Ovarian tumors are classified as benign (neoplastic and nonneoplastic), premalignant, or malignant. Benign nonneoplastic disease of the ovary is usually of an inflammatory or infectious nature and is discussed in Chapter 24 and Chapter 28. Table 23-1 details a classification of nonneoplastic ovarian lesions, Table 23-2 is the WHO classification of ovarian neoplasms, and Table 23-3 gives the characteristics of common ovarian neoplasms. | THE OVARY AND OVIDUCTS OVARY Ovarian tumors are classified as benign neoplastic and nonneoplastic premalignant or malignant. Benign nonneoplastic disease of the ovary is usually of an inflammatory or infectious nature and is discussed in Chapter 24 and Chapter 28. Table 23-1 details a classification of nonneoplastic ovarian lesions Table 23-2 is the WHO classification of ovarian neoplasms and Table 23-3 gives the characteristics of common ovarian neoplasms. BENIGN OVARIAN NONNEOPLASTIC CYSTS The clinical assessment and therapy of benign ovarian masses have been greatly aided by modern imaging techniques and the use of oral contraceptives to decrease pituitary gonadotropin stimulation. Sonographic scanning is the most frequently applied imaging technique for ovarian masses. Imaging modalities aid in the differentiation of ovarian enlargements from other masses or fullness in the pelvis determine the structure of a tumor solid or cystic multi-locular or unilocular determine the size of a tumor often difficult by physical examination in obese patients and document the change in size of masses over time. In complex cases . cancer more sophisticated imaging techniques . MRI may assist in preoperative determinations. Oral contraceptives administered dailyfor 4-8 weeks will resolve 80 of functional cystic ovarian masses not requiring surgery. Surgery for benign lesions in the premenopausal patient is removal of the lesion cystectomy not oophorectomy. The general indications for operative intervention are listed in Table 23-4. Copyright 2001 The McGraw-Hill Companies. Click Here for Terms ofUse. 651 TABLE 23-1 CLASSIFICATION OF OVARIAN TUMORS Nonneoplastic lesions Inflammatory diseases of the ovary Adhesive disease due to subacute or chronic infections Endometriosis Peritoneal inclusions Nonneoplastic cysts Follicle cysts Lutein cysts corpus luteum theca lutein cysts Polycystic ovarian disease Stein-Leventhal syndrome Focal proliferation Thecosis Cortical granuloma .
