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
Ovarian Remnant syndrome (ORS) is the presence of residual ovarian tissue after an oophorectomy was performed whether associated with a hysterectomy or not. We report the case of a 39-year-old woman with a past surgic...Ovarian Remnant syndrome (ORS) is the presence of residual ovarian tissue after an oophorectomy was performed whether associated with a hysterectomy or not. We report the case of a 39-year-old woman with a past surgical history of total abdominal hysterectomy and left salpingo-oophorectomy with an indication of placenta accreta incidentally discovered during a caesarian section. The patient presented with pelvic pain and was diagnosed with ORS. She was successfully managed by laparoscopy with removal of the cyst and the surrounding ovarian tissue, confirmed by histopathological analysis. The post operative period was uneventful, and the patient was discharged after 2 days of good evolution. In our context, surgery remains the main treatment option, however, other treatment options including radiotherapy or medical management need to be considered as either adjunct or main therapy.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
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
BACKGROUND Turner syndrome(TS)with leukemia is a complicated clinical condition.The clinical course and outcome of these patients are poor,so the treatment and prognosis of TS with hematological malignancies deserve o...BACKGROUND Turner syndrome(TS)with leukemia is a complicated clinical condition.The clinical course and outcome of these patients are poor,so the treatment and prognosis of TS with hematological malignancies deserve our attention.CASE SUMMARY Here,we report a case of a 20-year-old woman diagnosed with TS,primary myelofibrosis(PMF),cirrhosis,and an ovarian cystic mass.This is the first report on the coexistence of TS and PMF with the MPL and SH2B3 mutations.The patient was diagnosed with cirrhosis of unknown cause,splenomegaly and severe gastroesophageal varices.Additionally,an ovarian cystic mass caused the patient to appear pregnant.The patient was treated with the JAK2 inhibitor-ruxolitinib according to peripheral blood cells,although myelofibrosis was improved,the splenomegaly did not reduce.Moreover,hematemesis and melena occasionally occurred.CONCLUSION Ruxolitinib may clearly reduce splenomegaly.Though myelofibrosis was improved,cirrhosis and splenomegaly in this case continued to worsen.Effective treatment should be discussed.展开更多
Ovarian cystic masses include a spectrum of benign, borderline and high grade malignant neoplasms. Imaging plays a crucial role in characterization and pretreatment planning of incidentally detected or suspected adnex...Ovarian cystic masses include a spectrum of benign, borderline and high grade malignant neoplasms. Imaging plays a crucial role in characterization and pretreatment planning of incidentally detected or suspected adnexal masses, as diagnosis of ovarian malignancy at an early stage is correlated with a better prognosis. Knowledge of differential diagnosis, imaging features, management trends and an algorithmic approach of such lesions is important for optimal clinical management. This article illustrates a multi-modality approach in the diagnosis of a spectrum of ovarian cystic masses and also proposes an algorithmic approach for the diagnosis of these lesions.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
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
The dermoid ovarian is an organic mild tumor. It can be revealed by an adnexal torsion which constitutes a gynecological emergency that can bring into play in a short term after the functional prognosis. We are report...The dermoid ovarian is an organic mild tumor. It can be revealed by an adnexal torsion which constitutes a gynecological emergency that can bring into play in a short term after the functional prognosis. We are reporting an observed case in an 11-year-old teenager who is in times peri-pubertal. The patient was presenting a painful abdomino-pelvic syndrome and a pelvic mass at the physical examination. The ultrasound was showing a right cyst mass with a right moderated hydronephrosis. A right adnexectomy was realized. The histological test after excision of the adnexal was showing a mature cystic teratoma of the right ovary with a congestive and edematous tubal fragment.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 ourhospital. The diameter of cysts was ＜5 cm in 76 cases, and wa...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 ourhospital. 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 cystsand corpus luteum were found histologically in 90.8% of cases with cysts ＜5 cm, and 60% of those withcysts ＞7 cm respectively, their difference was significant (X2=-37.13, P＜0.001). The simple cysts, paraovar-ian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of pre-menopausal women. Conclusion. Patients with cysts ＞7 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 dur-ing followup. Postmenopausal women with cysts should have operations.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
Aim: To evaluate and compare the efficacy of methotrexate injection in management of persistent simple ovarian cyst versus the use of transvaginal ultrasound aspiration alone. Patients and Methods: This randomized con...Aim: To evaluate and compare the efficacy of methotrexate injection in management of persistent simple ovarian cyst versus the use of transvaginal ultrasound aspiration alone. Patients and Methods: This randomized controlled study was conducted at Tanta University Hospitals in the period from April 1, 2016 to October 31, 2016. Patients were randomly allocated into two groups;each group has 25 patients with benign persistent simple ovarian cyst. Group I: Patients were subjected to transvaginal aspiration of the cyst. Group II: patients were subjected to methotrexate injection inside the cyst. Patients in both group were followed up at 1, 3, 6 months after procedure for the recurrence and occurrence spontaneous pregnancy. Results: The mean age in group I was 28.8 years, and the mean age in group II was 26.52 years with non-significant difference. Also there was non-significant difference between both groups regarding size of the cyst. No case recorded to have a cyst recurrence in group II and four cases in group I within six months with significant difference (P value 0.037), and there was non-significant differences as regard the pregnancy rate and complications. Conclusion: Transvaginal intra-cystic methotrexate injection is a safe and effective choice for management of persistent simple benign ovarian cyst.展开更多
Intestinal duplications are rare congenital anomalies that can occur anywhere in the gastrointestinal tract.They are most commonly located in the ileum and are usually detected in infancy or early childhood.Duplicated...Intestinal duplications are rare congenital anomalies that can occur anywhere in the gastrointestinal tract.They are most commonly located in the ileum and are usually detected in infancy or early childhood.Duplicated segments are usually firmly attached to and sometimes communicate with the normal gastrointestinal tract.Rarely,intestinal duplications are completely isolated,thus not associated at all with any part of the gastrointestinal tract.Such duplications do not share a common blood supply with the adjacent normal intestinal segment,unlike the usual form of duplication,but rather have a separate vascular pedicle.Reports of completely isolated duplication cysts in adults are extremely rare;we found only five such reports in the English-language medical literature.Here,we report a case of a completely isolated duplication cyst 12 cm long in an adult female.The cyst had no connection to any part of the intestinal tract and had a dedicated vascular pedicle.展开更多
Pelvic ultrasound is the first-line examination for the diagnosis of ovarian cysts. When coupled with Doppler, it allows the diagnosis to be directed towards the benign or malignant nature of the cyst. These benign tu...Pelvic ultrasound is the first-line examination for the diagnosis of ovarian cysts. When coupled with Doppler, it allows the diagnosis to be directed towards the benign or malignant nature of the cyst. These benign tumors are frequent in pubertal period. We report a descriptive study in 35 patients aged between 18 and 32 years of age who received a pelvic inflammatory etiology assessment. The purpose of this study was to show the place of pelvic ultrasound in the diagnosis of ovarian cysts.展开更多
We present a case of a very large ovarian cyst extending up to the patient’s xiphisternum, which was managed through a Pfannensteil incision. The cyst was excised without any spill of fluid, using a5 mmlaparoscopic p...We present a case of a very large ovarian cyst extending up to the patient’s xiphisternum, which was managed through a Pfannensteil incision. The cyst was excised without any spill of fluid, using a5 mmlaparoscopic port under suction, through a Pfannensteil incision. By this method, the operating time and the post-operative in-patient stay were reduced. Also, as our patient had a very high BMI, the associated morbidity was significantly reduced.展开更多
Objective:To investigate the effects of suspension laparoscopy and pneumoperitoneum laparoscopic surgery on inflammatory response, stress hormone and ovarian function in patients with ovarian cystectomy.Methods: Retro...Objective:To investigate the effects of suspension laparoscopy and pneumoperitoneum laparoscopic surgery on inflammatory response, stress hormone and ovarian function in patients with ovarian cystectomy.Methods: Retrospective analysis of the data of laparoscopic ovarian cyst denudation in our hospital from July 2015 to August 2017, and they were were divided into the control group and the treatment group according to the surgical methods they accepted. The levels of inflammatory factors and stress hormone preoperative and postoperative 24 h, and ovarian function of the menstrual period 3rd day preoperative and postoperative 3 months of the two groups were compared.Results: There was no significant difference in the levels of TNF-α, CRP, COR, NE, E2, LH and FSH between the two groups before the operation. Postoperative 24 h, the levels of TNF-α, CRP, COR and NE in the treatment group were significantly lower than those in the control group, and the level of E2 in the treatment group was higher than that in control group, the levels of LH and FSH in the treatment group were lower than those in control group postoperative 3 months, the difference were statistically significant.Conclusion: Compared with pneumoperitoneum laparoscopic surgery, suspended laparoscopic surgery can effectively reduce the inflammatory response, reduce the level of stress hormone and improve ovarian function in patients undergoing ovarian cystectomy, which has a certain clinical value.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
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
Objective:To quantitatively analyze apparent diffusion coefficient(ADC)value of cystic composition and solid composition in ovarian cystadenocarcinoma,borderline cystadenoma and cystadenoma by 3.0T magnetic resonance ...Objective:To quantitatively analyze apparent diffusion coefficient(ADC)value of cystic composition and solid composition in ovarian cystadenocarcinoma,borderline cystadenoma and cystadenoma by 3.0T magnetic resonance imaging(MRI),and to investigate its diagnostic and differential diagnostic values in ovarian cystic adenoid tumors.Methods:Retrospective analysis was carried out on 28 patients with ovarian cystic adenoid tumor as confirmed by surgical and pathological examinations.Examination was performed by Siemens 3.0T MRI scanner.Tumor size,margin,composition(cystic or solid),signal characteristic and presence of ascites were observed.Combined with localization using T2WI and diffusion weighted imaging(DWI),ADC value was calculated from ADC mapping using region of interest ROI(the largest surface area of cystic and solid compositions in tumor).Statistical analysis was performed.Results:Among the 28 ovarian tumors,there were 13 cases of cystadenomas(5 serous cystadenomas and 9 mucinous cystadenomas),4 borderline mucinous cystadenomas and 11 cystadenocarcinoma(9 serous cystadenocarcinoma and 2 mucinous cystadenocarcinoma).There was no significant intragroup difference in ADC values of cystic composition and solid composition in ovarian cystadenoma and cystadenocarcinoma respectively(P>0.05).The ADC value of solid composition between benign cystadenoma and borderline cystadenoma(P<0.05)showed statistically significantly difference.The difference in ADC value of solid composition between benign cystadenoma and cystadenocarcinoma was also statistically significant(P<0.05).There was no significant difference in ADC value of cystic composition between benign cystadenoma,borderline cystadenoma and cystadenocarcinoma(P>0.05).Conclusion:Quantitative analysis of ADC value of solid composition using 3.0T MRI has great value in differential diagnosis of benign and malignant ovarian cystic adenoid tumors.Its combination with conventional MRI method can improve the accuracy of diagnosis of ovarian cystic adenoid tumors.展开更多
Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrel-releasing i...Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon) and the levonorgestrel-releasing implant (Jadelle). Bimanual pelvic examination and vaginal ultrasound were performed during routine 3,6 and 12-month visits of asymptomatic women(control group). Women with ovarian cysts (or enlarged ovarian follicles >25 mm) (cysts group) were assessed weekly until disappearence or reduction of the image (including estradiol (E2) and progesterone measurement) and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle,respectively,at 3rd month. At the 6th month of use,prevalences were 7.1% and 7.8%,and at 12th month rates were 25.7% and 14.7% in the two groups,respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.展开更多
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Ovarian Remnant syndrome (ORS) is the presence of residual ovarian tissue after an oophorectomy was performed whether associated with a hysterectomy or not. We report the case of a 39-year-old woman with a past surgical history of total abdominal hysterectomy and left salpingo-oophorectomy with an indication of placenta accreta incidentally discovered during a caesarian section. The patient presented with pelvic pain and was diagnosed with ORS. She was successfully managed by laparoscopy with removal of the cyst and the surrounding ovarian tissue, confirmed by histopathological analysis. The post operative period was uneventful, and the patient was discharged after 2 days of good evolution. In our context, surgery remains the main treatment option, however, other treatment options including radiotherapy or medical management need to be considered as either adjunct or main therapy.
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BACKGROUND Turner syndrome(TS)with leukemia is a complicated clinical condition.The clinical course and outcome of these patients are poor,so the treatment and prognosis of TS with hematological malignancies deserve our attention.CASE SUMMARY Here,we report a case of a 20-year-old woman diagnosed with TS,primary myelofibrosis(PMF),cirrhosis,and an ovarian cystic mass.This is the first report on the coexistence of TS and PMF with the MPL and SH2B3 mutations.The patient was diagnosed with cirrhosis of unknown cause,splenomegaly and severe gastroesophageal varices.Additionally,an ovarian cystic mass caused the patient to appear pregnant.The patient was treated with the JAK2 inhibitor-ruxolitinib according to peripheral blood cells,although myelofibrosis was improved,the splenomegaly did not reduce.Moreover,hematemesis and melena occasionally occurred.CONCLUSION Ruxolitinib may clearly reduce splenomegaly.Though myelofibrosis was improved,cirrhosis and splenomegaly in this case continued to worsen.Effective treatment should be discussed.
文摘Ovarian cystic masses include a spectrum of benign, borderline and high grade malignant neoplasms. Imaging plays a crucial role in characterization and pretreatment planning of incidentally detected or suspected adnexal masses, as diagnosis of ovarian malignancy at an early stage is correlated with a better prognosis. Knowledge of differential diagnosis, imaging features, management trends and an algorithmic approach of such lesions is important for optimal clinical management. This article illustrates a multi-modality approach in the diagnosis of a spectrum of ovarian cystic masses and also proposes an algorithmic approach for the diagnosis of these lesions.
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The dermoid ovarian is an organic mild tumor. It can be revealed by an adnexal torsion which constitutes a gynecological emergency that can bring into play in a short term after the functional prognosis. We are reporting an observed case in an 11-year-old teenager who is in times peri-pubertal. The patient was presenting a painful abdomino-pelvic syndrome and a pelvic mass at the physical examination. The ultrasound was showing a right cyst mass with a right moderated hydronephrosis. A right adnexectomy was realized. The histological test after excision of the adnexal was showing a mature cystic teratoma of the right ovary with a congestive and edematous tubal fragment.
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 ourhospital. 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 cystsand corpus luteum were found histologically in 90.8% of cases with cysts ＜5 cm, and 60% of those withcysts ＞7 cm respectively, their difference was significant (X2=-37.13, P＜0.001). The simple cysts, paraovar-ian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of pre-menopausal women. Conclusion. Patients with cysts ＞7 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 dur-ing followup. Postmenopausal women with cysts should have operations.
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Aim: To evaluate and compare the efficacy of methotrexate injection in management of persistent simple ovarian cyst versus the use of transvaginal ultrasound aspiration alone. Patients and Methods: This randomized controlled study was conducted at Tanta University Hospitals in the period from April 1, 2016 to October 31, 2016. Patients were randomly allocated into two groups;each group has 25 patients with benign persistent simple ovarian cyst. Group I: Patients were subjected to transvaginal aspiration of the cyst. Group II: patients were subjected to methotrexate injection inside the cyst. Patients in both group were followed up at 1, 3, 6 months after procedure for the recurrence and occurrence spontaneous pregnancy. Results: The mean age in group I was 28.8 years, and the mean age in group II was 26.52 years with non-significant difference. Also there was non-significant difference between both groups regarding size of the cyst. No case recorded to have a cyst recurrence in group II and four cases in group I within six months with significant difference (P value 0.037), and there was non-significant differences as regard the pregnancy rate and complications. Conclusion: Transvaginal intra-cystic methotrexate injection is a safe and effective choice for management of persistent simple benign ovarian cyst.
基金Supported by The 2013 scientific promotion program funded by Jeju National UniversityNo.2013-0237
文摘Intestinal duplications are rare congenital anomalies that can occur anywhere in the gastrointestinal tract.They are most commonly located in the ileum and are usually detected in infancy or early childhood.Duplicated segments are usually firmly attached to and sometimes communicate with the normal gastrointestinal tract.Rarely,intestinal duplications are completely isolated,thus not associated at all with any part of the gastrointestinal tract.Such duplications do not share a common blood supply with the adjacent normal intestinal segment,unlike the usual form of duplication,but rather have a separate vascular pedicle.Reports of completely isolated duplication cysts in adults are extremely rare;we found only five such reports in the English-language medical literature.Here,we report a case of a completely isolated duplication cyst 12 cm long in an adult female.The cyst had no connection to any part of the intestinal tract and had a dedicated vascular pedicle.
文摘Pelvic ultrasound is the first-line examination for the diagnosis of ovarian cysts. When coupled with Doppler, it allows the diagnosis to be directed towards the benign or malignant nature of the cyst. These benign tumors are frequent in pubertal period. We report a descriptive study in 35 patients aged between 18 and 32 years of age who received a pelvic inflammatory etiology assessment. The purpose of this study was to show the place of pelvic ultrasound in the diagnosis of ovarian cysts.
文摘We present a case of a very large ovarian cyst extending up to the patient’s xiphisternum, which was managed through a Pfannensteil incision. The cyst was excised without any spill of fluid, using a5 mmlaparoscopic port under suction, through a Pfannensteil incision. By this method, the operating time and the post-operative in-patient stay were reduced. Also, as our patient had a very high BMI, the associated morbidity was significantly reduced.
基金Project of Natural Science Foundation of Jiangsu Provincial Science and Technology Department.(BK2010576).
文摘Objective:To investigate the effects of suspension laparoscopy and pneumoperitoneum laparoscopic surgery on inflammatory response, stress hormone and ovarian function in patients with ovarian cystectomy.Methods: Retrospective analysis of the data of laparoscopic ovarian cyst denudation in our hospital from July 2015 to August 2017, and they were were divided into the control group and the treatment group according to the surgical methods they accepted. The levels of inflammatory factors and stress hormone preoperative and postoperative 24 h, and ovarian function of the menstrual period 3rd day preoperative and postoperative 3 months of the two groups were compared.Results: There was no significant difference in the levels of TNF-α, CRP, COR, NE, E2, LH and FSH between the two groups before the operation. Postoperative 24 h, the levels of TNF-α, CRP, COR and NE in the treatment group were significantly lower than those in the control group, and the level of E2 in the treatment group was higher than that in control group, the levels of LH and FSH in the treatment group were lower than those in control group postoperative 3 months, the difference were statistically significant.Conclusion: Compared with pneumoperitoneum laparoscopic surgery, suspended laparoscopic surgery can effectively reduce the inflammatory response, reduce the level of stress hormone and improve ovarian function in patients undergoing ovarian cystectomy, which has a certain clinical value.
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Objective:To quantitatively analyze apparent diffusion coefficient(ADC)value of cystic composition and solid composition in ovarian cystadenocarcinoma,borderline cystadenoma and cystadenoma by 3.0T magnetic resonance imaging(MRI),and to investigate its diagnostic and differential diagnostic values in ovarian cystic adenoid tumors.Methods:Retrospective analysis was carried out on 28 patients with ovarian cystic adenoid tumor as confirmed by surgical and pathological examinations.Examination was performed by Siemens 3.0T MRI scanner.Tumor size,margin,composition(cystic or solid),signal characteristic and presence of ascites were observed.Combined with localization using T2WI and diffusion weighted imaging(DWI),ADC value was calculated from ADC mapping using region of interest ROI(the largest surface area of cystic and solid compositions in tumor).Statistical analysis was performed.Results:Among the 28 ovarian tumors,there were 13 cases of cystadenomas(5 serous cystadenomas and 9 mucinous cystadenomas),4 borderline mucinous cystadenomas and 11 cystadenocarcinoma(9 serous cystadenocarcinoma and 2 mucinous cystadenocarcinoma).There was no significant intragroup difference in ADC values of cystic composition and solid composition in ovarian cystadenoma and cystadenocarcinoma respectively(P>0.05).The ADC value of solid composition between benign cystadenoma and borderline cystadenoma(P<0.05)showed statistically significantly difference.The difference in ADC value of solid composition between benign cystadenoma and cystadenocarcinoma was also statistically significant(P<0.05).There was no significant difference in ADC value of cystic composition between benign cystadenoma,borderline cystadenoma and cystadenocarcinoma(P>0.05).Conclusion:Quantitative analysis of ADC value of solid composition using 3.0T MRI has great value in differential diagnosis of benign and malignant ovarian cystic adenoid tumors.Its combination with conventional MRI method can improve the accuracy of diagnosis of ovarian cystic adenoid tumors.
基金This study received partial financial support from the Fundaǎo de Amparo a Pesquisa do Estado de So Paulo (FAPESP), Brazil under award #03/083917.
文摘Objective To evaluate the prevalence of functional ovarian cysts in users of two different types of contraceptive implants. Methods A total of 239 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon) and the levonorgestrel-releasing implant (Jadelle). Bimanual pelvic examination and vaginal ultrasound were performed during routine 3,6 and 12-month visits of asymptomatic women(control group). Women with ovarian cysts (or enlarged ovarian follicles >25 mm) (cysts group) were assessed weekly until disappearence or reduction of the image (including estradiol (E2) and progesterone measurement) and women with no ovarian enlargement underwent same evaluation for the same period of time. Results Ovarian cysts were detected in 5.1% and 13.0% of users of Implanon and Jadelle,respectively,at 3rd month. At the 6th month of use,prevalences were 7.1% and 7.8%,and at 12th month rates were 25.7% and 14.7% in the two groups,respectively. E2 levels were significantly higher in cysts group than in control group. The time until disappearance of the ovarian cyst was similar in Implanon and Jadelle group. There were more cases of menorrhagia in patients rveth ovarian cysts than in patients with no ovarian enlargement. Conclusions The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.
