These findings point to a diagnosis of endometriosis,in which endometrial glands and stoma are found outside the uteru implan osis hlee strual cycles.ca na The proce gn very large. se oma presents clinicallyw enlargement,weig s and ca xia The ovary which gave rise to the primary tumor is generally enlarged on pelvic examin on.There may be dyspareunia,dysuria.dysmenorrhea and pelvic pain on defecation. e symptoms do not persist for many years prior to diagnosis.Metastatic ovarian carcinoma is generally fatal within I or 2 years of diagnosis. Ovarian cyst is a benign process readily detected on pelvic examination.It is not associated with the symptoms described.Tubo-ovarian abscess can be an acute complication ofpelvic inflammatory disease. 11.A 50-year-old woman has had menometrorrhagia for the past 3 months.On physical examination,there are no remarkable findings.The microscopic appearance of an endometrial biopsy specimen is shown in the figure above.The patient then undergoes a dilation and curettage,and the bleeding stops,with no further problems Which of the following conditions is most likely to produce these findings? A.Ovarian mature cystic teratoma B.Chronic cervicitis C.Failure of ovulation D.Pregnancy E.Use oforal contraceptives Ans:C This patient has endometrial hyperplasia.which results from excessive estrogenic stimulation.This lesion ofen occurs with failre of ovulation about the time of menopause.Estrogen-secreting ovarian tumors may also produce endometrial hyperplasia,but teratomas are not known for this phenomenon.Hyperplasias do not develop from cervicitis.A secretory pattern of endometrium is seen in pregnancy.not the proliferative pattern These findings point to a diagnosis of endometriosis, in which endometrial glands and stoma are found outside the uterus. The implants of endometriosis bleed with menstrual cycles, causing local irritation and pain. The process is chronic and can be difficult to diagnose. Leiomyoma is generally asymptomatic unless it becomes very large. If it is large it is easily detected on bimanual pelvic examination. It may also cause irregular menses. Metastatic ovarian adenocarcinoma presents clinically with abdominal enlargement, weight loss and cachexia. The ovary which gave rise to the primary tumor is generally enlarged on pelvic examination. There may be dyspareunia, dysuria, dysmenorrhea and pelvic pain on defecation, but these symptoms do not persist for many years prior to diagnosis. Metastatic ovarian carcinoma is generally fatal within 1 or 2 years of diagnosis. Ovarian cyst is a benign process readily detected on pelvic examination. It is not associated with the symptoms described.Tubo-ovarian abscess can be an acute complication of pelvic inflammatory disease. 11. A 50-year-old woman has had menometrorrhagia for the past 3 months. On physical examination, there are no remarkable findings. The microscopic appearance of an endometrial biopsy specimen is shown in the figure above. The patient then undergoes a dilation and curettage, and the bleeding stops, with no further problems. Which of the following conditions is most likely to produce these findings? A. Ovarian mature cystic teratoma B. Chronic cervicitis C. Failure of ovulation D. Pregnancy E. Use of oral contraceptives Ans: C This patient has endometrial hyperplasia, which results from excessive estrogenic stimulation. This lesion often occurs with failure of ovulation about the time of menopause. Estrogen-secreting ovarian tumors may also produce endometrial hyperplasia, but teratomas are not known for this phenomenon. Hyperplasias do not develop from cervicitis. A secretory pattern of endometrium is seen in pregnancy, not the proliferative pattern