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Neuro-Chirurgie Apr 2021Abdominal pseudocysts are common complications of ventriculoperitoneal shunt (VPS). We report the case of a 37-year-old woman treated by VPS for congenital obstructive...
Abdominal pseudocysts are common complications of ventriculoperitoneal shunt (VPS). We report the case of a 37-year-old woman treated by VPS for congenital obstructive hydrocephalus, who presented shunt dysfunction related to a voluminous abdominal cyst initially diagnosed as cerebrospinal fluid pseudocyst. The cyst was drained and the VPS was removed after endoscopic third ventriculocisternostomy (ETV). A few months later, a large new abdominal cyst appeared and was operated on. Diagnosis was rectified as massive ovarian mucinous cystadenoma. In any intra-abdominal cyst, differential diagnoses need considering to avoid mis-diagnosis in shunted patients, especially if the cyst is very large. The etiology of the hydrocephalus should also be investigated in case of shunt dysfunction. Even in case of longstanding shunt, ETV can be an alternative to shunt revision surgery in obstructive hydrocephalus, enabling VPS withdrawal and treatment of the hydrocephalus.
Topics: Adult; Diagnostic Errors; Female; Humans; Hydrocephalus; Laparotomy; Ovarian Cysts; Postoperative Complications; Reoperation; Ventriculoperitoneal Shunt; Ventriculostomy
PubMed: 33166567
DOI: 10.1016/j.neuchi.2020.09.012 -
Menopause (New York, N.Y.) May 2023
Topics: Female; Humans; Follow-Up Studies; Ovarian Cysts; Ultrasonography; Retrospective Studies; Ovarian Neoplasms
PubMed: 37074211
DOI: 10.1097/GME.0000000000002189 -
The Journal of Surgical Research Mar 2022Surgical management of pediatric ovarian torsion includes total oophorectomy (TO) or ovarian preservation surgery (OPS). This study sought to identify factors...
PURPOSE
Surgical management of pediatric ovarian torsion includes total oophorectomy (TO) or ovarian preservation surgery (OPS). This study sought to identify factors contributing to surgical management and readmission outcomes for ovarian torsion.
METHODS
The Nationwide Readmission Database from 2010-2014 was used to identify patients < 18 years admitted with ovarian torsion. Patient factors, hospital characteristics, and readmission outcomes were compared by TO and OPS. Standard statistical analysis was performed and results were weighted for national estimates.
RESULTS
There were 6028 patients (age 13 ± 4 years) identified with ovarian torsion who underwent either TO (50%) or OPS (50%). Patients had secondary pathology of ovarian cyst (41%), benign mass (19%), and malignant mass (0.4%). OPS was more common in teaching hospitals (84% vs. 74% TO, P<0.001), patients < 13 years of age (41% vs. 37% TO, P = 0.001), and those from high-income households (51% vs. 41% TO, P<0.001). The overall readmission rate was 4%, with no difference between surgical approach (4.3% OPS vs. 4.4% TO, P = 0.882). Of those readmitted (n = 265), readmission diagnoses were cyst (10%), malignant mass (9%), benign mass (7%), and torsion (5%). The overall rate of recurrent torsion was 0.2%, with no difference between OPS and TO (< 0.3% vs. < 0.2%, P = 0.282).
CONCLUSION
Half of pediatric patients are undergoing TO for ovarian torsion in the U.S. and disparities exist with the utilization of OPS. There is no difference in rate of readmission or recurrent torsion between surgical approaches, and the overall rate of retorsion is lower than previously reported.
Topics: Adolescent; Child; Female; Humans; Ovarian Cysts; Ovarian Torsion; Ovariectomy; Retrospective Studies; Torsion Abnormality
PubMed: 34844056
DOI: 10.1016/j.jss.2021.10.004 -
Journal of Gynecologic Oncology Jul 2017Ovarian needle aspiration and biopsy (ONAB) may be employed for pretreatment diagnosis of ovarian malignancies or intraoperatively to facilitate removal of ovarian...
OBJECTIVE
Ovarian needle aspiration and biopsy (ONAB) may be employed for pretreatment diagnosis of ovarian malignancies or intraoperatively to facilitate removal of ovarian masses. However, there is reluctance to utilize this procedure due to potential cyst rupture or seeding of malignant cells. The objective of this study was to examine the efficacy of ONAB over a 13-year period at our institution.
METHODS
Between 2000 and 2013, all ONAB specimens were identified from the Queen's Medical Center Pathology Department database. All cytologic specimens were reviewed and correlated with histopathologic findings. A retrospective chart review was conducted to retrieve data on clinical course and treatment.
RESULTS
This study identified 144 cases of ovarian masses sampled by aspiration or needle biopsy between 2000 and 2013. Ninety-two (64%) cases had corresponding histopathology, 84 (91%) of which were obtained concomitantly. On histology, 12 (13%) cases were malignant and 80 (87%) benign. Three false negative cases were noted; 2 serous borderline tumors and 1 mucinous cystadenocarcinoma. These were sampling errors; no diagnostic tumor cells were present in the aspirates. Sensitivity and specificity of ONAB in the detection of malignancy were 75% and 100%, respectively. The positive and negative predictive values were 100% and 96%, respectively.
CONCLUSION
ONAB represents a valuable tool in the diagnosis of malignancy and treatment of ovarian masses. In our study, it was highly specific, with excellent positive and negative predictive value.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Needle; False Negative Reactions; Female; Humans; Image-Guided Biopsy; Intraoperative Period; Middle Aged; Ovarian Cysts; Ovarian Neoplasms; Ovary; Predictive Value of Tests; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 28541632
DOI: 10.3802/jgo.2017.28.e40 -
Journal of Pediatric Surgery Apr 2022Cystic ovarian masses in children may be physiological or neoplastic. It is mandatory that suspected neoplastic lesions are resected without tumour spillage. However, a...
AIM
Cystic ovarian masses in children may be physiological or neoplastic. It is mandatory that suspected neoplastic lesions are resected without tumour spillage. However, a large midline incision is cosmetically unappealing incision to young women. Here we describe our experience of using controlled drainage without spillage that allows a cosmetic pfannenstiel approach without compromising oncological principles.
METHOD
All girls treated with large ovarian cystic masses since 2008 in our centre were identified and data was collected prospectively. A small pfannenstiel incision was performed followed by peritoneal washings; tissue glue was used to stick an Opsite™ dressing to the cyst surface and fluid drained so there was no leakage back into the patient. Once aspirated the cyst was delivered and an ovarian preserving cystectomy was performed where possible.
RESULTS
Twenty-three girls (median age 14.5 years (8.1 to 16.5 years) were included. Pre-operative MRI scan showed a complex lesions with median volume of 1169 ml (range 252-7077 ml). At surgery 22/23 cysts were intact and removed without spillage.
HISTOLOGY
mature teratoma (11), serous cyst (3), mucinous cyst adenocarcinoma (2), mucinous cystadenoma (5), Sertoli-Leydig tumour, sclerosing stromal tumour. One girl with pre-operative rupture of a mucinous adenocarcinoma subsequently died. Ovarian sparing cystectomy was performed in 17/23 girls. All other patients are well without evidence of recurrence.
CONCLUSION
This is the largest series in children and adolescents using controlled drainage of cystic ovarian tumours. Though there were a range of diagnoses we have shown that these can be removed safely with a cosmetic pfannenstiel approach while following oncological principles.
Topics: Adenocarcinoma, Mucinous; Adolescent; Child; Dermoid Cyst; Female; Humans; Ovarian Cysts; Ovarian Neoplasms; Teratoma
PubMed: 34348845
DOI: 10.1016/j.jpedsurg.2021.06.012 -
The Journal of Veterinary Medical... Oct 2020Ovarian cysts are one of the most common ovarian dysfunctions in dairy cattle, which can lead to a considerable economic loss through its high incidence and can reduce... (Review)
Review
Ovarian cysts are one of the most common ovarian dysfunctions in dairy cattle, which can lead to a considerable economic loss through its high incidence and can reduce the reproductive performance. Anestrus is the most significant clinical sign observed in dairy cattle suffering from this condition. For diagnosis, most of the veterinarians use a combination of methods, from ultrasonography as an additional approach to trans-rectal palpation and symptomatology when assessing ovarian cysts. Although the Ovsynch treatment seems to be preferred, the pregnancy rate after this treatment is relatively low. Despite such reports on dairy cattle ovarian cysts, the data is insufficient to validate all the characteristics of this condition. This review summarizes what the literature has so far provided from definition to treatment of ovarian cysts in dairy cattle.
Topics: Animals; Cattle; Cattle Diseases; Diagnosis, Differential; Female; Incidence; Insemination, Artificial; Ovarian Cysts; Pregnancy; Pregnancy Rate; Reproduction; Risk Factors
PubMed: 32814749
DOI: 10.1292/jvms.20-0381 -
Genes Sep 2023Corpus luteum cysts are a serious reproductive disorder that affects the reproductive performance of sows. In this study, transcriptome and metabolome datasets of...
Corpus luteum cysts are a serious reproductive disorder that affects the reproductive performance of sows. In this study, transcriptome and metabolome datasets of porcine normal and cyst luteal granulosa cells were generated to explore the molecular mechanism of luteal cyst formation. We obtained 28.9 Gb of high-quality transcriptome data from luteum tissue samples and identified 1048 significantly differentially expressed genes between the cyst and normal corpus luteum samples. Most of the differentially expressed genes were involved in cancer and immune signaling pathways. Furthermore, 22,622 information-containing positive and negative ions were obtained through gas chromatography-mass spectrometry, and 1106 metabolites were successfully annotated. Important differentially abundant metabolites and pathways were identified, among which abnormal lipid and choline metabolism were involved in the formation of luteal cysts. The relationships between granulosa cells of luteal cysts and cancer, immune-related signaling pathways, and abnormalities of lipid and choline metabolism were elaborated, providing new entry points for studying the pathogenesis of porcine luteal cysts.
Topics: Humans; Female; Animals; Swine; Transcriptome; Ovarian Cysts; Metabolome; Choline; Lipids
PubMed: 37895197
DOI: 10.3390/genes14101848 -
Best Practice & Research. Clinical... May 2016Adnexal masses are diagnosed in 5% pregnancies and pose diagnostic and management challenges. Ultrasound and magnetic resonance imaging (MRI) are the mainstay as an...
Adnexal masses are diagnosed in 5% pregnancies and pose diagnostic and management challenges. Ultrasound and magnetic resonance imaging (MRI) are the mainstay as an evaluation procedure; surgery is warranted for persistent masses with a diameter of >5 cm and sonographic signs of possible malignancy. Optimal timing for a planned surgery is the second trimester and does not adversely affect neonatal outcome. Laparoscopy is safe in pregnancy. Management for ovarian cancer during pregnancy should be individualised and formulated by a multidisciplinary team in a specialised centre while also considering the patients' wishes to preserve pregnancy. The following options can be considered: (i) induced abortion followed by standard management of ovarian cancer, (ii) pregnancy-preserving surgery followed by chemotherapy, planned delivery and secondary surgical completion or (iii) neoadjuvant chemotherapy followed by surgery during the postpartum period. Standard chemotherapy administered in non-pregnant population can only be used during the first trimester of pregnancy.
Topics: Antineoplastic Agents; Biomarkers, Tumor; Female; Gestational Age; Humans; Laparoscopy; Magnetic Resonance Imaging; Ovarian Cysts; Ovarian Neoplasms; Ovariectomy; Perioperative Care; Pregnancy; Pregnancy Complications, Neoplastic; Salpingectomy; Ultrasonography
PubMed: 26707193
DOI: 10.1016/j.bpobgyn.2015.10.015 -
Journal of Ultrasound in Medicine :... Sep 2022To evaluate the growth rate of benign ovarian cystadenomas and the degree of variability in ultrasound measurements.
OBJECTIVES
To evaluate the growth rate of benign ovarian cystadenomas and the degree of variability in ultrasound measurements.
METHODS
Two independent retrospective cohorts of women found to have benign cystadenomas at surgery were identified. To assess growth rate, ultrasounds on women in a community-based health system were reviewed and the growth rate was determined based on the maximum reported size dimension using a mixed effect model. To assess measurement variability, two radiologists independently measured presurgical adnexal imaging findings for women in a tertiary care referral setting. Interobserver, intra-observer, and intermodality (cine clip versus still images) variability in measurements was determined using correlation coefficients (CC) and Bland-Altman analysis, with the proportion of measurements varying by more than 1 cm calculated.
RESULTS
For growth rate assessment, 405 women with 1412 ultrasound examinations were identified. The median growth rate was 0.65 cm/year with mucinous cystadenomas growing faster at 0.83 cm/year compared to 0.51 cm/year for serous cystadenomas (median test P < .0001). To evaluate measurement variability, 75 women were identified with 176 ultrasound studies. The within-subject standard deviations for ultrasound measurements were 0.74 cm for cine clip images and 0.41 cm for static images, with 11% of measurements overall differing by more than 1 cm.
CONCLUSIONS
Cystadenomas grow on average 0.65 cm/year, which is similar in magnitude to the inherent error observed in measurement on ultrasound, suggesting that repeat ultrasound at intervals of longer than a year will often be needed to accurately assess growth if a cyst represents a benign cystadenoma.
Topics: Cystadenoma; Cystadenoma, Mucinous; Female; Humans; Ovarian Cysts; Ovarian Neoplasms; Reproducibility of Results; Retrospective Studies
PubMed: 34846072
DOI: 10.1002/jum.15895 -
Journal of Pediatric and Adolescent... Oct 2018A mild degree of clitoromegaly can be associated with patients with polycystic ovarian syndrome (PCOS). We describe an unusually significant clitoromegaly in a patient...
BACKGROUND
A mild degree of clitoromegaly can be associated with patients with polycystic ovarian syndrome (PCOS). We describe an unusually significant clitoromegaly in a patient with PCOS.
CASE
An 18-year-old nonobese female patient was referred for clitoromegaly. Her genitalia exam showed significant clitoral enlargement with a well-formed glans, clitoris measured at 35 mm for length and 10 mm for width. Pelvic ultrasound showed a left ovarian cyst. Her testosterone level ranged from 28.8 to 64.1 ng/dL (normal: 8.4-48.1 ng/dL) with normal sex hormone binding globulin. Other ovarian hormones were in acceptable ranges.
SUMMARY AND CONCLUSION
This case demonstrates the coexistence of significant clitoromegaly, PCOS, and nonfunctioning ovarian cyst.
Topics: Adolescent; Clitoris; Female; Humans; Hyperandrogenism; Hypertrophy; Ovarian Cysts; Polycystic Ovary Syndrome; Testosterone; Ultrasonography
PubMed: 29730432
DOI: 10.1016/j.jpag.2018.04.004