Ovaires : variations physiologiques et pathologies fonctionnelles

Knowledge of ovarian anatomy and physiology is an essential prerequisite to understand tumor-like lesions of the ovary. Dysfunction of the follicular or ovarian stroma generates multiple reversible abnormalities in women of childbearing age. Follicular disorders can be related to only one follicle, generating simple or hemorrhagic follicular cysts. Follicular disorders related to numerous ovarian follicles create polycystic ovarian diseases that are frequently associated with clinical and biological disturbances. Involvement of the ovarian stroma is less frequent and is responsible for stromal hyperplasia, massive ovarian edema or ovarian fibromatosis. Transvaginal ultrasound is the first-line examination for the evaluation of all these disorders. In the presence of sonographically indeterminate lesions, magnetic resonance imaging is useful to characterize these disorders. Pregnancy is associated with various modifications giving rise to tumor-like lesions that must not lead to inappropriate surgical management. The hyperstimulation syndrome which is related to induction of the ovulation during medical assisted procreation is similar to hyperreactio luteinalis.