Pelvic Masses
Dr Jeffrey Kalei
Author and illustrator for Hyperexcision. Interested in emergency room medicine. I have a passion for medical education and drawing.
Uterine Fibroids
Fibroids are benign smooth muscle neoplasms arising from myometrial cells. They are oestrogen and progesterone–sensitive, with an average growth rate of 0.5 cm They peak between 40 and 50 years of age. Fibroid degeneration Type of Degeneration Description Hyaline degeneration (most common, ~60%)…
Endometrial Cancer
Endometrial cancer is an epithelial malignancy of the uterine corpus mucosa. 90% are adenocarcinomas. It is characterised by abnormal uterine bleeding, particularly post-menopausal bleeding. It peaks between 60 and 70 years. Types of endometrial cancer Type I Type II Unopposed estrogen Present Absent Estrogen…
Endometrial Hyperplasia
Endometrial hyperplasia is the proliferation and thickening of the endometrium. It is usually considered in post-menopausal women with an endometrial stripe measuring > 5 mm thick with post-menopausal bleeding, and > 10 mmthick without. Normal endometrial thickness variations during the menstrual cycle Phase Endometrial…
Adenomyosis
Adenomyosis is uterine enlargement due to focal or diffuse ectopic rests of endometrial tissue within the myometrium. It is most likely due to direct invasion of the endometrium into the myometrium. It is characterised by abnormal uterine bleeding and secondary dysmenorrhea. It peaks between 40 and…
Endometriosis
Endometriosis is the presence of endometrial glands and stroma outside the endometrial cavity. It presents with cyclical pelvic pain and severe dysmenorrhoea since it is oestrogen and progesterone-sensitive.
Cervical Cancer
Cervical cancer is a malignant neoplasm arising from the cervical epithelium. It is strongly associated with the human papillomavirus (HPV). 80% are squamous cell carcinomas, while 20% are adenocarcinomas. It peaks between 30 and 40 years. FIGO Staging and Treatment…
Vulvovaginitis
Vulvovaginitis Trichomoniasis Candida vaginitis Bacterial vaginosis Physical Exam Erythema and irritation Erythema and irritation Unremarkable Discharge Yellow-green, malodorous “Cottage-cheese”like Gray/White, “fishy Wet mount “Motile, flagellated protozoa Nothing Clue cells KOH prep Nothing Pseudohyphae, spores + whiff test pH Elevated (> 4.5) Normal (4.0…
Vulvar Cancer
Vulvar carcinoma is a malignant neoplasm that can arise from anywhere between the mons pubis and the perianal region. 90% of vulvar cancers are squamous cell carcinomas. Other histological subtypes include melanoma and Bartholin’s gland adenocarcinoma. Vulvar intraepithelial neoplasia (VIN)…
Benign Epithelial Lesions of the Vulva
Benign Epithelial Lesions of the Vulva Disorder Features Management Lichen simplex chronicus Thickened, discolored epithelium caused by chronic scratching. Leathery appearance. Medium-potency corticosteroid (Betamethasone) Lichen sclerosis Symmetric thinning of labial skin (cigarette paper or parchment-like), distortion of normal anatomy and/or…