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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.
Ceska Gynekol ; 84(4): 260-268, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31818108

RESUMO

OBJECTIVE: To summarise the current knowledge and trends in the basic ultrasound diagnosis of adenomyosis, endometroid cysts and pelvic adhesions. DESIGN: Review article. SETTING: Centre for diagnostics and treatment of endometriosis and Gynecologic Oncology Centre, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Department of Gynaecology and Obstetrics, Burton Hospitals NHS, United Kingdom. METHODS: Literature review. RESULTS: Endometriosis is a relatively common disease, which often escapes timely diagnosis, although sonographic features of adenomyosis, endometriomas and pelvic adhesions can be easily assessed on the basic ultrasound examination. Endometriomas are ovarian cysts in a premenopausal patient with ground glass echogenicity of the cyst fluid, one to four locules and no papilary projections with detectable blood flow. Adenomyosis is characterised by an asymmetrical thickening of the myometrium due to an ill-defined myometrial lesion with fan-shaped shadowing, non-uniform echogenicity with myometrial cysts, hyperechogenic islands, hyperechogenic subendometrial lines and buds with an irregular or interrupted junctional zone, and translesional vascularity containing vessels crossing the leasion perpendicular to the endometrium. Pelvic adhesions can be detected using dynamic aspect of ultrasound examination demonstrating negative sliding sign of the uterus and/or ovaries against surrounding tissue planes and site-specific tenderness. Distorted pelvic anatomy (the presence of uterine ‚question mark sign and/or ‚kissing ovaries) is another sign of adhesions. CONCLUSION: First step in basic transvaginal ultrasound is visualisation of the uterus and ovaries, assessment of their mobility and tenderness during examination. Knowledge of the characteristic ultrasound features of adenomyosis, endometriomas and adhesions enables timely diagnosis of endometriosis by the community gynecologist and prompt referral to the endometriosis centre.


Assuntos
Adenomiose , Endometriose , Cistos Ovarianos , Adenomiose/diagnóstico por imagem , Endometriose/diagnóstico por imagem , Feminino , Humanos , Cistos Ovarianos/diagnóstico por imagem , Aderências Teciduais , Ultrassonografia
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
5.
Adv Clin Exp Med ; 28(11): 1531-1535, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31660708

RESUMO

BACKGROUND: The widespread availability of ultrasonography means that transvaginal ultrasonography has become a routine procedure during gynecological examinations, even in asymptomatic patients. Nowadays the imaging technology offered by ultrasonography and tumor biomarkers give us an opportunity to implement transvaginal ultrasound-guided aspiration as a less radical treatment of simple ovarian cysts (SOC). OBJECTIVES: The aim of the study was a retrospective evaluation of the diagnostic and therapeutic efficacy of transvaginal ultrasound-guided aspiration of SOC in postmenopausal and premenopausal patients. MATERIAL AND METHODS: A total of 84 women, divided into a premenopausal group (38/84) and a postmenopausal group (46/84), underwent transvaginal ultrasound-guided aspiration of small SOC (40-80 mm in diameter). Simple cysts were defined ultrasonographically according to the International Ovarian Tumor Analysis (IOTA) guidelines as cysts with negative risk of ovarian malignancy algorithm (ROMA) scores and CA125 levels. Simple ovarian cyst-related data was obtained from medical documentation (diagnostic tests, medical reproductive and surgical history, and clinical status during SOC aspiration). Follow-up data was collected by means of a telephone interview and medical database. The survey included questions focused on cyst recurrence during the 24-month period following the aspiration of SOC. RESULTS: We had 100% compatibility with ultrasound diagnosis and cytological examination of aspirated fluid. The cumulative rate of cyst recurrence among 84 patients was 20.2% (17/84). There was a higher percentage of cyst recurrence in the premenopausal group: 27% (10/38) vs 15.2% (7/46) in the postmenopausal group, but the difference was not statistically significant (hazard ratio (HR) = 1.89, 95% confidence interval (95% CI) = 0.72-4.97; p = 0.19). Recurrent cysts were treated with laparoscopic cystectomy, adnexectomy or a second aspiration in accordance with individual indications. CONCLUSIONS: Ultrasound-guided aspiration of small (<80 mm) adnexal SOC is a diagnostic and alternative therapeutic procedure, which allows cytological examination and may reduce the need for surgery, which is especially beneficial for women of reproductive age.


Assuntos
Biópsia por Agulha/métodos , Cistos Ovarianos/terapia , Neoplasias Ovarianas , Sucção/métodos , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Cistos Ovarianos/diagnóstico por imagem , Pós-Menopausa , Pré-Menopausa , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia de Intervenção/métodos , Vagina
6.
J Med Case Rep ; 13(1): 292, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31506106

RESUMO

BACKGROUND: Generally, ovarian hyperstimulation syndrome develops after superovulation caused by ovulation-inducing drugs in infertile patients. However, ovarian hyperstimulation syndrome associated with natural pregnancy is rare, and most cases of ovarian hyperstimulation syndrome have been associated with a hydatidiform mole. CASE PRESENTATION: We describe a case of a 16-year-old Japanese girl with a complete hydatidiform mole. The patient was referred for intensive examination and treatment of the hydatidiform mole and underwent surgical removal of the hydatidiform mole at 9 weeks, 5 days of gestation. Histopathological examination revealed a complete hydatidiform mole. The patient's blood human chorionic gonadotropin level decreased from 980,823 IU/L to 44,815 IU/L on postoperative day 4, and it was below the cutoff level on postoperative day 64. Transvaginal ultrasonography on postoperative day 7 revealed a multilocular cyst measuring 82 × 43 mm in the right ovary and a multilocular cyst measuring 66 × 50 mm in the left ovary. Both ovarian cysts enlarged further. Magnetic resonance imaging on postoperative day 24 revealed that the right multilocular ovarian cyst had enlarged to 10 × 12 cm and that the left multilocular ovarian cyst had enlarged to 25 × 11 cm. Blood examination showed an elevated estradiol level as high as 3482 pg/ml. We diagnosed the patient with bilateral giant multilocular cysts accompanied by ovarian hyperstimulation syndrome because of the rapid increase in the size of the cysts. The patient complained of mild abdominal bloating; however, symptoms such as nausea, vomiting, dyspnea, and abdominal pain were not observed. Therefore, we chose spontaneous observation in the outpatient clinic. The cysts gradually decreased and disappeared on postoperative day 242. CONCLUSION: Physicians should be aware that ovarian cysts can occur and can increase rapidly after abortion of a hydatidiform mole. However, the ovarian cyst can return to its original size spontaneously even if it becomes huge.


Assuntos
Mola Hidatiforme/cirurgia , Síndrome de Hiperestimulação Ovariana/etiologia , Complicações Pós-Operatórias , Neoplasias Uterinas/cirurgia , Adolescente , Estradiol/sangue , Feminino , Humanos , Imagem por Ressonância Magnética , Cistos Ovarianos/diagnóstico por imagem , Gravidez
7.
J Comput Assist Tomogr ; 43(4): 619-622, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31268877

RESUMO

OBJECTIVE: This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and T2 shading signs on magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts. METHODS: Seventy-two hemorrhagic lesions were included in this retrospective study. The presence of T2 dark spot, T2 dark rim, and T2 shading signs in the lesions and the presence of complete or incomplete rim in lesions exhibiting T2 dark rim signs were evaluated. RESULTS: Of 72 lesions, 50 were diagnosed with endometrioma and 22 were diagnosed with hemorrhagic cyst. Twenty-six of 50 endometriomas and none of the hemorrhagic cysts showed T2 dark spot sign. T2 shading was observed in 90% of endometriomas and 18% of hemorrhagic cysts. Incomplete T2 dark rim was detected in 67% of endometriomas and 21% of hemorrhagic cysts. CONCLUSIONS: T2 dark spot and T2 dark rim signs could be useful for distinguishing endometriomas from hemorrhagic cysts.


Assuntos
Endometriose/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Cistos Ovarianos/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Adolescente , Adulto , Diagnóstico Diferencial , Feminino , Hemorragia/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Adulto Jovem
8.
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
9.
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
10.
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
11.
Ceska Gynekol ; 84(1): 61-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31213060

RESUMO

OBJECTIVE: Endometriosis in pregnancy predominantly tends to regress or to stay stable but small part of endometriomas and nodules of deep infiltrating endometriosis may undergo the process of decidualization. Therefore, the foci of endometriosis enlarge their volume and change their structure due to cellular hypertrophy and stromal edema associated with higher vascularization caused by the hormonal changes in pregnant women. Consequently, these totally benign lesions may resemble malignant tumors in ultrasound examination. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague. METHODS: A literature review of published data on decidualization of endometriosis. RESULTS: Majority of decidualized ovarian endometriomas is asymptomatic so it is mostly accidentally found during the routine ultrasound check-ups within the frame of perinatologic screening. The rounded, smooth, highly vascularized solid papillary projections in internal wall of endometroid cysts are the most specific characteristics of decidualization. If ultrasound simple rules are not applicable or show probable malignancy, the pregnant patient should be referred to a tertiary center for expert ultrasound assessment. Magnetic resonance is indicated in cases of uncertain ultrasound findings, because it can clarify the diagnostics due to its high accuracy in detection of products of blood degradation and ability of diffusion-weighted imaging to recognize lower tissue cellularity of benign decidualized endometriomas in comparison to malignant ovarian tumors. CONCLUSION: If the imaging methods confirm supposed decidualized endometriosis, watch and wait management based on regular ultrasound examinations during the whole pregnancy and after childbed is recommended. The regression of the tumor size and disappearance of the solid portions within endometriomas is expected after delivery. Decidualized endometriosis is rarely a source of gestational or obstetrical complications demanding acute surgical intervention. Elective surgical procedures in pregnant women are indicated only if expert ultrasound or magnetic resonance imaging assess the masses as border-line or invasive tumors (carcinomas) and in cases of suspicious changes of the originally presumed benign cysts during the surveillance.


Assuntos
Endometriose/diagnóstico por imagem , Cistos Ovarianos/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Feminino , Humanos , Valor Preditivo dos Testes , Gravidez , Ultrassonografia
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
16.
J Coll Physicians Surg Pak ; 29(2): 105-108, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30700345

RESUMO

OBJECTIVE: To determine the values of diffusion-weighted magnetic resonance imaging (DWI) parameters on differential diagnosis of benign and malignant ovarian tumours with solid and cystic components. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, China, from January to December 2017. METHODOLOGY: Forty-four cases of malignant and benign ovarian tumours were selected as respective groups. Inclusion criteria were ovarian masses found by pelvic and abdominal imaging examination. Exclusion criteria of two groups were endometriosis and pelvic inflammatory diseases found by relevant examination, those with chronic diseases, tumors in other organs found by relevant examination, and those with family cancer history. Conventional MRI plain scans, enhanced scans and DWI scans, were performed after admission. Apparent diffusion coefficient (ADC) and exponential apparent diffusion imaging (eADC) of solid lesions of two groups were recorded and compared. RESULTS: Solid ADC in malignant group was lower than that in benign group (p<0.001). Solid eADC in malignant group was higher than that in benign group (p<0.001). CONCLUSION: Diffusion-weighted magnetic resonance imaging is of high application value in the differential diagnosis of benign and malignant ovarian tumours with solid and cystic components, and it is worthy of promotion and application.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Adulto , Idoso , Biópsia por Agulha , China , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Curva ROC
17.
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
18.
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
19.
J Obstet Gynaecol ; 39(3): 349-354, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30406700

RESUMO

This retrospective study aimed to evaluate the sonographic diagnosis and management strategy of symptomatic adnexal torsion at a teaching hospital in Hyderabad, India. All women with abdominal pain and preoperative or operative diagnosis of adnexal torsion from January 2011 to December 2015 were included. A total of 76 women with 78 episodes were included; 28 (36%) occurred during pregnancy. The ovarian mass (in 71%) and pregnancy (in 35%) constituted the most common risk factors. The overall sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of ultrasound were 75%, 27%, 86%, 15% and 68%, respectively. Ultrasonography was more sensitive in detecting torsions in the non-pregnant subgroup but had a higher specificity during pregnancy. An oophorectomy was performed in 9% of the women due to gangrene. Benign paraovarian cysts and teratomas were the most frequent lesions to undergo torsion. The obstetric outcome was good, the miscarriage rate being 5%. Impact statement What is already known on this subject? Adnexal torsion presents a diagnostic and therapeutic challenge. There are various sonographic criteria that aid in the clinical diagnosis. Discoloured ovaries do not routinely warrant removal. What the results of this study add? The sonographic diagnosis is inaccurate in a third of the cases. Torsion without the involvement of the ovary does not exhibit any of the classic ultrasound findings other than a torted pedicle and therefore a sonographic diagnosis may be difficult. Discoloured ovaries had a normal appearance at future surgeries, reinforcing the concept that an oophorectomy (after detorsion) should be the exception rather than the rule even if the ovary is bluish black. What the implications are of these findings for clinical practice and/or further research? Training in pelvic ultrasound to complement clinical judgement and regular audits of treatment must be conducted in order to minimise pitfalls in diagnosis and management. An ultrasound examination cannot be used as a sole diagnostic criterion to confirm or exclude torsion and a clinical assessment takes precedence.


Assuntos
Doenças dos Anexos/diagnóstico , Ovário/diagnóstico por imagem , Anormalidade Torcional/diagnóstico , Doenças dos Anexos/cirurgia , Adolescente , Adulto , Criança , Feminino , Humanos , Índia , Pessoa de Meia-Idade , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Ovário/irrigação sanguínea , Ovário/patologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Anormalidade Torcional/cirurgia , Ultrassonografia , Adulto Jovem
20.
Int J Gynaecol Obstet ; 144(2): 143-146, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30411348

RESUMO

OBJECTIVE: To evaluate the results of repeat pelvic ultrasonography before surgery in patients with suspicion of benign ovarian tumor. METHODS: A retrospective study included premenopausal women who were scheduled to undergo surgery for a benign-appearing ovarian mass and who had repeat ultrasonography on the day before surgery at Samsung Medical Center, Seoul, South Korea, between January 1, 2007, and December 31, 2011, to check for any change in the mass. Ultrasonography findings and final histology were evaluated by medical record review. RESULTS: Of 1854 women studied, regression of mass was detected before surgery for 27 patients, and 105 patients had histologically proven functional cysts; considered together, 132 patients had functional cysts, and the remaining 1722 women had benign ovarian tumors. Evaluation of the findings of initial ultrasonography revealed that mean size (P=0.008) and proportion of bilateral cysts (P<0.001) were lower in the presence of functional cysts than benign tumors. Additionally, an anechoic pattern was more common among regressed functional cysts than among histologically proven functional cysts (P<0.001). In total, 105 (5.7%) patients required surgery for a functional cyst despite repeat ultrasonography. CONCLUSION: Repeating ultrasonography prior to surgery may have only a limited ability to prevent unnecessary surgeries for functional cysts.


Assuntos
Cistos Ovarianos/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Ultrassonografia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Cistos Ovarianos/patologia , Cistos Ovarianos/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Pré-Menopausa , Cuidados Pré-Operatórios , República da Coreia , Estudos Retrospectivos
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