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1.
Medicine (Baltimore) ; 99(10): e18988, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150047

RESUMO

INTRODUCTION: Carbohydrate antigen 19-9 (CA 19-9) is a tumor glycolipid, frequently elevated in the serum of patients due to malignancies from gastrointestinal organs; in particular, the pancreas. This carbohydrate antigen is also expressed in benign diseases. PATIENT CONCERNS: A case of a 27-year-old female who has an unknown origin CA 19-9 elevation for 2 years. DIAGNOSIS: After the left ovarian cystectomy and microscopic examination, the final diagnosis is a dermoid cyst. The dermoid cyst shows increased F-fluorodeoxyglucose (F-FDG) uptake in the F-FDG positron emission tomography (PET)/computed tomography (CT) study. INTERVENTION AND OUTCOMES: The laparoscopic oophorocystectomy was performed. It was observed that the patient's CA 19-9 level returned to normal after the surgery 6 months later. This showed that the dermoid cyst was responsible for the abnormal CA 19-9 level. CONCLUSION: In this case, we can learn that the F-FDG PET/CT scan has potential use in patients with unknown origin of elevation CA 19-9.


Assuntos
Antígeno CA-19-9/sangue , Cisto Dermoide/diagnóstico , Cistos Ovarianos/diagnóstico , Adulto , Biomarcadores Tumorais/sangue , Cisto Dermoide/sangue , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Diagnóstico Diferencial , Feminino , Fluordesoxiglucose F18 , Humanos , Cistos Ovarianos/sangue , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Ovariectomia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
2.
Infect Dis Obstet Gynecol ; 2019: 4149587, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31871398

RESUMO

Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy-with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature include Escherichia coli (E. coli) and Group B streptococcus (GBS) but Staphylococcus lugdunensis (S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.


Assuntos
Coagulase/metabolismo , Endometriose/microbiologia , Cistos Ovarianos/microbiologia , Técnicas de Reprodução Assistida/efeitos adversos , Infecções Estafilocócicas/diagnóstico , Staphylococcus lugdunensis/metabolismo , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Cefalexina/administração & dosagem , Cefalexina/uso terapêutico , Clindamicina/administração & dosagem , Clindamicina/uso terapêutico , Endometriose/cirurgia , Feminino , Humanos , Contagem de Leucócitos , Recuperação de Oócitos/efeitos adversos , Cistos Ovarianos/cirurgia , Gravidez , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/cirurgia , Staphylococcus lugdunensis/isolamento & purificação , Resultado do Tratamento
3.
Pan Afr Med J ; 33: 240, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692748

RESUMO

Ovarian torsion is a rare cause of pelvic pain during the postpartum period. The absence of specific clinical and radiological signs makes suspicion and preoperative diagnosis difficult. Delayed management can compromise ovarian viability. We report the case of a 24-year patient presenting to the Emergency Department five days after delivery with severe pelvic pain. The diagnosis of ovarian torsion associated with cystic mass was made on the basis of ultrasound images. The patients underwent cystectomy and a conservative treatment.


Assuntos
Cistos Ovarianos/diagnóstico por imagem , Período Pós-Parto , Anormalidade Torcional/diagnóstico por imagem , Serviço Hospitalar de Emergência , Feminino , Humanos , Cistos Ovarianos/cirurgia , Dor Pélvica/etiologia , Gravidez , Anormalidade Torcional/cirurgia , Ultrassonografia , Adulto Jovem
4.
Yonsei Med J ; 60(9): 864-869, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31433584

RESUMO

PURPOSE: The aim of this study was to evaluate the feasibility and safety of laparoendoscopic single site (LESS) surgery using an angiocatheter needle in patients with huge ovarian cysts (diameter ≥15 cm). MATERIALS AND METHODS: Thirty-one patients with huge ovarian cysts underwent LESS surgery using an angiocatheter needle between March 2011 and August 2016. An intra-umbilical vertical incision (1.5-2.0 cm) was made in the midline. After the cyst wall was punctured using an angiocatheter needle, the fluid contents were aspirated with a connected vacuum aspirator. After placing a Glove port in the umbilical incision, LESS surgery was performed using a rigid 0-degree, 5-mm laparoscope and conventional, rigid, straight laparoscopic instruments. Knife-in-bag morcellation was instituted for specimen collection. RESULTS: The median maximal diameter of ovarian cysts was 18 cm (range, 15-30 cm), the median operation time was 150 minutes (range, 80-520 minutes), and the median volume of blood loss was 100 mL (range, 20-800 mL). Three patients (9.7%) were diagnosed with malignant ovarian cancer using intraoperative frozen examination, and 1 patient was converted to laparotomy due to advanced disease. Thirty patients underwent LESS, and there was no need for an additional laparoscopic port. CONCLUSION: LESS surgery using an angiocatheter needle, with leaving only a small postoperative scar, was deemed feasible for the management of huge ovarian cysts.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Laparoscopia/instrumentação , Laparoscopia/métodos , Laparotomia/métodos , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Agulhas , Duração da Cirurgia , Estudos Retrospectivos , Instrumentos Cirúrgicos , Resultado do Tratamento , Adulto Jovem
5.
Trials ; 20(1): 410, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288827

RESUMO

BACKGROUND: Laparoscopic cystectomy is currently considered the gold standard for the treatment of ovarian endometrioma, resulting in an improvement in symptoms, a lower recurrence rate, and a higher pregnancy rate among infertile patients. However, this treatment is not free from risk, since it is associated with a reduction in ovarian reserve. There is still controversy in the literature regarding whether the cause of the reduction in ovarian reserve is due to damage caused by the coagulation energy during hemostasis or whether the procedure itself is the cause of the damage irrespective of the hemostatic method used. The aim of this study is to compare the effects of different hemostatic methods on the ovarian function of women subjected to laparoscopic surgery for ovarian endometrioma. METHODS: An open-label randomized clinical trial to be conducted at the Lauro Wanderley University Hospital between December 2017 and August 2020. Eighty-four patients will be randomly allocated to three groups according to the hemostatic technique used during laparoscopic surgery for ovarian endometrioma: bipolar coagulation; laparoscopic suture; and hemostatic matrix. Ovarian function will be assessed by serum anti-Müllerian hormone measurement and by performing an antral follicle count using ultrasound before surgery and one, three, and six months after surgery. The internal review board of the Medical Sciences Center, Federal University of Paraíba approved the study protocol under reference CAAE 71621717.9.0000.8069. DISCUSSION: Bearing in mind the need for more randomized clinical trials to clarify this issue, we hope to contribute with data that will determine whether there is any difference between hemostatic methods despite the rational use of bipolar energy or whether the procedure itself explains the ovarian damage irrespective of the hemostatic technique used. TRIAL REGISTRATION: ClinicalTrials.gov, NTC03430609 . Registered on XX.10/31/2017. ISRCTN Registry, ISRCTN11469394 . Registered on XX.17/12/2017. Unique Protocol ID: U1111-1203-2508.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Endometriose/cirurgia , Procedimentos Cirúrgicos em Ginecologia , Técnicas Hemostáticas , Laparoscopia , Cistos Ovarianos/cirurgia , Reserva Ovariana , Hormônio Antimülleriano/sangue , Biomarcadores/sangue , Brasil , Endometriose/diagnóstico por imagem , Endometriose/fisiopatologia , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Técnicas Hemostáticas/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/fisiopatologia , Folículo Ovariano/diagnóstico por imagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
6.
Medicine (Baltimore) ; 98(29): e16432, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335696

RESUMO

RATIONALE: Mesenteric cysts are benign gastrointestinal cystic lesions, with an incidence of <1/100 000. They usually develop in the small bowel mesentery, mesocolon (24%), retroperitoneum (14.5%), and very rarely originate from the sigmoid mesentery. Endometriomas represent a localized type of endometriosis and are usually within the ovary. Our case is unique because there are no reports in the literature of endometrial mesenteric cysts. PATIENT CONCERNS: We present a case of a 29-year-old woman who underwent a routine gynecologic control. DIAGNOSIS: Clinical examination and imaging identified 2 endometriomas on the left and posterior to the uterus. INTERVENTIONS: The patient underwent exploratory laparoscopy. Unexpectedly, a 10 cm mesenteric cyst was identified; this was associated with adhesions in the left adnexal area and a left ovarian endometrioma. The classic surgical approach which was necessary identified the mesenteric cyst with cranial mesosigmoid and ileal adhesions, as well as distal adhesions which included the uterus, ileum, left ovarian endometrioma, left hydrosalpinx, left ureter, and rectum. The cyst was removed completely and a left adnexectomy was performed because of the presence of the endometrioma and adhesions. OUTCOMES: The patient's outcome was favorable, with discharge at 72 hours after surgery. The histopathological report revealed that both the mesenteric and ovarian cysts were endometriomas. LESSONS: Our case is unusual in that a mesenteric cyst was identified in a patient with no clinical symptoms. Furthermore, the histopathological examination revealed the endometriotic origin of the mesenteric cyst which has not previously been reported in the literature.


Assuntos
Dissecação/métodos , Endometriose , Laparoscopia/métodos , Cisto Mesentérico , Cistos Ovarianos , Adulto , Doenças Assintomáticas , Endometriose/diagnóstico , Endometriose/diagnóstico por imagem , Endometriose/patologia , Endometriose/cirurgia , Feminino , Humanos , Achados Incidentais , Cisto Mesentérico/diagnóstico por imagem , Cisto Mesentérico/patologia , Cisto Mesentérico/cirurgia , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Cistos Ovarianos/cirurgia , Aderências Teciduais/diagnóstico , Aderências Teciduais/cirurgia , Resultado do Tratamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-31343141

RESUMO

We present a rare occurrence of precocious puberty (PP) probably due to an autonomous ovarian cyst in a 15-month-old girl who presented to us with growth spurt, breast and pubic hair development, and vaginal bleeding over the last few months. The clinical presentation was suggestive of central precocious puberty (CPP). However, the rapid progression of pubertal changes and occurrence of menarche at breast Tanner stage 2 indicated peripheral precocious puberty (PPP). Due to uncertainty of clinical diagnosis, investigations were conducted for CPP as well as PPP. The basal and peak stimulated LH concentrations were < 0.3 IU/l and < 2 IU/l, respectively, indicating PPP. However, the peak LH : FSH ratio was > 1, which is consistent with CPP. Abdominal imaging revealed an ovarian mass, which was laparoscopically excised, but the true nature of the mass could not be ascertained because the excised specimen showed only haemorrhage and features of ovarian torsion on histopathological examination. Regression of pubertal development occurred over a three-month period postoperatively.


Assuntos
Cistos Ovarianos/complicações , Puberdade Precoce/etiologia , Feminino , Humanos , Índia , Lactente , Cistos Ovarianos/diagnóstico , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Puberdade Precoce/diagnóstico
8.
Int J Gynaecol Obstet ; 146(3): 350-356, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31197834

RESUMO

OBJECTIVE: To determine the long-term impact of laparoscopic cystectomy for endometriomas and benign cysts on ovarian reserve and selection of the most effective method of assessment. METHODS: The present study was carried out between November 2013 and December 2016. Participants were assigned to laparoscopic cystectomy for diagnosed unilateral benign ovarian cysts and divided into groups: the endometrioma group (EG) (n=35) and the other benign ovarian tumor group (OG) (n=35). Before and at 3 and 12 months after the procedure, transvaginal ultrasonography was performed to assess antral follicle count (AFC) and ovarian volume (OvVol); laboratory tests were ordered for anti-Mullerian hormone (AMH) serum concentration assays. Pregnancy rates were counted in a 12-month follow-up. Statistica12 software was used for analysis. RESULTS: The present study included 70 women aged 18-40 years. AMH serum concentration decreased significantly 3 months after laparoscopic cystectomy (4.89 ± 3.66 ng/mL to 3.45 ± 3.37 ng/mL; P<0.001). A greater decrease of AMH concentrations was observed in the EG (45.39% vs 14.87%; P=0.021). Twelve months of observation revealed a suppression in the drop of the AMH concentration, while AFC and OvVol remained unaffected. The likelihood of spontaneous pregnancy was three times higher in the OG (hazard ratio [HR] 3.57, 95% confidence interval [CI] 1.08-12.5). CONCLUSION: There was a significant decline in AMH levels in the EG 3 months after cystectomy. No further fall in AMH concentration was observed in the 12-month follow-up. The serum AMH concentration could be considered a valuable marker for ovarian reserve assessment after laparoscopic cystectomy.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/cirurgia , Laparoscopia/efeitos adversos , Cistos Ovarianos/cirurgia , Reserva Ovariana , Adolescente , Adulto , Biomarcadores/sangue , Feminino , Seguimentos , Humanos , Folículo Ovariano/diagnóstico por imagem , Gravidez , Taxa de Gravidez , Ultrassonografia , Adulto Jovem
10.
Endocr J ; 66(7): 653-656, 2019 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-31006723

RESUMO

A 34-year-old woman presented our hospital with complaint of irregular menstruation and abnormal uterine bleeding lasting for a month. After her second parturition at the age of 27, her menstrual cycle had been regular, but it suddenly became irregular at the age of 30. Transvaginal ultrasound revealed the presence of ovarian mass, and the patient underwent diagnostic laparoscopic surgery. Bilateral ovaries temporally shrink after puncture but the size soon resumed. Gonadotropins were almost normal, but estradiol and PRL levels turned out to be elevated, and cabergoline treatment was initiated. After referral to our hospital, we found that the ovaries showed multifollicular appearance. Brain magnetic resonance imaging showed an 18-mm macroadenoma in the suprasellar area. To suppress the secretion of endogenous gonadotropins and estrogen, low-dose estrogen-progestin was prescribed. Surprisingly, the treatment temporarily reduced the size of the ovaries. The patient was referred to a neurosurgeon, and a functioning gonadotroph adenoma was suspected. After the resection of the pituitary tumor, her menstrual cycle became regular, and the size of bilateral ovaries became normal. We also noticed that her ovarian reserve judged by anti-Müllerian hormone had been almost diminished after the surgical treatment, probably reflecting the exhaustion of follicular pool. Women with multifollicular ovaries and elevated estradiol levels may have functioning gonadotroph adenomas, although the level of FSH is relatively normal, and ovarian reserve can be followed by measuring anti-Müllerian hormone.


Assuntos
Adenoma/diagnóstico , Gonadotrofos/patologia , Gonadotrofos/fisiologia , Neoplasias Hipofisárias/diagnóstico , Adenoma/metabolismo , Adenoma/cirurgia , Adulto , Fatores Etários , Feminino , Hormônio Foliculoestimulante/metabolismo , Gonadotrofos/metabolismo , Humanos , Hiperprolactinemia/diagnóstico , Hiperprolactinemia/etiologia , Hiperprolactinemia/metabolismo , Hiperprolactinemia/cirurgia , Metrorragia/diagnóstico , Metrorragia/etiologia , Metrorragia/cirurgia , Cistos Ovarianos/diagnóstico , Cistos Ovarianos/etiologia , Cistos Ovarianos/cirurgia , Neoplasias Hipofisárias/metabolismo , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Reprodução/fisiologia
11.
Z Geburtshilfe Neonatol ; 223(2): 109-112, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30847878

RESUMO

Acute hemoperitoneum (AHP) in early gestation is commonly treated via laparotomy. A ruptured corpus luteum (CL) cyst is a rare cause of AHP in pregnancy. This case report describes a 33-year-old, hemodynamically stable G2/P1 who presented at 5+5 gestational weeks with an acute abdomen due to ruptured CL cyst (7 cm). Emergent laparoscopy was performed. After evacuation of 1 L of hemoperitoneum, an atraumatic hemostasis was obtained without diathermy by use of hemostatic matrix (Floseal®). The ovary was reformed with an absorbable suture under preservation of CL. The postoperative recovery was uncomplicated. The hemoglobin drop was 2.8 g/dl. Further pregnancy course was uneventful. A healthy baby (2860 g) was delivered vaginally at 38+3 weeks of gestation. CONCLUSION: Laparoscopic approach to AHP in early pregnancy is suitable. CL preservation is feasible by use of atraumatic hemostatics.


Assuntos
Hemoperitônio/cirurgia , Laparoscopia , Cistos Ovarianos , Adulto , Feminino , Hemoperitônio/etiologia , Humanos , Luteína , Cistos Ovarianos/complicações , Cistos Ovarianos/cirurgia , Gravidez , Ruptura Espontânea
12.
Georgian Med News ; (286): 28-32, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30829584

RESUMO

There is a controvercy in the scientific literature concerning the benefits of the enucleation of the endometroid cysts with respect to the treatment of infertility in ednometrioma sufferers. Some authors claim, that the laparoscopic surgical intervention leads to the reduction of the ovarian reserve. In particular, authors report on the decrease in the level of the serum anti-Müllerian hormone (AMH) after surgical intervention. Some other authors, however, did not find the long-lasting change in AMH after the surgical intervention. There are some study limitations such as an age hetrogeneity of patients under observation. To extent the data in this direction, we measured the level of the serum AMH before laparoscopic enucleation of the endometroid cyst and one month after the surgical intervention in the group of 21 patients with ovarian endometroid cyst, aged 32 - 32.4 yrs. The rate of pregnancy was calculated during the 1 year of the postoperative follow-up. Increase in the postoperative level of the serum AMH was found in 10 (47.6%) patients out of the 21. In 4 (19%) patients the serum level of the AMH was found decreased. No change in the serum AMH level was found in 7 patients (33.4%). Data statistical analysis did not confirm the significance of the change in the postoperative level of the serum AML. The rate of pregnancy during the one year of postoperative follow up was 8 (38.10%). We suggest that laparoscopic endometroid cystectomy does not cause the reduction of the ovarian reserve and promotes the physiological process of oogenesis.


Assuntos
Hormônio Antimülleriano , Laparoscopia , Cistos Ovarianos , Reserva Ovariana , Adulto , Hormônio Antimülleriano/sangue , Feminino , Humanos , Cistos Ovarianos/cirurgia , Gravidez , Estudos Prospectivos
13.
J Neonatal Perinatal Med ; 12(3): 339-343, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30883366

RESUMO

OBJECTIVE: Ovarian cysts are relatively common prenatal findings in female fetuses. The aim of this study is to evaluate the ability of antenatal ultrasound in predicting spontaneous regression or a need for surgery. DESIGN: All cases of fetal ovarian cysts treated in our Department between 2007 and 2016 were included. Patients underwent a sonographic monitoring in utero and after birth until spontaneous or surgical resolution. Subjects were divided into two groups according to their postnatal management. Receiver-operating characteristics (ROC) curves were used to test the predictive ability for postnatal surgery of the cyst's mean and maximum diameters; their optimal cut off points were also determined. RESULTS: 38 cases of antenatally-detected fetal ovarian cysts were included. 12/38 cases underwent surgery (Group A). 26/38 cases were resolved spontaneously (Group B). Cyst size of those which were surgically excised significantly differed from those that regressed spontaneously. ROC curve pointed to 45 mm and 47 mm as optimal cut off points for the mean and the maximum cystic diameters, respectively. CONCLUSIONS: Cyst size and echo-structure seemed good predictors for prognosis after birth. The optimal cut off points of the cysts mean and maximum diameters in predicting postnatal surgery have been identified as 45 mm and 47 mm, respectively.


Assuntos
Cistos Ovarianos/diagnóstico por imagem , Ultrassonografia Pré-Natal , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Cistos Ovarianos/cirurgia , Gravidez , Prognóstico , Remissão Espontânea
14.
J Pediatr Surg ; 54(11): 2435-2438, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30885558

RESUMO

INTRODUCTION: To evaluate if torsion of an otherwise healthy ovary (THO) has a different prognosis than torsion with an underlying ovarian mass (TUOM) in children. MATERIAL AND METHODS: Children with an ovarian torsion who were treated in our department from 1997 to 2016 were studied retrospectively. Patients with prenatal ovarian torsion and isolated oviduct torsion were excluded. Trophicity of the ovary was assessed by ultrasonography at the end of follow-up. RESULTS: Fifty-four girls were included. Twenty-seven presented a TUOM; the others had a THO. Beside the deleterious effect of late surgical management, another prognostic factor was identified. THO was more prone to an ovarian hypotrophy or atrophy than TUOM (n = 20 vs n = 5, p < 0.01). This was confirmed by logistic regression analysis (OR = 5.08, p = 0.01). To explain this finding, we further compared TUOM and THO. The diagnosis of TUOM was more frequently suspected on US at the first visit (p = 0.005). TUOM also occurred more often after puberty (>12 years, 52.9% vs 11.1%, p < 0.001) than THO. CONCLUSION: THO is more frequently associated with an ovarian atrophy or hypotrophy than TUOM. A less obvious diagnosis at US and the early occurrence of THO before puberty with a less favorable hormonal climate may explain this finding. LEVEL OF EVIDENCE: III.


Assuntos
Doenças Ovarianas/cirurgia , Anormalidade Torcional/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Cistos Ovarianos/cirurgia , Doenças Ovarianas/diagnóstico por imagem , Doenças Ovarianas/patologia , Prognóstico , Estudos Retrospectivos , Tempo para o Tratamento , Anormalidade Torcional/diagnóstico por imagem , Anormalidade Torcional/patologia , Ultrassonografia
15.
Fertil Steril ; 111(5): 944-952.e1, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30878253

RESUMO

OBJECTIVE: To examine whether serum antimüllerian hormone (AMH) levels correlate with the size of ovarian endometrioma (OMA). DESIGN: An observational cross-sectional study. SETTING: University hospital. PATIENT(S): Two hundred and sixty-seven nonpregnant women, aged 18-42 years, with no prior history of surgery for endometriosis and a histologically documented ovarian cyst. INTERVENTION(S): Surgical management for a benign ovarian cyst. MAIN OUTCOME MEASURE(S): Correlation between serum AMH concentration and cyst size according to OMA and non-OMA benign cyst. RESULT(S): Women with OMA were compared with a control group of women who had non-OMA benign ovarian cysts. The AMH assay samples were collected less than a month before the surgery. Between January 2004 and September 2016, 148 women were allocated to the OMA group and 119 to the non-OMA benign cyst group. The AMH concentrations were not statistically significantly different between the two groups (3.7 ± 2.8 ng/mL vs. 4.1 ± 3.3 ng/mL). A multiple linear regression model accounting for potential confounders revealed that the log10 of the serum AMH concentration positively correlated with the log10 of the OMA cyst volume (R2 = 0.23; coefficient = 0.05; 95% CI, 0.007-0.10). CONCLUSION(S): In women no prior history of surgery for endometriosis, serum AMH levels increased with cyst size in cases of OMA.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/sangue , Endometriose/diagnóstico por imagem , Cistos Ovarianos/sangue , Cistos Ovarianos/diagnóstico por imagem , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Endometriose/cirurgia , Feminino , Humanos , Cistos Ovarianos/cirurgia , Ovário/diagnóstico por imagem , Ovário/cirurgia , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-30808039

RESUMO

A 3-year-old intact female guinea pig was presented with a history of polydipsia, polyphagia, and hyperactivity combined with non-pruritic hair loss. The physical examination revealed bilateral alopecia mainly including the flanks and the ventral abdomen. Bilateral rounded masses just caudal to the kidneys were detected on abdominal palpation. Abdominal ultrasound examination confirmed bilateral ovarian cysts and an enlarged uterus with cystic lesions. Blood biochemistry revealed highly increased glucose and fructosamine concentrations. The final diagnoses were diabetes mellitus, bilateral ovarian cysts, and pathologic changes of the uterus. The guinea pig underwent ovariohysterectomy. After surgery, diabetes mellitus and all of the existing clinical signs were fully resolved. A causal relationship between hormonally active ovarian cysts and diabetes mellitus that commonly present independently from each other in the guinea pig can be strongly assumed in the present case. In suspicious cases of gestagen-induced diabetes mellitus ovariohysterectomy could be considered a potential treatment option in guinea pigs.


Assuntos
Diabetes Mellitus/veterinária , Cobaias , Histerectomia/veterinária , Cistos Ovarianos/veterinária , Ovariectomia/veterinária , Animais , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus/cirurgia , Feminino , Cistos Ovarianos/complicações , Cistos Ovarianos/cirurgia
18.
Gynecol Endocrinol ; 35(6): 494-497, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30732484

RESUMO

OBJECTIVE: To investigate temporary or long-term changes of AMH after laparoscopic endometrioma cystectomy and its dependency on characteristics of endometriomas. METHODS: One hundred and seventy-one women, open-labeled prospective study; five groups divided according age ≤/> 35, uni-/bilateral, cyst ≤/> 7 cm, coagulation/suture surgery, stage III/IV; between- and within-group analyses after 1, 3, 6, and 12 months. RESULTS: After 12 months, compared to pretreament, AMH decreased significantly for patients with bilateral cysts, cyst size >7 cm and endometriosis stage IV. In the between-group analysis all comparisons were significant, with exception of the surgery type. However, this was different performing the multiple linear regression analysis suggesting lower postoperative decrease using suturing technique. This analysis also showed higher age at pretreatment and bilateral cysts as risk factor for AMH decline. CONCLUSIONS: Effects of endometrioma cystectomy on AMH are dependent on characteristics of the endometrioma, showing long-term a decrease in patients with larger, bilateral cysts and in stage IV endometriosis, but only short-time decrease in smaller, unilateral cysts and stage III which sometimes also can fully recover in AMH production within one year. In our study suture compared to coagulation surgery was protective, i.e. may lead to lower postoperative AMH decline.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/cirurgia , Procedimentos Cirúrgicos em Ginecologia/métodos , Laparoscopia/métodos , Cistos Ovarianos/cirurgia , Doenças Ovarianas/cirurgia , Adulto , Endometriose/sangue , Feminino , Humanos , Cistos Ovarianos/sangue , Doenças Ovarianas/sangue , Reserva Ovariana/fisiologia
19.
J Pediatr Surg ; 54(5): 955-958, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30795909

RESUMO

PURPOSE: Prior studies of infant ovarian cysts have recommended intervention for those larger than 4 cm. We reviewed the natural history and features of those managed operatively versus nonoperatively. METHODS: A retrospective study was performed of ovarian lesions in children <1 year-old from 2000 to 2014. RESULTS: Forty patients were identified. Twenty-eight (70%) underwent operative management, while 12 (30%) were managed conservatively, including one undergoing aspiration. The mean age at surgery was 125 days. All but one patient (96%) had evidence of antenatal torsion intraoperatively or on final pathology. All resected lesions were benign. Ultrasound findings more common in those undergoing surgery included intracystic debris (p < 0.001), fluid-fluid or fluid-debris levels (p = 0.002), absence of Doppler flow (p = 0.014), solid components (p = 0.04), and calcifications (p = 0.001). Cysts managed nonoperatively had an average diameter of 2.5 cm, compared to 5.1 cm in the operative group (p < 0.001). Three of the lesions managed nonoperatively had a diameter greater than 3.5 cm (mean 5.1 cm) and were followed for an average of 153 days until resolution. CONCLUSIONS: The majority of infant ovarian lesions were excised, although none were malignant. Aspiration or observation of larger cysts was feasible and safe. Ovarian cysts in this age group should be considered for nonoperative management and closely followed. LEVEL OF EVIDENCE: IIC.


Assuntos
Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Tratamento Conservador , Feminino , Humanos , Lactente , Recém-Nascido , Cistos Ovarianos/terapia , Estudos Retrospectivos , Ultrassonografia Doppler , Ultrassonografia Pré-Natal
20.
BMJ Case Rep ; 12(1)2019 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-30635316

RESUMO

Giant abdominal cyst can lead to various non-specific symptoms such as abdominal bloating, nausea/vomiting, constipation due to its mass effect. In rarer circumstances, it can lead to bowel obstruction, hydronephrosis and even abdominal compartment syndrome. Hereby, we present a case of giant abdominal cyst in a young woman where its origin was a diagnostic dilemma despite exhausting all imaging techniques. A laparotomy was performed and the giant cyst was found to be originating from the left ovary. The final histopathology confirmed it as an ovarian benign serous cystadenoma. The patient made a fully recovery without any complications.


Assuntos
Cistadenoma Seroso/cirurgia , Cistos Ovarianos/patologia , Neoplasias Ovarianas/cirurgia , Ovário/patologia , Assistência ao Convalescente , Cistadenoma Seroso/diagnóstico por imagem , Cistadenoma Seroso/patologia , Feminino , Humanos , Laparotomia/métodos , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Ovário/diagnóstico por imagem , Doenças Raras , Resultado do Tratamento , Adulto Jovem
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