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The new ANDI classification is well suited to describe mammary hypertrophy. From normal breast volume to simple hypertrophy, or to major hypertrophy like gigantomastia, all the stages from normal…

Congenital Anomalies
Congenital anomalies may be uni- or bilateral and may involve the nipple, the breast or both. Breast abnormalities are classically observed along the line extending from…

Before the peri-menarchal period, the mammary gland consists of only a few ducts. During peri-menarchal development, the principal changes are duct sprouting and the addition of lobular structures. Estrogen induces connective…

The breast remains quiescent in the prepubertal stage and undergoes major changes at puberty under the influence of ovarian hormones. Estrogen increases adipose tissue and initiates stromal and ductal growth. Progesterone is probably important for…

Three major phases associated with the physiological processes of the mammary gland characterize this new classification.

Lobular Development between Puberty and 25 Years of Age
Lobular development is important…

Breast tissue originates from ectodermal layers. During the sixth week of embryogenesis, epidermal cells migrate into the underlying mesenchymal tissue and form primitive mammary ridges. These ridges initially extend from the…

A thorough understanding of the different mammary gland structures and their respective physiological roles helps to detect anatomic variations and diagnose breast disease at various ages. Mammary abnormalities may be classed as either…

Whether benign or malignant, functional or organic, fluid or solid, ovarian masses are the most common gynecological tumors, with benign tumors and functional cysts greatly predominating. The annual incidence of ovarian neoplasms…

The symptoms leading to diagnosis are varied and not necessarily specific to the pelvic region. They may follow a chronic course mainly marked by poorly defined pain, heaviness or a palpable mass. In…

Epithelial ovarian neoplasms are rare in patients under the age of 20 years.
Few series have found any premenarchal adolescents with these lesions.

Serous cystadenomas are the most common. They are often unilocular,…

Imaging
Numerous techniques are available and play a fundamental role not only in establishing a positive diagnosis and orienting the etiology, but also in surveillance and the…

In practice, the clinician is confronted by two very different situations: (1) a pelvic mass or an endocrine syndrome is discovered and complementary investigations are required for better definition of…

The detection of adnexal masses is common and the vast majority is benign. These benign masses are predominantly functional ovarian cysts, most of which resolve spontaneously. Ultrasonography is the preferred…

Sex cord-stromal tumors are neoplasms which contain granulosa cells, Sertoli cells, Leydig cells and fibroblasts of stromal origin. These tumors are notable for their endocrine activity, with feminizing or predominantly estrogenproducing tumors…

Many emergency caesareans could be prevented by the attendance of a more skilled obstetrician, say senior doctors in this week’s British Medical Journal.

They call for better training in instrumental vaginal…

PCOS
The treatment of hyperandrogenism in women with PCOS aims at interrupting androgen production and/or action. Suppression of ovarian function with oral contraceptives is usually the first line of therapy.…

In most cases, hyperandrogenism in adolescence is related to a nascent PCOS. Since the laboratory and ultrasonic findings are often not conclusive at this age, the diagnosis may remain presumptive providing…

These causes of hyperandrogenism are rare. The clinical presentation is often suggestive (see above, Diagnosis of Hyperandrogenism in Female Adolescents). The laboratory investigations will rapidly confirm the clinical suspicion and…

NCAH is encountered with relatively high frequency (1 - 6%) among adolescent and adult patients with hyperandrogenism. This incidence may vary from one geographic area to another, as reported for classical 21-OHD, because of…

Actually, the difficulty of diagnosing PCOS varies according to the clinical presentation. In some cases, only one or two of the three above-mentioned components are present (e.g., ‘ovulatory PCOS’ or ‘non-hirsute…

Making the diagnosis of PCOS remains a difficult challenge and a controversial issue, especially in adolescent girls. In particular, whether ultrasonography should be used as a universal standard is still disputed.

Hormonal Markers…