the menopause Often found together with endometrial

hhyperplasia

“ Theory of Nest Cell” Immatur muscle cell that trigger all the time

by oestrogen

UTERINE MYOMA

Pathology :Servix of the uterine (3%), uterine body(97%)Intramural myoma, Submucous myoma, and subserous myomaPedunculated myoma or Geburt myoma, wandering fibroidMostly in nullipara, rarely in < 20 years and > 40 years

Secunder changingAtrofiHyalin degenerationCalciferous degenerationRed degeneration

UTERINE MYOMA

Berbagai Jenis Mioma Uteri

Bertangkai di vagina

Intraligamenter

Bertangkai di fundus

Subserosa

Submukosa

Mioma Submukosum diLahirkan ke Vagina

Complication : Growing of leiomyomatousTorsionNecrosis and infection

Sign and symptoms :Abnormal bleeding, mostly hypermenorrhea, buat sometime metrorrhagiaPain caused by pressure of the tumour to ureter, renal, rectum, venous system or torsion of the stalkInfertility and abortion

UTERINE MYOMA

Uterine myoma to pregnancy :No effectInfertilityAbortusmalpositionAvoidinh the lowest part to downwardInertia and atonia of the utrineHard to remove the placenta

Pregnancy to uterine myoma :Getting bigger in pregnancyRed degenerationTorsion

UTERINE MYOMA in PREGNANCY

Therapy :55% no need therapySymptomatic therapy while waiting definitif therapyOperatif : miomectomy dan hysteretomy

UTERINE MYOMAUTERINE MYOMA in PREGNANCY

I. Non neoplastic tumour :1. Tumour caused by inflammation2. Another tumour

2.1 Follicle cyst2.2 Corpus lutein cyst2.3 lutein cyst2.4 Germinal inclution cyst2.5 Endommetrial cyst2.6 Stein Leventhal cyst

BENIGN TUMOUR Of THE OVARIUM

II. Neoplastic beningn tumour A. Cyst

1. Simplex ovarian cyst2. Serous ovarian cystadenoma3. Mucinous ovarian cystadenoma4. endometrioid cyst5. dermoid csyt

B. Solid1. fibroma, leiomyoma, fibroadenoma, papilloma,

angioma, limfangioma2. Brenner tumour3. Masculinoblastoma

CAUSE OF GROW :abdominal enlargementPressure on the surrounding area disturbance of micturition, obstipation

RESULT of THE HORMONAL ACTIVITYdoesn’t change menstrual cycle, unless if the tumour produce hormone

COMPLICATIONBleeding intio the cysttorsion of the stalkinfection of the tumour laceration of cyst wallmalignancy chhanginng

SINDROM MEIGS40% case of ovarian fibroma, accompany with asccites and hydrothorax, this kasus fibroma ovarii ditemukan asites dan hidrotorak

Metode to diagnosis:

Laparoskopi: to know is the tumor came from ovarium or notfor to know the characteristisc of the tumor

Ultrasonografi :can fixed the place and the border of the tumor, does it came from uterus or ovarium

Foto Rontgen :to fixed the hidrothorak on dermoid cyst can see the teeth on tumor

Parasentesis :can fixed the ascites cause

Diagnosis of ovarian tumour

PRINCIPALNeoplastic ovarian tumour operationNonneoplastic ovarian tumour not operation

OPERATION :Non malignnat neoplastic tumour Recection on the part of ovarium which is tumor is biggest (salpingo-ooforektomi) durante operation, tumor ovarium as soon as posible have to opened malignant/notif worry frozen section if malignant histerektomi dan salpingo – ooforectomi bilateral

MANAGEMENT