Factors Associated with Torsion in Pediatric Patients with Ovarian Masses.

BACKGROUND: Management of ovarian torsion has evolved toward ovarian preservation regardless of ovarian appearance during surgery. However, patients with torsion and an ovarian neoplasm undergo a disproportionately high rate of oophorectomy. Our objectives were to identify factors associated with ovarian torsion among females with an ovarian mass and to determine if torsion is associated with malignancy. METHODS: A retrospective review of females aged 2-21 y who underwent an operation for an ovarian cyst or neoplasm between 2010 and 2016 at 10 children's hospitals was performed. Multivariate logistic regression was used to assess factors associated with torsion. Imaging data were assessed for sensitivity, specificity, and predictive value in identifying ovarian torsion. RESULTS: Of 814 girls with an ovarian neoplasm, 180 (22%) had torsion. In risk-adjusted analyses, patients with a younger age, mass size >5 cm, abdominal pain, and vomiting had an increased likelihood of torsion (P < 0.01 for all). Patients with a mass >5 cm had two times the odds of torsion (odds ratio: 2.1; confidence interval: 1.2, 3.6). Imaging was not reliable at identifying torsion (sensitivity 34%, positive predictive value 49%) or excluding torsion (specificity 72%, negative predictive value 87%). The rates of malignancy were lower in those with an ovarian mass and torsion than those without torsion (10% versus 17%, P = 0.01). Among the 180 girls with torsion and a mass, 48% underwent oophorectomy of which 14% (n = 12) had a malignancy. CONCLUSIONS: In females with an ovarian neoplasm, torsion is not associated with an increased risk of malignancy and ovarian preservation should be considered.

A prospective validation of the IOTA logistic regression models (LR1 and LR2) in comparison to subjective pattern recognition for the diagnosis of ovarian cancer.

OBJECTIVES: This study aimed to assess the accuracy of the International Ovarian Tumour Analysis (IOTA) logistic regression models (LR1 and LR2) and that of subjective pattern recognition (PR) for the diagnosis of ovarian cancer. METHODS AND MATERIALS: This was a prospective single-center study in a general gynecology unit of a tertiary hospital during 33 months. There were 292 consecutive women who underwent surgery after an ultrasound diagnosis of an adnexal tumor. All examinations were by a single level 2 ultrasound operator, according to the IOTA guidelines. The malignancy likelihood was calculated using the IOTA LR1 and LR2. The women were then examined separately by an expert operator using subjective PR. These were compared to operative findings and histology. The sensitivity, specificity, area under the curve (AUC), and accuracy of the 3 methods were calculated and compared. RESULTS: The AUCs for LR1 and LR2 were 0.94 [95% confidence interval (CI), 0.92-0.97] and 0.93 (95% CI, 0.90-0.96), respectively. Subjective PR gave a positive likelihood ratio (LR+ve) of 13.9 (95% CI, 7.84-24.6) and a LR-ve of 0.049 (95% CI, 0.022-0.107). The corresponding LR+ve and LR-ve for LR1 were 3.33 (95% CI, 2.85-3.55) and 0.03 (95% CI, 0.01-0.10), and for LR2 were 3.58 (95% CI, 2.77-4.63) and 0.052 (95% CI, 0.022-0.123). The accuracy of PR was 0.942 (95% CI, 0.908-0.966), which was significantly higher when compared with 0.829 (95% CI, 0.781-0.870) for LR1 and 0.836 (95% CI, 0.788-0.872) for LR2 (P < 0.001). CONCLUSIONS: The AUC of the IOTA LR1 and LR2 were similar in nonexpert's hands when compared to the original and validation IOTA studies. The PR method was the more accurate test to diagnose ovarian cancer than either of the IOTA models.

Histology and prevalence of ovarian tumours in postmenopausal women: is follow-up required in all cases?

The objective of this study was to determine if follow-up is required for all ovarian tumours incidentally diagnosed in postmenopausal women, by studying the prevalence and histology of ovarian tumours in postmenopausal women undergoing hysterectomy. The histopathology of adnexa in 100 consecutive postmenopausal women who underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy for various indications, was reviewed. A total of 200 adnexa were examined. Ovarian pathology was found in 62/200 (31%). Of these 34/62 (53%) were unilocular cystic tumours, 9/62 (15%) were multilocular tumours, 11/62 (18%) were solid tumours and 8/62 (11%) were uni or multilocular with solid elements. The prevalence of borderline tumours was 4% and that of malignant tumours was 5%. All tumours < 2 cm were found to be benign. All unilocular cysts < 5 cm were benign. In conclusion, a vast majority of ovarian tumours in this group of women were benign. It may be reasonable not to follow-up women with unilocular ovarian tumours < 5 cm who have a normal CA125.

MDCT imaging findings for characterization pancreatic cystic lesion: differentiation between benign and malignant pattern.

OBJECTIVE: The purpose of the present study was to determine the characteristic imaging findings for diagnosis of the benign or malignant nature of pancreatic cystic lesions by 64 slice multidetector computed tomography (MDCT) for further investigation or treatment. MATERIAL AND METHOD: A retrospective study was performed in 33 patients with pancreatic cystic lesion who underwent 64 slice MDCT to characterize and establish the diagnosis. The patients were enrolled between January 2004 and March 2009. The MDCT scan of abdomen from patients with pancreatic cystic lesion was retrospectively evaluated by two gastrointestinal radiologists without knowledge of the patient's history, clinical data, and final diagnosis. Sensitivity, specificity, accuracy, PPV, and NPV of CT scan for discriminate benign and malignant pancreatic cystic lesion were calculated. Weighted-kappa statistics were used to estimate agreement between readers. RESULTS: Thirty-three patients with pancreatic cystic lesion were included in the present study. Benign pancreatic cystic lesion are pancreatic pseudocyst (n = 16), serous cystadenoma (n = 4) and benign intraductal papillary mucinous neoplasms IPMN (n = 2). Premalignant and malignant pancreatic cystic tumor are mucinous cystic tumor (n = 5) and include solid pseudopapillary epithelial neoplasm of pancreas (n = 3) and malignant intraductal papillary mucinous neoplasms IPMN (n = 3). The final diagnosis was established either by pathological diagnosis (20 patients), EUS with FNA (11 patients) or F/U clinical and imaging findings (2 patients). Pseudopod sign is a helpful finding for diagnosis pancreatic pseudocyst (3/16) and not observed in other types pancreatic cystic lesions. Type of cyst (unilocular, multilocular microcystic, multilocular macrocystic and solid component) is the only finding that has statistical significance for differentiating between the benign and malignant groups (p < 0.005). The overall sensitivity, specificity and accuracy of 64-slice MDCT to discriminate benign and malignant pancreatic cystic lesion were 36.3%, 100% and 78.8%, respectively. In addition, the PPV and NPV were 100% and 75.9%, respectively. CONCLUSION: The 64 sliced MDCT is a noninvasive method that can be used for discriminating between benign and malignant pancreatic cystic lesions, which is an important finding for further investigation and proper treatment.

Thyroid Cysts in Cats: A Retrospective Study of 40 Cases.

BACKGROUND: Thyroid cysts are rare in cats and poorly documented. OBJECTIVES: To report distinguishing clinical features and treatment responses of cats with thyroid cysts. ANIMALS: Forty client-owned cats. METHODS: Retrospective review of medical records for cats with thyroid cysts confirmed by scintigraphy, ultrasound, magnetic resonance imaging, or necropsy at 4 referral centers between 2005 and 2016. Signalment, clinical findings, diagnostic testing, treatment, and outcome were recorded. RESULTS: Cats ranged in age from 8 to 20 years with no apparent breed or sex predilection. 37 of 40 (93%) cats were hyperthyroid (duration, 1-96 months). Clinical findings included palpable neck mass (40/40, 100%), weight loss (15/40, 38%), dysphagia (8/40, 20%), decreased appetite (5/40, 13%), and dyspnea (4/40, 10%). Cysts were classified as small (≤8 cm3 ) in 16 (40%) and large (>8 cm3 ) in 24 (60%) cats. Of 25 cats treated with radioiodine, hyperthyroidism resolved in 23 (92%), whereas thyroid cysts resolved in 12 (50%). Radioiodine treatment resolved small cysts in 8 of 13 (62%) cats and large cysts in 4 of 11 (36%) cats. Eight cats, including 2 euthyroid cats, underwent thyroid-cystectomy; 3 with bilateral thyroid involvement were euthanized postoperatively for hypocalcemia. Excised cystic thyroid masses were identified as cystadenoma (4) and carcinoma (4). CONCLUSIONS AND CLINICAL IMPORTANCE: Thyroid cysts are encountered in hyperthyroid and euthyroid cats with benign and malignant thyroid tumors. Radioiodine treatment alone inconsistently resolved thyroid cysts. Thyroid-cystectomy could be considered in cats with unilateral thyroid disease or when symptomatic cysts persist despite successful radioiodine treatment of hyperthyroidism.

Primary harderian gland neoplasms in mice.

Five hundred and seventy-four spontaneous harderian gland neoplasms were observed in 3,123 male and 9,024 female untreated experimental mice of various ages and of 6 inbred strains and substrains and 3 hybrid stocks. Adenomas occurred in 86 males and 458 females, and adenocarcinomas were present in 3 males and 27 females. The highest tumor incidence occurred in mice after 24 months of age; no tumors were observed in any mice prior to 6 months of age. With the exception of 1 age group, both sexes of the BALB/c mice had the highest incidence, and also this strain accounted for 463 of the neoplasms. The adenomas were classified into one of four different histologic types: papillary, cystic papillary, acinar, and cystic. The papillary type was the most frequently observed in both sexes. The cystic papillary type was the second most frequently observed and was the type most frequently associated with gross lesions. This type may represent a developmental variant of the papillary type. The incidence of the acinar type was similar in both sexes. The cystic type had the lowest incidence. All except 3 adenocarcinomas appeared to evolve from adenomas, with evolvement occurring primarily in the acinar type. Five of the adenocarcinomas either metastasized to the lung or invaded periorbital tissues. The remaining 25 were confined to the harderian gland.

Benign and Malignant Salivary Gland Tumors - Clinical and Demographic Characteristics.

AIM: To examine the demographic, ethnic, and clinical characteristics of salivary benign and malignant tumors for better etiological understanding. PATIENTS AND METHODS: We examined medical records of 287 primary salivary gland tumor patients. RESULTS: Overall, 216 tumors were benign and 71 malignant. The mean age at diagnosis was 56.4 years for those with malignant tumors and 48.5 years for those with benign, a highly significant difference (p=0.001). Females had 45% of malignant tumors and 59% of benign, a significant difference (p=0.037). Ethnic origin, alcohol consumption and cigarette smoking rates were not significantly different (p>0.05) between groups. A total of 87% of benign and 55% of malignant tumors were in the parotid glands, a highly significant predilection (p<0.0001), sublocated mostly in the superfacial lobe; 36.6% of malignant tumors and 4.7% of benign (p<0.0001) were in the minor salivary glands, mostly in the hard palate. CONCLUSION: Baseline clinical, demographic and locational aspects of benign and malignant tumors are substantiated.

Cystadenoma and laparoscopic surgery for hepatic cystic disease: a need for laparotomy?

BACKGROUND: This study aimed to evaluate the incidence of cystadenoma diagnosis in a series of laparoscopic treatments for nonparasitic liver cysts, as well as its management. METHODS: From 1996 to 2004, 26 patients with a nonparasitic cyst of the liver were selected for laparoscopic liver surgery. Solitary nonparasitic liver cysts were, whenever feasible, completely enucleated. RESULTS: In four patients, the histopathologic examination showed a cystadenoma. Three patients with 13, 9, and 12-cm cysts, respectively, had undergone complete enucleation of the lesion, with no evidence of recurrence in the follow-up visit. One patient with multicystic liver experienced a recurrence and required an open hepatic resection. CONCLUSIONS: When a complete laparoscopic enucleation of the cyst can be ensured, a strict follow-up assessment should be considered as the definitive treatment, with surgical intervention demanded only in the case of recurrence or high suspicion for malignancy.

Diagnosis and Management of Pancreatic Cystic Neoplasms.

Incidentally discovered pancreatic cystic lesions are increasingly common, affecting up to 10% to 15% of patients undergoing cross-sectional imaging. Although some pancreatic cystic neoplasms harbor invasive malignancy or the potential to progress over time, a majority are benign and can be observed safely. Accurate diagnosis is key to appropriate management. Diagnosis requires a multidisciplinary and multimodal approach. This review discusses each type of pancreatic cystic neoplasm and the current data on diagnosis and treatment.

Prevalence, Diagnosis and Management of Pancreatic Cystic Neoplasms: Current Status and Future Directions.

Cystic neoplasms of the pancreas are found with increasing prevalence, especially in elderly asymptomatic individuals. Although the overall risk of malignancy is very low, the presence of these pancreatic cysts is associated with a large degree of anxiety and further medical investigation due to concerns about malignancy. This review discusses the different cystic neoplasms of the pancreas and reports diagnostic strategies based on clinical features and imaging data. Surgical and nonsurgical management of the most common cystic neoplasms, based on the recently revised Sendai guidelines, is also discussed, with special reference to intraductal papillary mucinous neoplasm (IPMN; particularly the branch duct variant), which is the lesion most frequently identified incidentally. IPMN pathology, its risk for development into pancreatic ductal adenocarcinoma, the pros and cons of current guidelines for management, and the potential role of endoscopic ultrasound in determining cancer risk are discussed. Finally, surgical treatment, strategies for surveillance of pancreatic cysts, and possible future directions are discussed.

New von Hippel-Lindau manifestations develop at the same or decreased rates in pregnancy.

OBJECTIVE: In a national retrospective cohort study, we aimed to determine the effect of pregnancy on new von Hippel-Lindau (vHL) tumor development during pregnancy and at 1, 3, and 5 years after conception. METHODS: We included 52 VHL mutation carriers (26 men and 26 women) with 581 manifestations diagnosed throughout their lifetimes. We analyzed age-dependent manifestation rates using Poisson regression. We compared the women's rates in intervals where they had been pregnant with their age-matched nonpregnant intervals. We investigated possible long-term effects using pregnancy intervals of increasing lengths of 1, 3, and 5 years after conception. Furthermore, we compared age-related manifestation rates for women and men. RESULTS: From birth to the participants' current age, 581 manifestations were diagnosed; mean age was 37.5 years (range 2-64 years). Seventeen women had completed 30 pregnancies. Manifestation rates in women's pregnant intervals were lower compared with their age-matched nonpregnant intervals (1 year: hazard ratio [HR] = 0.439, 95% confidence interval [CI] 0.131-1.474, p = 0.18; 3 years: HR = 0.412, 95% CI 0.214-0.796, p = 0.0083; and 5 years: HR = 0.450, 95% CI 0.136-1.489, p = 0.19). Men and women had similar manifestation rates, both increasing from their 20s. CONCLUSIONS: Pregnancy does not aggravate vHL tumor development, and we neither discourage pregnancy in VHL mutation carriers nor recommend intensified surveillance during pregnancy. The pregnancy effect is not due to concurrence of a naturally milder tumor development in women's fertile ages, as the rate of new tumor development increases for both men and women from 20 years of age, even more in men than in women.

Occurrence of ovarian malignancy in childhood and adolescence: a community-wide evaluation.

During childhood and adolescence, the rate of malignancy in ovarian enlargement is reported to be high-approximately 35% in many large series from tertiary centers. To assess whether this represents an overestimation because of the referral patterns of these institutions, a retrospective review was conducted at five hospitals in Nashville, Tennessee. In females 21 years of age and under, borderline or malignant ovarian neoplasms were identified in only eight (5.8%) of 137 individuals with ovarian enlargement and eight (9.8%) of 82 females with ovarian neoplasms. All six malignant neoplasms were of germ-cell origin. The borderline neoplasms were of epithelial origin, and occurred in females in their late teens. We conclude that the frequency with which ovarian enlargement represents malignancy in this age group appears to be much smaller than previously suggested. Nevertheless, because of the potential for malignant ovarian neoplasia in young females, the presence of an abdominal-pelvic mass requires prompt and thorough attention.

Nonductal tumors of the pancreas. The importance of laparotomy.

OBJECTIVES: To delineate the incidence of nonductal pancreatic neoplasms and determine whether distinguishing clinical or radiologic characteristics exist. METHODS: From 1977 through 1990, we examined 353 patients with a pancreatic mass as demonstrated on abdominal computed tomography or ultrasonography. Patients with chronic pancreatitis or functioning neuroendocrine tumors were excluded. All patients underwent operative exploration for histopathologic diagnosis and resection when possible. RESULTS: Adenocarcinoma of the pancreas was seen in 322 patients. The remaining 31 patients (8.8%) were found to have nonductal tumors of the pancreas, including nonfunctioning islet cell tumors (15), cystadenoma (nine), lymphoma (five), lipoma (one), and mesothelioma (one). These neoplasms were evenly distributed between the head and tail of the pancreas, while most of the ductal pancreatic carcinomas were located in the pancreatic head. While abdominal computed tomography and ultrasonography accurately identified most cystic neoplasms, the remaining nonductal lesions were indistinguishable from ductal pancreatic tumors. Preoperative biochemical studies and liver function tests failed to separate ductal and nonductal pancreatic masses. Average survival for patients with nonductal lesions was significantly longer compared with ductal tumors of the pancreas. CONCLUSIONS: Because increasing reliance on advanced radiologic and invasive nonoperative diagnostic testing may deny proper surgical therapy to patients with nonductal neoplasms of the pancreas, laparotomy and histopathologic diagnosis are advisable in most patients with an isolated pancreatic mass.

Large cystic lesions of the liver in adults: a 15-year experience in a tertiary center.

BACKGROUND: Cystic lesions of the liver consist of a heterogeneous group of disorders and may present a diagnostic and therapeutic challenge. Large hepatic cysts tend to be symptomatic and can cause complications more often than smaller ones. STUDY DESIGN: We performed a retrospective review of adults diagnosed with large (> or = 4 cm) hepatic cystic lesions at our center, over a period of 15 years. Polycystic disease and abscesses were not included. RESULTS: Seventy-eight patients were identified. In 57 the lesions were simple cysts, in 8 echinococcal cysts, in 8 hepatobiliary cystadenomas, and in 1 hepatobiliary cystadenocarcinoma. In four patients, the precise diagnosis could not be ascertained. Mean size was 12.1 cm (range, 4 to 30 cm). Most simple cysts were found in women (F:M, 49:8). Bleeding into a cyst (two patients) and infection (one patient) were rare manifestations. Percutaneous aspiration of 28 simple cysts resulted in recurrence in 100% of the cases within 3 weeks to 9 months (mean 4(1/2) months). Forty-eight patients were treated surgically by wide unroofing or resection (laparoscopically in 18), which resulted in low recurrence rates (11% for laparoscopy and 13% for open unroofing). Four of the eight patients with echinococcal cysts were symptomatic. All were treated by open resection after irrigation of the cavity with hypertonic saline. There was no recurrence during a followup period of 2 to 14 years. Hepatobiliary cystadenomas occurred more commonly in women (F:M, 7:1) and in the left hepatic lobe (left:right, 8:0). Seven were multiloculated. All were treated by open resection, with no recurrence, and none had malignant changes. Cystadenocarcinoma was diagnosed in a 77-year-old man, and was treated by left hepatic lobectomy. CONCLUSIONS: Large symptomatic simple cysts invariably recur after percutaneous aspiration. Laparoscopic unroofing can be successfully undertaken, with a low recurrence rate. Open resection after irrigation with hypertonic saline is a safe and effective treatment for echinococcal cysts. Hepatobiliary cystadenomas have predilection for women and for the left hepatic lobe. Malignant transformation is an uncommon but real risk. Open resection is a safe and effective treatment for hepatobiliary cystadenoma, and is associated with a low recurrence rate.

Spectrum of cystic tumors of the pancreas.

The pathologic and clinical classification, as well as the behavior, of cystic tumors of the pancreas has been the subject of controversy. We retrospectively reviewed 50 patients with a diagnosis of cystic tumor of the pancreas observed at The Johns Hopkins Hospital from 1984 to 1991. These tumors were classified into three broad groups: I, cystadenoma; II, cystadenocarcinoma; and III, adenocarcinoma with mucin production or an associated cyst. The three groups did not differ with respect to age or sex. The most common clinical presentation was abdominal pain. Symptoms and signs among the three groups were similar except that patients with cystadenomas were less likely (p less than 0.05) to be jaundiced and more likely (p less than 0.05) to be asymptomatic. Radiologic findings on computerized tomography, cholangiography, and arteriography also overlapped, making precise preoperative determination of tumor type difficult. Operative classification was also often not possible. The resectability rate (Group I, 91%; Group II, 67%; Group III, 53%) and 5-year survival rate (Group I, 90%; Group II, 72%; Group III, 14%) correlated with careful pathologic determination. Cystic tumors of the pancreas represent a spectrum of disease ranging from benign cystadenoma to adenocarcinoma masquerading as cystadenocarcinoma. We recommend resection whenever possible, even when preoperative evaluation suggests benign disease.

Appendix tumors in the era of laparoscopic appendectomy.

BACKGROUND: The safety of laparoscopic appendectomy for the management of incidentally discovered appendiceal tumors has not yet been established. METHODS: Appendiceal tumor cases managed by laparoscopy or laparotomy over a 10-year period were reviewed. RESULTS: The pathological diagnoses were 23 carcinoid and 20 cancerous lesions. The median patient ages were 36 and 69 years, respectively, for carcinoid and other tumors (p < 0.05). Acute appendicitis was present in 70% of carcinoid cases and 35% of other tumors (p < 0.05). Eight patients with carcinoid tumors were operated on by laparoscopy, whereas 15 underwent laparotomy. Laparoscopic and open procedures were performed in three and 17 patients with cancerous lesions, respectively. Invaded surgical margins were seen after laparoscopy in 20% of patients and open surgery in 6%. Synchronous colon carcinoma was detected in 14% of the patients with an appendix neoplasm. The 5-year survival rates were similar after both laparoscopic and open appendectomy for either carcinoid or other tumors. CONCLUSION: Laparoscopic appendectomy for appendiceal tumors seems to have a slightly higher rate of inadequate resection. However, it is not associated with a significantly worse patient prognosis than open appendectomy.

Giant, benign, mucinous cystadenoma of the ovary: case study and literature review.

Benign, mucinous cystadenomas account for 15 per cent of all ovarian neoplasms. Of these, the giant variant occurs rarely. A morbidly obese, 52-year-old, white woman was seen for acute abdominal pain and diagnosed using computerized tomography as having a giant, benign, mucinous cystadenoma. At laparotomy, 21-kg cystic mass attached to the right ovary was removed. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. In such patients, special consideration must be given to hemodynamic and ventilatory monitoring and intraoperative fluid management. Recognition and subsequent surgical management of this and other large abdominal masses can be optimized by thoughtful, preoperative evaluation and careful planning of the operative approach.

Incidence of the histologic types of ovarian tumors in Benghazi (Libya) and Poland.

The distribution of histological types of ovarian tumors in two communities with different reproductive experience was compared. 108 cases of ovarian neoplasms diagnozed in Benghazi and 2238 cases collected in Ovarian Tumors Registry in Poland were classified according to the WHO histological typing. The difference in the incidence of histologic types and malignancy was statistically evaluated. Unlike Poland series, in Benghazi germ cell tumors are the most common type of ovarian neoplasms (50% of all reported cases), while the percentage of epithelial tumors accounts for 33.3. This proportion of incidence of epithelial and germ cell tumors in Benghazi is similar to relative frequency of these tumor types noted in teenagers in Europe and the USA. The difference in incidence of the histologic types of ovarian tumors in Benghazi and Poland is probably due to the significantly higher rate of fertility among Libyan women as compared with Polish female population.

Incidence and morphology of spontaneous thyroid tumours in different strains of rats.

The incidence and morphology of thyroid neoplasms in different strains and stocks of rats are reported. The frequency of thyroid tumours varied to a great extent between different strains of rats. Low incidences were observed in DA/Han (0.85 per cent) and BDII/Han rats (1.25 per cent), while somewhat higher incidences occurred in Han:WIST rats (7.3 per cent). The highest number of thyroid tumour-bearing rats was found in the Han:SPRD stock (55.5 per cent). Thyroid neoplasms were classified histologically as polymorphofollicular adenomas, papillary adenomas, cystadenomas, polymorphofollicular carcinomas, papillary carcinomas, C-cell adenomas and C-cell carcinomas (medullary carcinomas). C-cell neoplasms were predominant in Han:SPRD rats (93.0 per cent), while the majority of tumour-bearing Han:WIST rats (61.4 per cent) had follicular tumours.

Ovarian tumors complicating pregnancy.

Between the years 1977 and 1981, 9037 patients gave birth at Jordan University Hospital (JUH). Among these ten patients were found to have an associated ovarian tumor, an incidence of one in 900 deliveries. Benign cystic teratomas were the most common ovarian tumors found, followed by mucinous cystadenomas. All of the tumors were benign except one case of Burkitt's lymphoma.