Quiste de ovario intraligamentario gigante y miomatosis uterina / Giant intraligamentary ovary cyst and uterine myomatosis

Se presenta el caso de una paciente de 55 años de edad con quiste gigante de ovario. Fue atendida por integrantes de la Brigada Médica Cubana en la consulta de Ginecología del Hospital Regional de New Ámsterdam de la República de Guyana en el mes agosto de 2016 por presentar aumento de tamaño del abdomen, de aproximadamente dos años de evolución. El diagnóstico fue sospechado por ultrasonografía y tomografía axial computarizada. Se confirmó una tumoración quística gigante del ovario derecho a través de una laparotomía exploradora con dimensiones extraordinarias 48 cm de diámetro y peso 12,5 kg; además, miomatosis uterina. Se le realizó histerectomía total con doble anexectomía. El estudio histológico concluyó ser un cistoadenoma seroso de ovario y miomatosis uterina(AU)

We present the case of a 55-year-old female with giant ovarian cyst. She was attended in the gynecology consultation by members of the Cuban Medical Brigade, at the Regional Hospital of New Amsterdam in the Republic of Guyana during August, 2016. She presented a size increase abdomen, of approximately two years of evolution. The diagnosis was suspected by ultrasonography and computerized axial tomography. An exploratory laparotomy confirmed a giant cystic tumor in the right ovary of extraordinary dimensions (48 cm in diameter and 12.5 kg in weight), beside uterine myomatosis. A total hysterectomy was performed with double annexectomy. The histological study concluded that it was a serous cystadenoma of ovary and uterine myomatosis(AU)

Adenexal cysts;survey of ultrasonography, preoperative findings, histopathology

[1] To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. [2] To determine the relationship of age with type of ovarian tumour. [3] To categorize the management of these cases according to the intra-operative findings. [4] To analyze the occurrence of various histopathological types of tumour. Medline Study Single centered prospective descriptive study of 150 cases. Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to, 31st December 2006. 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain [53%] followed by menstrual disturbances [30%], abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management

Operative laparoscopy in pregnancy for a large paraovarian cyst

The use of operative laparoscopy for paraovarian cysts in pregnancy is relatively new. A 26-year-old primigravida at 20 weeks of gestation was discovered to have a 20 x 15-cm adnexal cyst during ultrasound. Laparoscopic excision of the 20 x 15-cm paraovarian cyst after aspiration of 2.5 L of fluids was performed without complications. The operative time was 60 minutes. The patient was released from the hospital less than 24 hours after surgery in good general condition. Follow-up in the outpatient clinic was satisfactory. The final histopathology confirmed the 20 x 15-cm paraovarian cyst. The patient delivered vaginally and spontaneously at term. Operative laparoscopy may be safe for removing large paraovarian cysts during pregnancy

Ovarian tumors with elevated ca-125 levels and severe juvenile hypothyroidism: A need for increased awareness.

A 15-yr-old girl presented with bilateral gross ovarian tumors, clinical features of long-standing unrecognized hypothyroidism and markedly elevated CA-125 levels. Ovarian resection was avoided, as the presentation was consistent with the Van Wyk and Grumbach syndrome; and the patient was treated with replacement of thyroid hormone. Regression of the ovarian tumors occurred 6 months after initiation of the treatment. The authors emphasise the need for increased awareness and screening for hypothyroidism in patients with ovarian tumors, in order to prevent inadvertent operative interventions.

Ovarian dermoid cyst

Mature teratoma is the most common germ cell tumor [and the most common tumor] of the ovary, composing more than 20% of all ovarian neoplasms. Super infection of dermoid ovarian cyst is very rare. A 72 years-old woman admitted to the gynecological outpatient clinic because of lower abdominal pain and fever. Gynecological examination and ultrasonography revealed a heterogeneous cystic mass in the right ovary. Abdominopelvic CT scan revealed a right ovarian mass [15 x 15cm] thought to be a dermoid cyst. Right adnexectomy was performed. The pathological evaluation suggested infected benign ovarian dermoid. Infection of a mature teratoma is a relatively uncommon event. However, based on our case and others, superinfection with abscess formation should be considered in the differential diagnosis whenever a patient with a documented pelvic mass and fever

Pode a ecografia fornecer o diagnostico de teratoma ovariano de maneira similar ao diagnóstico histopatológico? / Can echography provide a diagnosis of ovarian teratomas similar to the histopatolhogicl diagnosis?

Os teratomas ovarianos são tumores geralmente benignos e relativamente comuns. Adquirem maior importância por acometerem principalmente mulheres em idade reprodutiva e por serem a neoplasia ovariana mais comumente excisada. O objetivo foi analisar se ecografia bidimensional, Doppler e 3-D têm valor em predizer adequadamente o diagnóstico e os achados histopatológicos de teratoma ovariano. O assunto foi revisado em bases de dados eletrônicas, com a seleção de artigos com bom nível de evidência científica publicados de janeiro de 1994 a janeiro de 2008. Os achados ecográficos bidimensionais no teratoma ovariano são variáveis como imagem heterogênea com diversos tipos de conteúdos. A sensibilidade, a especificidade e os valores preditivos positivo e negativo variam nas diversas séries, com evidente melhora da acurácia nos trabalhos mais recentes. Alguns trabalhos apresentam dados que avaliam se o Doppler poderia melhorar o diagnóstico quando associado à ultrassonografia. Em relação à ecografia tridimensional, poucos dados estão disponíveis. A ecografia bidimensional é um método com boa acurácia diagnóstica para teratoma ovariano, e os achados ecográficos têm alta correlação com a histopatologia dos tumores avaliados após ressecção cirúrgica.

Ovarian teratomas are usually benign and relatively common tumors. They are important because they affect mainly women of reproductive age and because they are the most commonly ovarian neoplasia excised. The objective was to determine whether two-dimensional, Doppler and three-dimensional echography methods are of reasonable predictive methods for the diagnosis and for the histopathological findings of ovarian teratomas. A review of electronic data bases with the selection of good level articles of scientific evidence published from January 1994 to January 2008. The two-dimensional echographic findings regarding ovarian teratomas are variable, with heterogeneous images having diverse types of content. Sensitivity, specificity and positive and negative predictive values vary in the different series, with a clear improvement of accuracy in more recent studies. Some studies present data that evaluate whether Doppler could improve the diagnosis in association with ultrasonography. Few data are available about three-dimensional echography. Two-dimensional echography is a method of good diagnotic accuracy regarding ovarian teratomas and the echographic findings are highly correlated with the histopathology of the tumors examined after surgical resection.

[Ovarian cyst: comparison between sonography, coelioscopy and patholy about 100 cases]

The ovarian cysts are a common pathology in gynecology. The aim of our study is to confront ultrasound and coelioscopic data in final anatomo pathological diagnosis of ovarian cysts and to assess the efficiency and the morbidity of coelioscopic treatment. We report a retrospective study of 100 ovarian cysts collected in CHU of Mongi Slim La Marsa from October 1st, 2003 to November 30th, 2007. The coelioscopic exploration coupled with the extemporany review has a sensitivity of 100%. The benefits of coelioscopy are: less esthetic desagrement, a decrease in morbidity per and post operatory and economic benefit. The risk of ignoring a malignant lesion is not zero with a risk of spread tumor .That's why it must respect strict rules and convert if malignancy is suspected. Coelioscopy has let a reliable diagnosis of malignancy with a low morbidity, it is an efficient and comfortable technic for patients

Quistes de ovario en la urgencia: ¿un dilema terapéutico para el cirujano general? / Ovarian cysts in the urgency: a therapeutic dilemma for the general surgeon?

Ovarian cysts occur in women of all ages. In young women, the majority are benign, and the incidence of malignancy is maximal in the fifth to seventh decades. An ovaian cyst may present to the emergency surgeon as a pelvic or abdominal mass. it may also be discovered as an incidental finding on pelvic examination. An ultrasound scan yields valuable information about the nature of an ovaian cyst. The aim of this report was to present an experience with this pathology with laparoscopic management and with a revision of the literature

Aspectos das lesões císticas ovarianas à ressonância magnética / Magnetic resonance imaging features of cystic ovarian lesions

O objetivo deste trabalho de revisão é apresentar as características de imagem das lesões ovarianas mais freqüentes (císticas ou predominantemente císticas) à ressonância magnética, bem como os aspectos relevantes para um diagnóstico diferencial. A ressonância magnética tem papel importante em esclarecer dúvidas surgidas no exame de rastreamento ultrasonográfico, indicar os aspectos com suspeita de malignidade, estadiar as lesões malignas e permitir um melhor planejamento cirúrgico.

Teratoma quístico de ovario con concreciones solidas

Se presenta un caso de teratoma quístico maduro de ovario que contiene numerosas esférulas flotantes en el quiste. Se trataba de quiste de ovario gigante en una paciente en edad fértil. Las imágenes ecográficas y de la resonancia magnética destacan por su extraordinaria rareza y se piensa que son patognomónicas de teratoma quístico. El análisis anatomopatológico confirmó este resultado

We present a case of mature cystic teratoma of the ovary containing numerous spherules floating in the cyst. Sonography and MR imaging revealed spherical structures, which is thought to be pathognomonic for a cystic teratoma. Microscopically, the pathological report confirmed this finding. The cyst appears as a massive tumor in a reproductive age patient

Unicystic granulosa cell tumor: a case report.

Granulosa Cell Tumors (GCT) constitutes 1.5% to 3.5% of all primary ovarian neoplasms. They may be solid, cystic or both. Unilocular cystic GCT are very rare. We report here a case of 32 years female with unicystic GCT in which the distinction from follicular cyst was difficult and was made by carefully examining the lining of the cyst,which showed occasional multiple layers of granulosa cells with a few Call-Exner bodies.

prevalence and age distribution of ovarian cysts

A prospective study conducted at Lady Willingdon Hospital LHR over two years for prevalence and age distribution of ovarian cyst. According to study 85% ovarian cyst were benign, 13% cyst were malignant while 2% were borderline malignant. The commonest histopathological type was serous cystadenoma. Only age was not the determining factor for the type of the ovarian cyst

Laparoscopy versus lapartomy in the treatment of benign ovarian cyst

To compare laparoscopy with laparotomy in the treatment of benign ovarian cyst in women under 40 years of age. Experimental. The study was conducted over a period of one and half year from June 2003 to Nov 2004 in Obstetrics and Gynaecology Department, Unit-III, Lady Willingdon Hospital, Lahore. The sixty consecutive patients of benign ovarian cysts who required surgical treatment underwent either Laparoscopy[group I]. or laparotomy [group II]. The laparoscopic fenestration, aspiration and cystectomies were performed in group I [30 patients]. However, ovarian cystectomies, salpingo-oophorectomy and oophorectomy were performed by laparotomy in group II [30 patients]. The comparison was done with respect to duration of surgery intra-operative blood loss, time of mobilization, duration of hospital stay and amount of analgesia used, time to return to normal activity. The amount of analgesics used, time of mobilization, duration of hosp ital stay and time to return to normal activity was less [P<0.05] in Laparoscopy as compared to Laparotomy. There was statistically no significant difference in the duration of surgery, blood loss and post operative morbidity [P>0.05]. With appropriate preoperative evaluation, laparoscopic surgery is safe and effective in treating benign ovarian cyst in women under 40 years of age where the risk of malignancy is low. It is associated with early mobilization, less use of analgesia, shorter hospital stay

Hidatidosis ovárica / Ovarian echinococcosis

Se reporta un caso excepcional de hidatidosis ovárica en una paciente joven, con esterilidad primaria. Se evalúan los métodos de diagnóstico, el tratamiento, la evolución clínica y el posible efecto en la fertilidad.

Role of fine needle aspiration cytology [FANC] in diagnosis of uni-locular ovarian cysts - a Cytohistological correlation

This study was carried out to assess the ability of fine needle aspiration cytology [FNAC] in the diagnosis of ovarian cysts by comparing the results with histological findings of tissue biopsies. This study includes 48 cases by ovarian cysts reported to Pathology department, Allama Iqbal Medical College, Lahore and Author's Lab. mainly from Jinnah Hospital, Lahore, Sir Ganga Ram Hospital, Lahore and Services Hospital, Lahore. In 28 cases, aspiration was done per-operatively while in 20 cases preoperatively. These aspirates were examined cytologically by making the appropriate smears. The same cysts removed surgically were then examined histologically and results were compared. In a total of 48 cases, on FNAC, serous, follicular, luteal, mucinous and endometriotic cysts were diagnosed in 12, 8, 7, 5 and 5 cases respectively with inconclusive aspirate in 11 cases. When histology was done on excised specimens of these ovarian cysts, serous cysts were found in 17 patients, follicular cysts in 10, luteal cysts in 12, mucinous cysts in 6 and endometriotic cysts in 3 patients. On correlating the FNAC and histopathology results, a sensitivity of 58.34% to 100% and a specificity of 60% to 100% were calculated in different types of cysts. It is concluded that FNAC of ovarian cysts is a fairly useful diagnostic technique which can further improve by more experience and ancillary techniques

Massive cystic degeneration of a uterine leiomyoma presenting as an ovarian cyst: a case report.

An unusual case of massive cystic degeneration in an uterine leiomyoma measuring 21 cm in diameter, in a 40 year old female is being presented. It was diagnosed as a cystic adnexal tumor on ultrasonogram. Interlacing bundles of smooth muscle were identified in the cyst wall, which was confirmed on special stains. The differential diagnoses considered in this case are discussed. To the best of our knowledge, this is the largest cystic degeneration in an uterine leiomyoma reported in the literature.

Ovarian Mature Cystic Teratoma Containing Homunculus: A Case Report

We report a partial fetus-like structure (homunculus) in benign ovarian mature cystic teratoma removed from a 23-yr-old female. The cyst displayed various tissues derived from the three germ layers. The homunculus had a distinguished fetal cranial structure with one upper extremity. A partially developed osteocartilagenous skeleton was identified in the cranial structure of the homunculus. Intracranial structures such as cerebral cortex, retinal pigment, and leptomeninges were extruded from the partially disrupted calvarium.

Ovarian cyst; laparoscopic management

OBJECTIVE: To assess the Results of operative laparoscopy in the management of ovarian cysts. Design: Retrospective evaluation of women who had undergone laparoscopic management of cystic ovarian masses. SUBJECT: Forty five women with clinically and sonographically benign cystic ovarian masses. INTERVENTION: Operative laparoscopy under general anaesthesia. No major intra-operative complication occurred in this series. Minor complications included injury of inferior epigastric artery, nausea, shoulder pain and urinary retention. Adnexal cystic mass varied form 4 to 12 cms with a mean size 6.5 cms. Histopathological examination showed malignancy in 2% of cases. Operative laparoscopy appears to be safe and effective method for treating clinically and ultrasonographically benign ovarian cysts. Day surgery is possible in majority of cases