Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, ...Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .展开更多
Objective. To evaluate the surgery in simple ovarian cysts.Methods. From Jan.1994 to Dec.1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was <5 cm in 76 cases, and w...Objective. To evaluate the surgery in simple ovarian cysts.Methods. From Jan.1994 to Dec.1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was <5 cm in 76 cases, and was>5 cm in 145 cases ultrasonically. One hundred and eighty-four patients underwent laparosocopy, and thirty-seven underwent laparotomy.Results. Histological findings showed no malignancy in this series. Simple cysts, paraovarian cysts and corpus luteum were found histologically in 90.8% of cases with cysts <5 cm, and 60% of those with cysts >1 cm respectively, their difference was significant (x2=37.13, P<0.001). The simple cysts, paraovarian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of pre-menopausal women.Conclusion. Patients with cysts >1 cm are indicated for surgical procedures, while a period of fol-lowup is acceptable for patients with cysts <7 cm, and surgery is advisable if the cyst is persistent during followup. Postmenopausal women with cysts should have operations.展开更多
The scope of this review is to focus on the management of benign ovarian cyst in the reproductive-age group of women undergoing ART. Ovarian cysts are a common occurrence in this patient population. The differential d...The scope of this review is to focus on the management of benign ovarian cyst in the reproductive-age group of women undergoing ART. Ovarian cysts are a common occurrence in this patient population. The differential diagnosis includes functional cysts, dermoid cysts, endometrioma. The appropriate evaluation includes medical history and physical examination, laboratory tests and imaging. The treatment options include conservative follow-up, medical treatment and surgery. This review will explore the differential diagnosis, appropriate work-up and treatment options to the various cyst types encountered.展开更多
Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, reveal...Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.展开更多
The presentation of an adnexal mass in an adolescent is a concerning event for the patient and the family. Patients are most likely to present with abdominal pain or a palpable mass. The diagnostic imaging of choice i...The presentation of an adnexal mass in an adolescent is a concerning event for the patient and the family. Patients are most likely to present with abdominal pain or a palpable mass. The diagnostic imaging of choice is pelvic ultrasonography. The majority of these lesions are benign ovarian cysts. These cysts should be followed with ultrasound, as many will spontaneously regress. Further evaluation with laboratory tests may also be warranted, which will aid in diagnosis and treatment. Ovarian cysts that are failed to resolve, severely symptomatic, or concerned with malignancy require surgical intervention. Laparoscopy has shown to be beneficial in the adolescent population and should be the procedure of choice. In addition, ovarian conservation is the ideal treatment in order to continue normal pubertal development and preserve reproductive health.展开更多
Van Wyk-Grumbach syndrome (VWGS) is characterized by juvenile hypothyroidism, delayed bone age, isosexual precocious puberty and massive ovarian cysts. We report such a case in a 7-year-old girl who presented with a b...Van Wyk-Grumbach syndrome (VWGS) is characterized by juvenile hypothyroidism, delayed bone age, isosexual precocious puberty and massive ovarian cysts. We report such a case in a 7-year-old girl who presented with a bilateral pelvic pain, abdominal distension and signs of hypothyroidism. Physical examination showed a breast development and lack of pubic and axillary hair. There was no clitoromegaly. Pelvic ultrasonography and CT scan showed enlarged bilateral multiloculared multicystics ovarian masses. The pituitary MRI was recommended before an elevated prolactin, revealed a large sellar and suprasellar mass. The patient was started on thyroid replacement using L-Thyroxine. Clinically, the patient’s fatigue, pelvic pain, and abdominal distension are resolved. During the follow-up, her thyroid functions and serum prolactin normalized within 8 months. Ultrasonography revealed regression of ovarian cysts in 2 months measuring, with normal sized ovaries in 14 months.展开更多
Objective:To explore the recent 20 years' herbal administration rules in TCM treatments of ovarian cysts (OCs) based on data mining.Methods:A prescription database for ovarian cysts was established by ACCESS 2007....Objective:To explore the recent 20 years' herbal administration rules in TCM treatments of ovarian cysts (OCs) based on data mining.Methods:A prescription database for ovarian cysts was established by ACCESS 2007.Importing the database into SPSS17.0 and SPSS Modeler14.1.SPSS17.0 was used for descriptive and cluster analyses,while SPSS Modeler14.1 was used for association rules analysis.Results:After screening,363 prescriptions were obtained.The 10 most frequently-used Chinese herbal medicines are Zedoaria (Rhizoma Curcumae),Poria cocos (Poria),Common buried rubber (Rhizoma Sparganii),Red peony root (Radix Paeoniae Rubra),Peach seed (Semen Persicae),Danggui (Radix Angelicae Sinensis),Chinese angelica (Ramulus Cinnamomi),Liquorice root (Radix Glycyrrhizae),Pangolin scales (Squama Manis) and Moutan cortex (Cortex Moutan Radicis);the 5 most common syndromes of OCs are qi stagnation and blood stasis,phlegm and blood stasis,uterine blood stasis,stagnation of liver qi and retention of phlegm and dampness,nearly to 54.26%;In association rules analysis,5 sets of two-herbs association rules were obtained,17 sets of three-herbs association rules were obtained,22 sets of four-herbs association rules were obtained and 4 sets of five-herbs association rules were obtained;By clustering,13 sets of core couplet medicinals were obtained.Conclusion:Medicinal herbs for promoting blood circulation to remove blood stasis,resolve hard lumps,for strengthening the spleen,eliminating phlegm,and relieving liver qi stagnation were highly used in the treatment of OCs;Herbs attributed to the Liver Meridian,the Spleen Meridian and the Heart Meridian were highly used in OCs;The compatibility of herbs for promoting blood circulation to remove blood stasis and resolve hard lumps were highly used;Guizhi Fuling Wan (GFW) was often used and combined with other herbs in the treatment of OCs.展开更多
TAKOTSUBO cardiomyopathy （TC）, also known as ＂left apical ballooning syndrome＂ and ＂broken heart syndrome＂, has been reported throughout the world occasionally. The major cause of thisdisease is psychological or...TAKOTSUBO cardiomyopathy （TC）, also known as ＂left apical ballooning syndrome＂ and ＂broken heart syndrome＂, has been reported throughout the world occasionally. The major cause of thisdisease is psychological or physical stress, and it has various clinical presentations. In this article, we present a TC case caused by laparoscopic oophorocystectomy.展开更多
The diagnosis and management of ovarian cystic tumor is sometimes difficult. In this manuscript, we wish to summarize this issue by showing three cases. Ultrasound and Color Doppler are very useful to diagnose the pre...The diagnosis and management of ovarian cystic tumor is sometimes difficult. In this manuscript, we wish to summarize this issue by showing three cases. Ultrasound and Color Doppler are very useful to diagnose the presence of this tumor but also to distinguish between benign and malignant. Pelvic MRI is also a strong tool and is sometimes mandatory. HE4 and CA125 are often useful as a serum diagnostic marker of malignancy, but not always so. Recently, laparoscopic management has gained popularity;however, great caution should be exercised during laparoscopic operative procedures, as this may lead to intraperitoneal malignant cell spreading/proliferation when the tumor is malignant. During the surgery of malignant tumor, irrespective of laparoscopic or laparotomic, intraperitoneal rupture should be avoided. Since the final diagnosis must be made by histological examination, the patient must always be informed of this possibility.展开更多
BACKGROUND High humidity and temperature in Taiwan have significant effects on the reproductivity of Holstein cattle,resulting in the occurrence of bovine ovarian follicular cyst(OFC).Because of economic loss from OFC...BACKGROUND High humidity and temperature in Taiwan have significant effects on the reproductivity of Holstein cattle,resulting in the occurrence of bovine ovarian follicular cyst(OFC).Because of economic loss from OFC,manual rupture and hormone injection have been advocated for the management of OFC.However,these incomplete treatments increase hormone resistance in cattle.Mesenchymal stem cells(MSCs)derived from placental stem cells(PSCs)demonstrate potential properties for the treatment of several diseases via promoting angiogenesis and immune modulation.AIM To establish the possibility of cattle placental stem cells(CPSCs)as a treatment modality for OFC of cows in Taiwan.METHODS The cows with OFC were divided into three groups:control(BC1 and BC2),hormone(H1 and H2),and CPSC(PS1 and PS2)treatment groups.In the hormone treatment group,the cows were given gonadotrophin-releasing hormone(GnRH)-prostaglandin-GnRH intramuscular injection with or without drainage of follicular fluid.In the CPSC treatment group,CPSCs were isolated from the placenta after labor.With the identification of surface antigen on stem cells,the cows were administered ovarian injection of 1×106 or 6×106 CPSCs with drainage.In all groups,OFC was scanned by ultrasound once a week for a total of seven times.The concentrations of estradiol and progesterone in serum were tested in the same period.The estrus cycle was analyzed by food intake and activity.If estrus was detected,artificial insemination was conducted.Then the cow was monitored by ultrasound for confirmation of pregnancy.RESULTS After 7 d of culture,CPSCs were successfully isolated from placental pieces.CPSCs significantly proliferated every 24 h and had high expression of MSC markers such as cluster of differentiation 44,as determined by flow cytometry.Ultrasound showed lower numbers of OFCs with drainage of follicular fluid.We achieved recovery rates of 0%,50%,50%,75%,75%and 75%in BC1,BC2,H1,H2,PS1,and PS2,respectively.Higher concentrations of progesterone were detected in the CPSC treatment groups.However,both hormone and CPSC treatment groups had no significant difference in the concentration of estradiol.The estrus rate was 0%,100%,25%,75%,75%and 75%in BC1,BC2,H1,H2,PS1,and PS2,respectively.The two fetuses were born in H2 and PS1.In brief,cows with CPSC injection achieved higher recovery,estrus,and inseminated conception rates.CONCLUSION CPSCs have efficacy in treating cows with OFC,and thus,may serve as an alternative treatment for reproductive disorders.展开更多
Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ov...Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ovarii enables the general gynecologic surgeon to continue the planned surgery. However, a diagnosis of malignnancy in a struma ovarii would alter the course of surgery with the involvement of a gynecologic oncology surgeon. We present here that our experience with intraoperative consultation for preoperatively undiagnosed struma ovarii presenting as an adnexal cystic or solid mass at our teaching hospital. Fifty-three cases of struma ovarii, 5.2% of all cystic teratoma of the same period, were diagnosed between January 1991 and March 2011. All intraoperative consultation reports, gross descriptions and final pathology reports were reviewed. The H&E stained slides and in selected cases, immunohistochemistry stained slides, were reviewed. Of the 53 cases of struma ovarii, intraoperative consultation was requested on 48 cases. Frozen section was done on 24 cases and only gross examination was felt appropriate in remaining 24 cases. 83% cases were diagnosed when a frozen section was done. None of the remaining 24 cases were recognized as struma by gross inspection. Our findings reveal that in a large number of cases the diagnosis of struma ovarii remained unrecognized during intraoperative consultation, indicating its often subtle/deceptive gross morphologic appearance. However, the purpose of the intraoperative consultation was served, as appropriate information was provided to the surgeon to guide the surgical management.展开更多
The diagnosis and the treatment of twisted ovarian tumors are still challenging, especially in adolescent girls. We describe an adolescent girl with a twisted ovarian cyst, in whom emergent laparoscopic surgery was su...The diagnosis and the treatment of twisted ovarian tumors are still challenging, especially in adolescent girls. We describe an adolescent girl with a twisted ovarian cyst, in whom emergent laparoscopic surgery was successful. She visited us due to severe abdominal pain. Ultrasound revealed a large cystic mass, indicative of an ovarian cyst. Laparoscopy revealed a large left ovarian cyst twisted on its axis. We punctured the cyst and detorsed it. The lessons learned here are: sudden-onset abdominal pain of adolescent associated with nausea and vomiting is strongly suggestive of a ovarian cyst torsion;ultrasound should be performed immediately, if ovarian cyst torsion is suspected, timely intervention with diagnostic laparoscopy is indicated, a minimally invasive surgical approach is recommended to preserve the adnexal structures and ovarian function.展开更多
Objective:To observe the clinical efficacy of Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst and the effects on physical and chemical indicators.Methods: A total ...Objective:To observe the clinical efficacy of Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst and the effects on physical and chemical indicators.Methods: A total of 80 patients with blood stasis and phlegm stagnation type of ovarian cyst were randomly divided into two groups, research group (n=40) took Chuanxiong Hualiu Mixture, control group (n=40) took Guizhi Fuling Capsule, 3 months was a course of treatment, and the curative effect was compared between two groups.Results:(1) The overall response rate of Chuanxiong Hualiu mixture group after 3 months of treatment was 82.5%, that of Guizhi Fuling Capsule group was 62.5%, the overall response rate of Chuanxiong Hualiu mixture group was higher than that of control group, and the difference was statistically significant;(2) before and after treatment, sex hormone and hemorheology index E2 of both groups decreased significantly, whole blood viscosity, whole blood reduced viscosity and plasma viscosity decreased significantly, the results were statistically significant, but there was no difference between two groups;(3) rank sum test of TCM symptom efficacy between two groups before and after treatment showed that the overall response rate of Chuanxiong Hualiu mixture group was 95%, the overall response rate of Guizhi Fuling Capsule group was 85%, the overall response rate of research group was better than that of control group, and the difference was statistically significant.Conclusion:Chuanxiong Hualiu mixture has good curative effect for the treatment of ovarian cyst, it can effectively improve the patients' blood stasis and phlegm stagnation constitution, and its mechanism of action is associated with lowering estrogen levels and improving hemorrheology.展开更多
BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a ...BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a result of the continuous development of assisted reproductive technologies.When this type of pregnancy occurs,both the continuation of intrauterine pregnancy and the life of the pregnant woman are severely threatened.Early diagnosis and treatment using safe and effective methods are paramount in this situation.CASE SUMMARY A 30-year-old primigravida at a gestation age determined as 8 wk 4 d by scan was admitted to the hospital with heterotopic pregnancy and a right ovarian cyst.Laparoscopic resection of the ectopic pregnancy was performed,but the intrauterine pregnancy and ovarian cyst were preserved.CONCLUSION The approach to a patient with heterotopic pregnancy and a giant ovarian cyst is individualized base on the fertility requirements.We recommend the following:(1)If the patient satisfies parity and has no fertility requirement,a laparoscopic salpingectomy should be performed and the giant ovarian cyst and intrauterine pregnancy removed;(2)If the patient has fertility requirements wishes to have more children in the future,laparoscopic salpingectomy or salpingostomy should be performed and the intrauterine pregnancy preserved.Serial ovarian cyst aspiration can be performed under ultrasound and resection can be done after delivery;and(3)Heterotopic pregnancy should be diagnosed early by active surveillance during antenatal visits using ultra sound as this is important for the avoidance of catastrophic complications.展开更多
Background: Prolonged exposure to environmental toxicants like endocrine-disrupting chemicals has been linked to several ovarian pathologies. Exposure to endocrine-disrupting chemicals may start at any time of life fr...Background: Prolonged exposure to environmental toxicants like endocrine-disrupting chemicals has been linked to several ovarian pathologies. Exposure to endocrine-disrupting chemicals may start at any time of life from the fetal stage to adulthood resulting in various health complications The purpose of our study is to compare the concentration levels and association of benzopyrene, bisphenol A and genistein in patients with ovarian tumors and normal control group. We also sort to evaluate the predictive performance of benzopyrene, bisphenol A and genistein in patients with ovarian tumors. Methods: A case-control study was conducted for randomly selected participants involving 30 patients and 30 controls. 30 patients with radiologically diagnosed and histopathological confirmed ovarian tumors were included in the study between January 2022 and December 2022. Urine samples from each group were analyzed using liquid chromatography-mass spectrometry. Descriptive analysis for normally distributed continuous variables was done accordingly. Concentration levels of endocrine-disrupting chemicals were assessed using the Mann-Whitney test. The association of endocrine-disrupting chemicals with pathological ovarian tumors was analyzed using binary logistic regression. Evaluation of the diagnostic performance of endocrine-disrupting chemicals was analyzed using the ROC curve. Results: Overall, patients were significantly (P = 0.000) older than the healthy controls. Mean years (SD) were 36.7 (7.90) and 28.8 years (4.89) for patients and normal women respectively. Endometriomas had the highest incidence of 50%. The level of benzopyrene and bisphenol A in patients was significantly higher than those in the control group, while the level of genistein was significantly higher in normal controls. Benzopyrene and bisphenol A were significantly associated with ovarian cysts, and the incidence of pathological ovarian cysts was positively correlated to these EDCs, with OR value 64.79 (P = 0.005) for benzopyrene and 9.609 (P = 0.001) for bisphenol A. Genistein was significantly negatively correlated with the incidence of pathological ovarian tumors, with OR value of 0.153 (P = 0.007). Diagnostic performance on the AUC for benzopyrene, bisphenol A and genistein&l.展开更多
文摘Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .
文摘Objective. To evaluate the surgery in simple ovarian cysts.Methods. From Jan.1994 to Dec.1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was <5 cm in 76 cases, and was>5 cm in 145 cases ultrasonically. One hundred and eighty-four patients underwent laparosocopy, and thirty-seven underwent laparotomy.Results. Histological findings showed no malignancy in this series. Simple cysts, paraovarian cysts and corpus luteum were found histologically in 90.8% of cases with cysts <5 cm, and 60% of those with cysts >1 cm respectively, their difference was significant (x2=37.13, P<0.001). The simple cysts, paraovarian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of pre-menopausal women.Conclusion. Patients with cysts >1 cm are indicated for surgical procedures, while a period of fol-lowup is acceptable for patients with cysts <7 cm, and surgery is advisable if the cyst is persistent during followup. Postmenopausal women with cysts should have operations.
文摘The scope of this review is to focus on the management of benign ovarian cyst in the reproductive-age group of women undergoing ART. Ovarian cysts are a common occurrence in this patient population. The differential diagnosis includes functional cysts, dermoid cysts, endometrioma. The appropriate evaluation includes medical history and physical examination, laboratory tests and imaging. The treatment options include conservative follow-up, medical treatment and surgery. This review will explore the differential diagnosis, appropriate work-up and treatment options to the various cyst types encountered.
文摘Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.
文摘The presentation of an adnexal mass in an adolescent is a concerning event for the patient and the family. Patients are most likely to present with abdominal pain or a palpable mass. The diagnostic imaging of choice is pelvic ultrasonography. The majority of these lesions are benign ovarian cysts. These cysts should be followed with ultrasound, as many will spontaneously regress. Further evaluation with laboratory tests may also be warranted, which will aid in diagnosis and treatment. Ovarian cysts that are failed to resolve, severely symptomatic, or concerned with malignancy require surgical intervention. Laparoscopy has shown to be beneficial in the adolescent population and should be the procedure of choice. In addition, ovarian conservation is the ideal treatment in order to continue normal pubertal development and preserve reproductive health.
文摘Van Wyk-Grumbach syndrome (VWGS) is characterized by juvenile hypothyroidism, delayed bone age, isosexual precocious puberty and massive ovarian cysts. We report such a case in a 7-year-old girl who presented with a bilateral pelvic pain, abdominal distension and signs of hypothyroidism. Physical examination showed a breast development and lack of pubic and axillary hair. There was no clitoromegaly. Pelvic ultrasonography and CT scan showed enlarged bilateral multiloculared multicystics ovarian masses. The pituitary MRI was recommended before an elevated prolactin, revealed a large sellar and suprasellar mass. The patient was started on thyroid replacement using L-Thyroxine. Clinically, the patient’s fatigue, pelvic pain, and abdominal distension are resolved. During the follow-up, her thyroid functions and serum prolactin normalized within 8 months. Ultrasonography revealed regression of ovarian cysts in 2 months measuring, with normal sized ovaries in 14 months.
文摘Objective:To explore the recent 20 years' herbal administration rules in TCM treatments of ovarian cysts (OCs) based on data mining.Methods:A prescription database for ovarian cysts was established by ACCESS 2007.Importing the database into SPSS17.0 and SPSS Modeler14.1.SPSS17.0 was used for descriptive and cluster analyses,while SPSS Modeler14.1 was used for association rules analysis.Results:After screening,363 prescriptions were obtained.The 10 most frequently-used Chinese herbal medicines are Zedoaria (Rhizoma Curcumae),Poria cocos (Poria),Common buried rubber (Rhizoma Sparganii),Red peony root (Radix Paeoniae Rubra),Peach seed (Semen Persicae),Danggui (Radix Angelicae Sinensis),Chinese angelica (Ramulus Cinnamomi),Liquorice root (Radix Glycyrrhizae),Pangolin scales (Squama Manis) and Moutan cortex (Cortex Moutan Radicis);the 5 most common syndromes of OCs are qi stagnation and blood stasis,phlegm and blood stasis,uterine blood stasis,stagnation of liver qi and retention of phlegm and dampness,nearly to 54.26%;In association rules analysis,5 sets of two-herbs association rules were obtained,17 sets of three-herbs association rules were obtained,22 sets of four-herbs association rules were obtained and 4 sets of five-herbs association rules were obtained;By clustering,13 sets of core couplet medicinals were obtained.Conclusion:Medicinal herbs for promoting blood circulation to remove blood stasis,resolve hard lumps,for strengthening the spleen,eliminating phlegm,and relieving liver qi stagnation were highly used in the treatment of OCs;Herbs attributed to the Liver Meridian,the Spleen Meridian and the Heart Meridian were highly used in OCs;The compatibility of herbs for promoting blood circulation to remove blood stasis and resolve hard lumps were highly used;Guizhi Fuling Wan (GFW) was often used and combined with other herbs in the treatment of OCs.
文摘TAKOTSUBO cardiomyopathy （TC）, also known as ＂left apical ballooning syndrome＂ and ＂broken heart syndrome＂, has been reported throughout the world occasionally. The major cause of thisdisease is psychological or physical stress, and it has various clinical presentations. In this article, we present a TC case caused by laparoscopic oophorocystectomy.
文摘The diagnosis and management of ovarian cystic tumor is sometimes difficult. In this manuscript, we wish to summarize this issue by showing three cases. Ultrasound and Color Doppler are very useful to diagnose the presence of this tumor but also to distinguish between benign and malignant. Pelvic MRI is also a strong tool and is sometimes mandatory. HE4 and CA125 are often useful as a serum diagnostic marker of malignancy, but not always so. Recently, laparoscopic management has gained popularity;however, great caution should be exercised during laparoscopic operative procedures, as this may lead to intraperitoneal malignant cell spreading/proliferation when the tumor is malignant. During the surgery of malignant tumor, irrespective of laparoscopic or laparotomic, intraperitoneal rupture should be avoided. Since the final diagnosis must be made by histological examination, the patient must always be informed of this possibility.
文摘BACKGROUND High humidity and temperature in Taiwan have significant effects on the reproductivity of Holstein cattle,resulting in the occurrence of bovine ovarian follicular cyst(OFC).Because of economic loss from OFC,manual rupture and hormone injection have been advocated for the management of OFC.However,these incomplete treatments increase hormone resistance in cattle.Mesenchymal stem cells(MSCs)derived from placental stem cells(PSCs)demonstrate potential properties for the treatment of several diseases via promoting angiogenesis and immune modulation.AIM To establish the possibility of cattle placental stem cells(CPSCs)as a treatment modality for OFC of cows in Taiwan.METHODS The cows with OFC were divided into three groups:control(BC1 and BC2),hormone(H1 and H2),and CPSC(PS1 and PS2)treatment groups.In the hormone treatment group,the cows were given gonadotrophin-releasing hormone(GnRH)-prostaglandin-GnRH intramuscular injection with or without drainage of follicular fluid.In the CPSC treatment group,CPSCs were isolated from the placenta after labor.With the identification of surface antigen on stem cells,the cows were administered ovarian injection of 1×106 or 6×106 CPSCs with drainage.In all groups,OFC was scanned by ultrasound once a week for a total of seven times.The concentrations of estradiol and progesterone in serum were tested in the same period.The estrus cycle was analyzed by food intake and activity.If estrus was detected,artificial insemination was conducted.Then the cow was monitored by ultrasound for confirmation of pregnancy.RESULTS After 7 d of culture,CPSCs were successfully isolated from placental pieces.CPSCs significantly proliferated every 24 h and had high expression of MSC markers such as cluster of differentiation 44,as determined by flow cytometry.Ultrasound showed lower numbers of OFCs with drainage of follicular fluid.We achieved recovery rates of 0%,50%,50%,75%,75%and 75%in BC1,BC2,H1,H2,PS1,and PS2,respectively.Higher concentrations of progesterone were detected in the CPSC treatment groups.However,both hormone and CPSC treatment groups had no significant difference in the concentration of estradiol.The estrus rate was 0%,100%,25%,75%,75%and 75%in BC1,BC2,H1,H2,PS1,and PS2,respectively.The two fetuses were born in H2 and PS1.In brief,cows with CPSC injection achieved higher recovery,estrus,and inseminated conception rates.CONCLUSION CPSCs have efficacy in treating cows with OFC,and thus,may serve as an alternative treatment for reproductive disorders.
文摘Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ovarii enables the general gynecologic surgeon to continue the planned surgery. However, a diagnosis of malignnancy in a struma ovarii would alter the course of surgery with the involvement of a gynecologic oncology surgeon. We present here that our experience with intraoperative consultation for preoperatively undiagnosed struma ovarii presenting as an adnexal cystic or solid mass at our teaching hospital. Fifty-three cases of struma ovarii, 5.2% of all cystic teratoma of the same period, were diagnosed between January 1991 and March 2011. All intraoperative consultation reports, gross descriptions and final pathology reports were reviewed. The H&E stained slides and in selected cases, immunohistochemistry stained slides, were reviewed. Of the 53 cases of struma ovarii, intraoperative consultation was requested on 48 cases. Frozen section was done on 24 cases and only gross examination was felt appropriate in remaining 24 cases. 83% cases were diagnosed when a frozen section was done. None of the remaining 24 cases were recognized as struma by gross inspection. Our findings reveal that in a large number of cases the diagnosis of struma ovarii remained unrecognized during intraoperative consultation, indicating its often subtle/deceptive gross morphologic appearance. However, the purpose of the intraoperative consultation was served, as appropriate information was provided to the surgeon to guide the surgical management.
文摘The diagnosis and the treatment of twisted ovarian tumors are still challenging, especially in adolescent girls. We describe an adolescent girl with a twisted ovarian cyst, in whom emergent laparoscopic surgery was successful. She visited us due to severe abdominal pain. Ultrasound revealed a large cystic mass, indicative of an ovarian cyst. Laparoscopy revealed a large left ovarian cyst twisted on its axis. We punctured the cyst and detorsed it. The lessons learned here are: sudden-onset abdominal pain of adolescent associated with nausea and vomiting is strongly suggestive of a ovarian cyst torsion;ultrasound should be performed immediately, if ovarian cyst torsion is suspected, timely intervention with diagnostic laparoscopy is indicated, a minimally invasive surgical approach is recommended to preserve the adnexal structures and ovarian function.
文摘Objective:To observe the clinical efficacy of Chuanxiong Hualiu Mixture in the treatment of blood stasis and phlegm stagnation type of ovarian cyst and the effects on physical and chemical indicators.Methods: A total of 80 patients with blood stasis and phlegm stagnation type of ovarian cyst were randomly divided into two groups, research group (n=40) took Chuanxiong Hualiu Mixture, control group (n=40) took Guizhi Fuling Capsule, 3 months was a course of treatment, and the curative effect was compared between two groups.Results:(1) The overall response rate of Chuanxiong Hualiu mixture group after 3 months of treatment was 82.5%, that of Guizhi Fuling Capsule group was 62.5%, the overall response rate of Chuanxiong Hualiu mixture group was higher than that of control group, and the difference was statistically significant;(2) before and after treatment, sex hormone and hemorheology index E2 of both groups decreased significantly, whole blood viscosity, whole blood reduced viscosity and plasma viscosity decreased significantly, the results were statistically significant, but there was no difference between two groups;(3) rank sum test of TCM symptom efficacy between two groups before and after treatment showed that the overall response rate of Chuanxiong Hualiu mixture group was 95%, the overall response rate of Guizhi Fuling Capsule group was 85%, the overall response rate of research group was better than that of control group, and the difference was statistically significant.Conclusion:Chuanxiong Hualiu mixture has good curative effect for the treatment of ovarian cyst, it can effectively improve the patients' blood stasis and phlegm stagnation constitution, and its mechanism of action is associated with lowering estrogen levels and improving hemorrheology.
文摘BACKGROUND The coexistence of a heterotopic pregnancy with a giant ovarian cyst is an incredibly rare abnormal pregnancy in cases of natural conception.The incidence of this condition has increased significantly as a result of the continuous development of assisted reproductive technologies.When this type of pregnancy occurs,both the continuation of intrauterine pregnancy and the life of the pregnant woman are severely threatened.Early diagnosis and treatment using safe and effective methods are paramount in this situation.CASE SUMMARY A 30-year-old primigravida at a gestation age determined as 8 wk 4 d by scan was admitted to the hospital with heterotopic pregnancy and a right ovarian cyst.Laparoscopic resection of the ectopic pregnancy was performed,but the intrauterine pregnancy and ovarian cyst were preserved.CONCLUSION The approach to a patient with heterotopic pregnancy and a giant ovarian cyst is individualized base on the fertility requirements.We recommend the following:(1)If the patient satisfies parity and has no fertility requirement,a laparoscopic salpingectomy should be performed and the giant ovarian cyst and intrauterine pregnancy removed;(2)If the patient has fertility requirements wishes to have more children in the future,laparoscopic salpingectomy or salpingostomy should be performed and the intrauterine pregnancy preserved.Serial ovarian cyst aspiration can be performed under ultrasound and resection can be done after delivery;and(3)Heterotopic pregnancy should be diagnosed early by active surveillance during antenatal visits using ultra sound as this is important for the avoidance of catastrophic complications.
文摘Background: Prolonged exposure to environmental toxicants like endocrine-disrupting chemicals has been linked to several ovarian pathologies. Exposure to endocrine-disrupting chemicals may start at any time of life from the fetal stage to adulthood resulting in various health complications The purpose of our study is to compare the concentration levels and association of benzopyrene, bisphenol A and genistein in patients with ovarian tumors and normal control group. We also sort to evaluate the predictive performance of benzopyrene, bisphenol A and genistein in patients with ovarian tumors. Methods: A case-control study was conducted for randomly selected participants involving 30 patients and 30 controls. 30 patients with radiologically diagnosed and histopathological confirmed ovarian tumors were included in the study between January 2022 and December 2022. Urine samples from each group were analyzed using liquid chromatography-mass spectrometry. Descriptive analysis for normally distributed continuous variables was done accordingly. Concentration levels of endocrine-disrupting chemicals were assessed using the Mann-Whitney test. The association of endocrine-disrupting chemicals with pathological ovarian tumors was analyzed using binary logistic regression. Evaluation of the diagnostic performance of endocrine-disrupting chemicals was analyzed using the ROC curve. Results: Overall, patients were significantly (P = 0.000) older than the healthy controls. Mean years (SD) were 36.7 (7.90) and 28.8 years (4.89) for patients and normal women respectively. Endometriomas had the highest incidence of 50%. The level of benzopyrene and bisphenol A in patients was significantly higher than those in the control group, while the level of genistein was significantly higher in normal controls. Benzopyrene and bisphenol A were significantly associated with ovarian cysts, and the incidence of pathological ovarian cysts was positively correlated to these EDCs, with OR value 64.79 (P = 0.005) for benzopyrene and 9.609 (P = 0.001) for bisphenol A. Genistein was significantly negatively correlated with the incidence of pathological ovarian tumors, with OR value of 0.153 (P = 0.007). Diagnostic performance on the AUC for benzopyrene, bisphenol A and genistein&l.
