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:Ovarian cysts are uncommon gestational complications.Because of high-level progesterone,ovarian endometriomas may undergo decidualization during pregnancy,manifesting as enlarging cysts with papillae and ri...Background:Ovarian cysts are uncommon gestational complications.Because of high-level progesterone,ovarian endometriomas may undergo decidualization during pregnancy,manifesting as enlarging cysts with papillae and rich blood flow.Such cases can mimic malignant or borderline tumors,causing dilemmas in clinical management.Here,we present two cases of enlarging ovarian cysts during pregnancy with evidence suggesting decidualized endometrioma.The diagnosis and treatment are further discussed,which add to our limited knowledge and might help future clinical practice.Case summary:In the first case,a right ovarian cyst was detected by ultrasound in a 32-year-old pregnant woman.The cyst measured 4.2 cm in diameter at 7t6 weeks of gestation,and gradually increased to 9.6 cm7.6 cm5.6 cm at 37t5 weeks,with multiple solid papillae lining the inner wall.During cesarean section,an ovarian mass of approximately 9 cm in diameter was surgically removed,which was later identified by pathological review as an endometrioma with decidualization.The second case also presented as an enlarging ovarian mass during the first and second trimester.The size of the cyst peaked at 24t5 weeks of gestation,measuring 6.9 cm5.6 cm4.1 cm.But in the third trimester,the tumor slightly regressed.Careful follow-up was adopted after successful vaginal delivery,and the cyst was found to have undergone quick regression shortly after pregnancy.Both patients recovered well after delivery with no further complications.Conclusion:Endometriomas with decidualization during gestation may resemble borderline or malignant tumors.Close monitoring and proper management are essential for guiding clinical management.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
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
BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10...BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts.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
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
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
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.
基金the National Key Technology R&D Program of China(2019YFC1005200 and 2019YFC1005201).
文摘Background:Ovarian cysts are uncommon gestational complications.Because of high-level progesterone,ovarian endometriomas may undergo decidualization during pregnancy,manifesting as enlarging cysts with papillae and rich blood flow.Such cases can mimic malignant or borderline tumors,causing dilemmas in clinical management.Here,we present two cases of enlarging ovarian cysts during pregnancy with evidence suggesting decidualized endometrioma.The diagnosis and treatment are further discussed,which add to our limited knowledge and might help future clinical practice.Case summary:In the first case,a right ovarian cyst was detected by ultrasound in a 32-year-old pregnant woman.The cyst measured 4.2 cm in diameter at 7t6 weeks of gestation,and gradually increased to 9.6 cm7.6 cm5.6 cm at 37t5 weeks,with multiple solid papillae lining the inner wall.During cesarean section,an ovarian mass of approximately 9 cm in diameter was surgically removed,which was later identified by pathological review as an endometrioma with decidualization.The second case also presented as an enlarging ovarian mass during the first and second trimester.The size of the cyst peaked at 24t5 weeks of gestation,measuring 6.9 cm5.6 cm4.1 cm.But in the third trimester,the tumor slightly regressed.Careful follow-up was adopted after successful vaginal delivery,and the cyst was found to have undergone quick regression shortly after pregnancy.Both patients recovered well after delivery with no further complications.Conclusion:Endometriomas with decidualization during gestation may resemble borderline or malignant tumors.Close monitoring and proper management are essential for guiding clinical management.
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.
文摘BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts.
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.
