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Pelvic Mass

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Age has the greatest influence in the evaluation of a pelvic mass. Which of the following statements regarding demographic factors and pelvic masses is true?

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a. Malignant ovarian tumors in children and adolescents are common.

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b. Most gynecologic pelvic masses in prepubertal and adolescent girls involve the ovary.

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c. Malignancy is a more frequent cause of pelvic masses in reproductive-aged women than in postmenopausal women.

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d. None of the above

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Which of the following statements regarding the pathology of leiomyomas is true as shown in part by these low-and high-power histologic images?

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L = leiomyoma; M = myometrium. Photographs contributed by Dr. Kelley Carrick.

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a. Each leiomyoma is derived from multiple progenitor myocytes.

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b. Mitotic activity in their elongated smooth muscle bundles is common.

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c. Leiomyomas possess a distinct autonomy from their surrounding myometrium.

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d. Necrosis and degeneration develop infrequently in leiomyomas because of their abundant and well-organized blood supply.

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Which of the following factors decreases the risk for development of leiomyomas?

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a. Early menarche

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b. Cigarette smoking

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c. Elevated body mass index (BMI)

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d. Polycystic ovarian syndrome (PCOS)

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Mechanisms by which leiomyomas create a hyperestrogenic environment requisite for their growth and maintenance include which of the following?

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a. Leiomyomas convert estradiol to estrone.

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b. Leiomyoma cells contain a greater density of estrogen receptors compared with normal myometrium.

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c. Leiomyomas contain higher levels of cytochrome P450 aromatase, which allows for conversion of androgens to estrogen.

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d. All of the above

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What type of leiomyoma is shown in this sonographic image?

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a. Intramural

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b. Subserosal

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