-
BMC Pediatrics Aug 2023Prader-Willi syndrome (PWS) is a genetic disorder involving multiple systems, with an incidence of about 1/10000-25000. Ovarian torsion (OT) is not commonly found in...
BACKGROUND
Prader-Willi syndrome (PWS) is a genetic disorder involving multiple systems, with an incidence of about 1/10000-25000. Ovarian torsion (OT) is not commonly found in children. Ovarian cyst acts as one of the primary factors resulting in OT. While ovarian cyst torsion with Prader-Willi Syndrome has not been reported before.
CASE PRESENTATION
A 12-years old female was admitted to Emergency Department of our hospital with the chief complaint of abdominal pain. The outcomes of physical examination revealed the height of 150 cm, weight of 103 kg, BMI of 45.77 kg/m. The patient manifested the special facial features, an obese body, with the abdomen distended into a spherical shape. The fat accumulation in the abdomen significantly embarrassed the palpation. The abdominal CT scan indicated a huge cystic mass in the abdominal cavity, sized about 138 mm × 118 mm. According to medical history, the patient was born with low crying and hypotonia, who has developed the uncontrollable eating behavior since 3-years old. These abnormalities led to a speculation of PWS syndrome, so a genetic test was performed and finally confirmed it, concluding a torsion of ovarian cyst with PWS. With the multidisciplinary consultation, a careful treatment strategy containing the control of blood pressure and blood sugar, coenzyme Q10 was administrated to nourish the myocardium and the application of Growth Hormone was developed. All the above preoperative treatments have brought great benefits to patients. Thus promising the successful completion of operation. The postoperative follow-up till now indicated that the abdominal incision was well healed, without operative complications.
CONCLUSIONS
This may be the first case report. In the treatment of ovarian cyst torsion, PWS syndrome requires fully consideration, as the latter can lead to multisystem abnormalities, especially the relation to perioperative management, and even fatalities. Genetic testing should be conducted early when PWS was suspected, accompanied with adequate preparation for the perioperative period, the follow-ups of patients should be maintained for a long time after surgery.
Topics: Humans; Female; Child; Ovarian Cysts; Prader-Willi Syndrome; Abdominal Pain; Muscle Hypotonia; Obesity; Human Growth Hormone
PubMed: 37553631
DOI: 10.1186/s12887-023-04223-7 -
Frontiers in Endocrinology 2022This study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts.
OBJECTIVE
This study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts.
MATERIAL AND METHODS
This prospective study was performed on 113 women with ovarian cysts in a tertiary referral teaching hospital. All patients underwent laparoscopic cystectomy. Serum levels of antimüllerian hormone (AMH) were measured pre-and, 3 months postoperatively. The primary outcome of the study was to assess the effect of laparoscopic cystectomy on ovarian reserve based on alterations in serum AMH levels. The secondary outcome of the present study was to evaluate the impact of the number of cauterizations, size and type of cysts, bilaterality (bilateral or unilateral), age, and body mass index (BMI) on the ovarian reserve after laparoscopic excision.
RESULTS
Laparoscopic cystectomy reduced the serum AMH levels preoperatively (1.32 ± 4.48 ng/ml) to postoperatively (3.2 ± 1.93 ng/ml) and the difference (- 1.28 ng/ml) was statistically different (0.001 >P). There was a negative significant relationship between the number of cauterizations used and postoperative serum AMH levels (p ≤ 0.001). There was a significant relationship between the location (p ≤ 0.01), type of cyst (p ≤ 0.001) and the serum AMH levels reduction.
CONCLUSION
The number of cauterizations used during surgery, the type of cyst, and bilaterality can affect AMH levels that need to be addressed.
Topics: Anti-Mullerian Hormone; Cystectomy; Cysts; Endometriosis; Female; Humans; Laparoscopy; Ovarian Cysts; Ovarian Reserve; Peptide Hormones; Prospective Studies
PubMed: 36120464
DOI: 10.3389/fendo.2022.964229 -
Postgraduate Medical Journal Jul 2022Ruptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may...
BACKGROUND
Ruptured ovarian cysts are common gynaecological presentation to health institutions with abdominal pain. While this phenomenon is generally self-limiting, surgery may be necessary in cases of haemodynamic compromise or association with torsion. The aim of this audit is to identify the trend of hospital presentations, as well as the review the management of modern gynaecology practice.
METHODS
A retrospective audit of all women who presented to the emergency department with an imaging diagnosis of ruptured ovarian cysts was conducted over a 5-year period at St Vincent's Hospital, Sydney.
RESULTS
During the study period, 408 women were identified. There was a trend towards conservative management, as observed in 84.7% of women, while the remaining 15.4% underwent surgery. Haemorrhagic or ruptured corpus luteum was the most common diagnoses. As expected, women who had surgical intervention were more likely to have larger cysts (20 vs 50%; p<0.05), and larger free fluid findings on imaging (1.4 vs 23.8%; p<0.05) compared with those managed conservatively. There were no statistically significant differences in location of ovarian cysts (right or left) or antecedent to hospital presentation (vaginal intercourse or trauma).
CONCLUSION
Ruptured ovarian cysts of both functional and non-functional types remained a common clinical presentation of acute pain for women to the emergency department. Majority of women were managed conservatively in our cohort, and indications for surgery were large ovarian cysts and large free fluid seen on imaging findings. Surgery was largely feasible with minimal complications.
Topics: Cohort Studies; Conservative Treatment; Female; Humans; Ovarian Cysts; Retrospective Studies
PubMed: 33712434
DOI: 10.1136/postgradmedj-2020-138833 -
Women's Health (London, England) 2018Previous publications suggest a reduction in the ovarian reserve following ovarian surgery. The influence of the underlying disease, histology, size of the ovarian cyst...
Previous publications suggest a reduction in the ovarian reserve following ovarian surgery. The influence of the underlying disease, histology, size of the ovarian cyst and type of procedure remains unclear. The aim of this study was to investigate the influence of an ovarian operation on the ovarian reserve, based on the anti-Müllerian hormone levels. The anti-Müllerian hormone values were determined by means of a standardized enzyme-linked immunosorbent assay. In total, 52 patients with one or more ovarian cysts of different histologic entities treated at the Department of Women's Health at the Women's University Hospital in Tübingen were included in the study. Anti-Müllerian hormone was determined before and after surgery. The patients were 28 (range = 18-40) years old on average. There was a statistically significant decrease in anti-Müllerian hormone from 3.94 ± 3.18 to 3.14 ± 2.57 ng/mL (p = 0.001). In 80.8%, the cysts were unilateral, and in over 90.4%, a complete cyst extirpation was performed. A statistically significant reduction was seen in follicular cysts (4.72 ± 3.84 to 3.76 ± 2.91 ng/mL; p = 0.039) and endometriosis cysts (2.55 ± 1.87 to 1.72 ± 1.39 ng/mL; p = 0.024). Also, the size of the cysts had an influence on the ovarian reserve, only larger ovarian cysts with a diameter of 5 cm or more showed a statistically significant reduction in anti-Müllerian hormone. Our data showed a significant decrease in anti-Müllerian hormone levels after surgery on the ovaries. If this results in a long-term reduced ovarian reserve or is merely a short-term reaction to the procedure needs to be clarified. However, concerning young women, the indication of surgery should be given cautiously as-at least temporarily-a reduction in the ovarian reserve can occur.
Topics: Adult; Anti-Mullerian Hormone; Female; Germany; Humans; Laparoscopy; Organ Sparing Treatments; Ovarian Cysts; Ovarian Reserve; Ovary; Young Adult
PubMed: 29806554
DOI: 10.1177/1745506518778992 -
Medicina (Kaunas, Lithuania) Jan 2023Abdominal cystic masses are diagnosed during the intrauterine period and have a relatively low incidence. Fetal ovarian cysts are the most common form diagnosed... (Review)
Review
Abdominal cystic masses are diagnosed during the intrauterine period and have a relatively low incidence. Fetal ovarian cysts are the most common form diagnosed prenatally or immediately after birth. The pathophysiology of the development of these types of tumors is not fully elucidated, with ovarian hyperstimulation caused by maternal and placental hormones being the most accepted hypothesis. During intrauterine development, the diagnosis of fetal ovarian cysts is most often made accidentally during usual check-up ultrasounds corresponding to the first, second, and third trimesters of pregnancy. We conducted a scoping review with the aim to map the current knowledge regarding the treatment of fetal ovarian cysts diagnosed in the intrauterine period. Focusing on the articles published in the last 10 years in the specialized literature, we tried to identify a conceptualization regarding the surveillance and treatment of these anomalies.
Topics: Pregnancy; Female; Humans; Ultrasonography, Prenatal; Placenta; Ovarian Cysts; Pregnancy Trimester, Third
PubMed: 36837388
DOI: 10.3390/medicina59020186 -
Oncogene May 2020Epidemiologic and histopathologic findings and the laying hen model support the long-standing incessant ovulation hypothesis and cortical inclusion cyst involvement in...
Epidemiologic and histopathologic findings and the laying hen model support the long-standing incessant ovulation hypothesis and cortical inclusion cyst involvement in sporadic ovarian cancer development. MicroRNA-200 (miR-200) family is highly expressed in ovarian cancer. Herewith, we show that ovarian surface epithelial (OSE) cells with ectopic miR-200 expression formed stabilized cysts in three-dimensional (3D) organotypic culture with E-cadherin fragment expression and steroid hormone pathway activation, whereas ovarian cancer 3D cultures with miR-200 knockdown showed elevated TGF-β expression, mitotic spindle disorientation, increased lumenization, disruption of ROCK-mediated myosin II phosphorylation, and SRC signaling, which led to histotype-dependent loss of collective movement in tumor spread. Gene expression profiling revealed that epithelial-mesenchymal transition and hypoxia were the top enriched gene sets regulated by miR-200 in both OSE and ovarian cancer cells. The molecular changes uncovered by the in vitro studies were verified in both human and laying hen ovarian cysts and tumor specimens. As miR-200 is also essential for ovulation, our results of estrogen pathway activation in miR-200-expressing OSE cells add another intriguing link between incessant ovulation and ovarian carcinogenesis.
Topics: Carcinogenesis; Female; Gene Expression Regulation, Neoplastic; Humans; MicroRNAs; Ovarian Cysts; Ovarian Neoplasms; RNA, Neoplasm
PubMed: 32214198
DOI: 10.1038/s41388-020-1264-x -
Ceskoslovenska Patologie 2019Ovarian cysts are often found in both the clinically predicted and the unexpected context at the current level of imaging techniques. The cytological examination of the...
Ovarian cysts are often found in both the clinically predicted and the unexpected context at the current level of imaging techniques. The cytological examination of the transvaginally obtained cystic fluid can help to diagnose the nature of the cystic lesion via identification the lining structures. It is essential to distinguish functional cysts (follicular, corpusluteal) and implantation (inclusion and endometrial) from tumour cysts (dermoid, epithelial ovarian tumours, cystic metastases). A part of the cystic lesions remains unspecified for the absence of the defining structures after the cytological examination. Nevertheless, for its minimal invasiveness, high negative predictive value proven, and the possibility of contributing to diagnosis of selected patients (frequently with contraindications for larger diagnostic procedures), this investigation maintains its position in collaboration of a clinical specialist and a pathologist.
Topics: Cytodiagnosis; Female; Humans; Ovarian Cysts; Ovarian Neoplasms
PubMed: 31181943
DOI: No ID Found -
European Review For Medical and... Jun 2023To preserve ovarian reserve, we treated ovarian endometriomas by ultrasound-guided aspiration followed by sclerotherapy of the cyst mucosa. We compared the results with...
OBJECTIVE
To preserve ovarian reserve, we treated ovarian endometriomas by ultrasound-guided aspiration followed by sclerotherapy of the cyst mucosa. We compared the results with laparoscopic cystectomy.
PATIENTS AND METHODS
We conducted a retrospective study of 96 women with ovarian endometriomas. In 54 of the women, ultrasound-guided aspiration of the contents was performed, followed by chemical sclerotherapy of the cyst plaque with ethanol. Laparoscopic cystectomy was performed in the remaining 42 women.
RESULTS
Statistical analysis of anti-Mullerian hormone (AMH) levels before and after the procedures showed a significant decrease in the case of cystectomy compared with ethanolic ovarian sclerotherapy (EOS).
CONCLUSIONS
Conservative treatment by echo-assisted puncture and sclerotherapy with ethanol proved to be a viable treatment for the removal of ovarian endometriomas. It is a simple procedure that does not affect ovarian reserve or fertility.
Topics: Female; Humans; Endometriosis; Ovarian Reserve; Sclerotherapy; Retrospective Studies; Cysts; Laparoscopy; Ethanol; Ovarian Cysts
PubMed: 37401294
DOI: 10.26355/eurrev_202306_32795 -
Radiologic Technology 2015
Topics: Adult; Contrast Media; Female; Hemoperitoneum; Humans; Iopamidol; Ovarian Cysts; Rupture, Spontaneous; Tomography, X-Ray Computed
PubMed: 26199440
DOI: No ID Found -
Journal of Minimally Invasive Gynecology Feb 2017Ovarian cysts are common in the reproductive age. Pathologic cysts such as endometriomas and dermoids often require surgical intervention if symptomatic. Laparoscopic... (Review)
Review
Ovarian cysts are common in the reproductive age. Pathologic cysts such as endometriomas and dermoids often require surgical intervention if symptomatic. Laparoscopic cystectomy is the first-line treatment for these cysts and is associated with better pain control and less recurrence than drainage or cyst ablation procedures. There has been an emerging concern about the effect of ovarian cystectomy on ovarian reserve with some evidence of short-term and long-term reduction in ovarian reserve. Certain cyst characteristics (endometrioma pathology, large cyst size, bilateral presentation) are associated with a greater decline in ovarian reserve after cystectomy. The impact of surgery on ovarian reserve can be minimized by selecting the appropriate surgery for the patient, careful tissue handling, and limited use of electrosurgery. Patients should be counseled on the risks of surgery on reproductive potential, and the management plan should be individualized to the patient's symptoms and reproductive goals.
Topics: Adult; Female; Humans; Infertility, Female; Laparoscopy; Organ Sparing Treatments; Ovarian Cysts; Ovarian Reserve; Ovariectomy; Ovary; Patient Selection; Postoperative Complications; Reproductive Health
PubMed: 28089684
DOI: 10.1016/j.jmig.2016.12.010