Cistos ovarianos em cadelas: classificação, relevância clínica, diagnóstico e tratamento / Ovarian cysts in bitches: classification, clinical relevance, diagnostic and treatment

Diversos são os tipos de cistos ovarianos que podem acometer as cadelas. Dentre estes há cistosprodutores de hormônios ou não. Os cistos que produzem hormônios podem causar diversas alterações clínicasno animal e até mesmo interferir na fertilidade. Já os cistos não produtores podem comprometer a funçãoovariana por substituição do parênquima ovariano por tecido cístico. O diagnóstico se baseia no histórico,anamnese e achados clínicos, associado a exames complementares. O tratamento varia de acordo com o tipo decisto, bem como o interesse reprodutivo ou não no animal.(AU)

Several types of ovarian cysts can affect bitches. Among these are the endocrine active cysts and thenon-endocrine active cysts and the non-producing cysts. Cysts that are associated with the production ofhormones can cause various clinical changes in the animal, and even interfere with fertility. Non-endocrineactive cysts can compromise ovarian function by replacing the ovarian parenchyma with cystic tissue. Thediagnosis is based on anamnesis and clinical findings, associated with complementary exams. Treatment variesaccording to the type of cyst, as well as if the animal is intended for breeding or not.(AU)

Cistos ovarianos em cadelas: classificação, relevância clínica, diagnóstico e tratamento / Ovarian cysts in bitches: classification, clinical relevance, diagnostic and treatment

Diversos são os tipos de cistos ovarianos que podem acometer as cadelas. Dentre estes há cistosprodutores de hormônios ou não. Os cistos que produzem hormônios podem causar diversas alterações clínicasno animal e até mesmo interferir na fertilidade. Já os cistos não produtores podem comprometer a funçãoovariana por substituição do parênquima ovariano por tecido cístico. O diagnóstico se baseia no histórico,anamnese e achados clínicos, associado a exames complementares. O tratamento varia de acordo com o tipo decisto, bem como o interesse reprodutivo ou não no animal.

Several types of ovarian cysts can affect bitches. Among these are the endocrine active cysts and thenon-endocrine active cysts and the non-producing cysts. Cysts that are associated with the production ofhormones can cause various clinical changes in the animal, and even interfere with fertility. Non-endocrineactive cysts can compromise ovarian function by replacing the ovarian parenchyma with cystic tissue. Thediagnosis is based on anamnesis and clinical findings, associated with complementary exams. Treatment variesaccording to the type of cyst, as well as if the animal is intended for breeding or not.

Clinical management of incidental findings on pelvic adnexal masses.

Due to widespread use of pelvic and transvaginal ultrasound in routine gynecological evaluation, the incidental finding of adnexal masses has led to discussions about management in asymptomatic patients regarding the risk of ovarian cancer. Transvaginal ultrasonography remains the modality of choice in the evaluation of suspicious characteristics. The combined analysis of ultrasound morphological parameters with Doppler study, serum carcinoma antigen 125 and investigation of a symptom index may improve diagnosis. Surgical approach should be considered whenever there are suspicious images, rapid growth of cysts, changes in the appearance compared to the initial evaluation or when the patient has symptoms. Future studies on genetic and molecular mechanisms may help explain the pathophysiology of ovarian cancer, improving early diagnosis and treatment.

Clinical management of incidental findings on pelvic adnexal masses / Manejo clínico dos achados incidentais de massas pélvicas anexiais

Summary Due to widespread use of pelvic and transvaginal ultrasound in routine gynecological evaluation, the incidental finding of adnexal masses has led to discussions about management in asymptomatic patients regarding the risk of ovarian cancer. Transvaginal ultrasonography remains the modality of choice in the evaluation of suspicious characteristics. The combined analysis of ultrasound morphological parameters with Doppler study, serum carcinona antigen 125 and investigation of a symptom index may improve diagnosis. Surgical approach should be considered whenever there are suspicious images, rapid growth of cysts, changes in the appearance compared to the initial evaluation or when the patient has symptoms. Future studies on genetic and molecular mechanisms may help explain the pathophysiology of ovarian cancer, improving early diagnosis and treatment.

Resumo Em virtude da ampla utilização da ultrassonografia pélvica e transvaginal na avaliação ginecológica de rotina, o achado incidental de massas anexiais tem ocasionado discussões sobre a conduta em pacientes assintomáticas frente ao risco de desenvolvimento do câncer de ovário. A ultrassonografia transvaginal continua a ser a modalidade de primeira escolha na avaliação de características suspeitas. A análise conjunta de parâmetros morfológicos ultrassonográficos com o estudo Doppler, a pesquisa de CA-125 e a investigação de índice de sintomas pode incrementar as taxas de diagnóstico. Abordagem cirúrgica deve ser considerada sempre que houver alterações em exames de imagem, quando houver crescimento rápido do cisto, mudanças em seu aspecto em relação à avaliação inicial ou quando a paciente apresentar sintomatologia. Uma compreensão melhor de mecanismos genéticos e moleculares pode auxiliar na elucidação da fisiopatologia do câncer ovariano, aprimorando seu diagnóstico e tratamento precoces.

The relationship between ovarian structure and hyperandrogenism in premature pubarche.

The aim of this study was to describe the ovarian structure (OS) and its relationship with hyperandrogenism in girls with premature pubarche (PP). A pelvic ultrasound was carried out in 23 girls with PP and in 57 prepubertal age-matched controls (C), and the OS was subdivided into five classes (c): 1-homogeneous; 2-microcystic, 3-multicystic, 4-polycystic and 5-follicular. In the girls with PP, an ACTH test was performed, and the presence of hormonal levels >3 SD of postpubertal normal levels and not compatible with late-onset congenital adrenal hyperplasia were considered an exaggerated response. The fasting levels of glucose (G) and insulin (I) were measured and the fasting I to G ratio (FIGR) was calculated. FIGR >22 was suggestive of I resistance (IR). The microcystic structure (c2) was more frequently found in the PP than in the C group (63% vs 35%, p=0.03). In the PP group, we observed the following OS: cl (n=6), c2 (n=15), c3 (n=1) and c4 (n=1). 11-Deoxycortisol--both basal and after ACTH--was greater in the PPc2 group than in PPc1 (p=0.04, p=0.0008, respectively). We also observed an exaggerated response to ACTH in 87% of the girls with PP, greater in the PPc2 group than in PPc1 (p=0.04). The FIGR showed IR in 44% of girls with PP, but I levels and FIGR were similar between PPc1 and PPc2. These findings suggest generalized adrenocortical hyperresponsiveness in girls with PP, which is more accentuated in PPc2. Long-term follow-up of girls with PP into adulthood is warranted to ascertain whether microcystic ovarian structure precedes functional ovarian hyperandrogenism.

Cistoadenoma seroso gigante de ovario: reporte de un caso / Gigantic cystadenocarcinoma serous in ovary: report a case

En el presente trabajo, reportamos el caso de una paciente que fue referida a nuestro centro, por presentar un gran aumento del volumen abdominal, de 2 años de evolución. Al ingreso a hospitalización: Paciente en regulares condiciones; Talla: 1,52 m-Peso:130 Kg. Circunferencia abdominal total: 160 cm. Diametros longitudinal y transversal: 100 y 115 cm respectivamente. Luego de la evolución clínica y de los estudios paraclínicos, fue intervenida quirúrgicamente, encontrándose una gran tumoración de ovario derecho. El estudio de la pieza operatoria reportó: tumor quístico gigante unilateral de ovario derecho. Diámetro del tumor: más de 80 cm. Peso del tumor: 60,200 Kg. Diagnóstico histopatológico: Cistoadenoma Seroso. Este caso, representa uno de los tumores serosos más grande reportado hasta los momentos en la literatura

Implantação curiosa de um quisto do ovário

O A. apresenta diversas fotografias de um grande quisto do ovário direito, do volume de um útero de feto a têrmo, que no exame clínico simulava ser do esquerdo, por apresentar uma brida aderencial que unia seu polo inferior ao ligamento largo dêste lado. Refere-se aos distúrbios endocrínicos apresentados pela paciente, afasta a hipótese da ambigenia e conclue pela idéia de uma anexite esquerda, provocando a faixa sinequial. Apresenta os diversos exames complementares e a técnica cirúrgica empregada, bem como, os resultados colhidos pela paceinte que tem sido observada com frequência, até agora, cêrca de 1 ano após a intervenção.