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Internal and Emergency Medicine Jun 2017
Topics: Abdominal Pain; Diagnosis, Differential; Female; Humans; Laparoscopy; Magnetic Resonance Imaging; Ovarian Cysts; Salpingo-oophorectomy; Torsion Abnormality; Young Adult
PubMed: 27531002
DOI: 10.1007/s11739-016-1523-6 -
Journal of Women's Health (2002) May 2023There is a growing body of evidence that ovarian cystectomy may negatively impact ovarian reserve. However, it is unclear whether ovarian cyst surgery puts women at...
There is a growing body of evidence that ovarian cystectomy may negatively impact ovarian reserve. However, it is unclear whether ovarian cyst surgery puts women at risk of future infertility. This study investigates whether surgery for benign ovarian cysts is associated with long-term infertility risk. Women aged 22-45 years ( = 1,537) were invited to participate in an interview about their reproductive histories, including whether they ever had infertility or ovarian cyst surgery. Each woman reporting cyst surgery was randomly matched to a comparison woman, who was assigned an artificial surgery age equal to that of her match. Matching was repeated 1,000 times. Adjusted Cox models were fit to examine time to infertility after surgery for each match. A subset of women was invited to participate in a clinic visit to assess markers of ovarian reserve (anti-Müllerian hormone [AMH], antral follicle count). Approximately 6.1% of women reported cyst surgery. Infertility after surgery was more common for women reporting cyst surgery than those without surgery after adjusting for age, race, body mass index, cancer history, parity before assigned surgery age, history of infertility before surgery age, and endometriosis (median-adjusted hazard ratio 2.41, 95% simulation interval 1.03-6.78). The estimated geometric mean (95% confidence interval [CI]) AMH levels of those who reported a history of ovarian cyst surgery were 1.08 (95% CI: 0.57-2.05) times those of women who reported no history of surgery. Those with a history of ovarian cyst surgery were more likely to report having a history of infertility compared with age-matched women who reported no history of cyst surgery. It is possible that both ovarian surgery to remove cysts and the conditions that lead women to develop cysts requiring surgery may affect subsequent successful conception.
Topics: Pregnancy; Female; Humans; Ovarian Cysts; Infertility; Endometriosis; Fertilization; Anti-Mullerian Hormone
PubMed: 36971598
DOI: 10.1089/jwh.2022.0385 -
Journal of Obstetrics and Gynaecology :... Jul 2022The purpose of this study was to compare the surgical outcomes and efficacy of 3-dimensional (3D) 2-dimensional (2D) imaging systems for the treatment of ovarian cyst.... (Randomized Controlled Trial)
Randomized Controlled Trial
The purpose of this study was to compare the surgical outcomes and efficacy of 3-dimensional (3D) 2-dimensional (2D) imaging systems for the treatment of ovarian cyst. A total of 46 patients undergoing a laparoscopic ovarian cystectomy were randomly assigned to either the 3D or 2D laparoscopy group. The primary outcome measure was the operative blood loss. The secondary outcome measure was visually induced motion sickness (VIMS), task efficacy during laparoscopy, and postoperative complication. There were no differences in baseline demographics between the two groups. The operative blood loss was significantly smaller in the 3D groups (28.7 ± 11.6 mL) than in the 2D groups (46.5 ± 24.4 mL) ( = .012). VIMS score was significantly higher in the 3D groups than the 2D groups ( < .001). 3D laparoscopy was superior to 2D in terms of the task efficacy of ovarian cyst enucleation ( < .001), adhesiolysis or dissection ( < .001), and ovarian suturing ( = .008). None of the patients in both groups developed operative complications. In conclusion, a 3D imaging system showed a more favourable surgical outcome and improved task efficacy than 2D in laparoscopic ovarian cystectomy. However, 3D laparoscopy tends to cause more frequent VIMS in surgeons.Impact statement Several studies examining the possible benefits and drawbacks of a 3D imaging system 2D in laparoscopic surgery have brought about conflicting results. However, there have been few studies comparing the surgical outcomes of 3D and 2D laparoscopic ovarian cystectomy. 3D laparoscopy showed favourable surgical outcomes and improved task efficacy than 2D laparoscopy in ovarian cystectomy. More complex procedures, such as suturing and adhesiolysis, might be easier to perform with 3D laparoscopy than with 2D laparoscopy. Therefore, further large studies of 3D gynaecologic laparoscopy with different complexities and for surgeons with different surgical skills are needed.
Topics: Blood Loss, Surgical; Female; Humans; Imaging, Three-Dimensional; Laparoscopy; Operative Time; Ovarian Cysts; Treatment Outcome
PubMed: 34927539
DOI: 10.1080/01443615.2021.1990231 -
Immunobiology Nov 2022Naturally occurring antibodies to tumour antigens are gaining interest as clinically important cancer biomarkers for early diagnosis, prognosis and for the development...
Naturally occurring antibodies to tumour antigens are gaining interest as clinically important cancer biomarkers for early diagnosis, prognosis and for the development of anti-cancer therapeutics. The glycoprotein αβ heterodimer hormone human chorionic gonadotropin (hCG) and its β subunit (hCGβ) are produced by various cancers, and their increased serum levels correlate with poor prognosis. We have previously reported that patients with benign ovarian cysts, but not the malignant tumours, were characterized by augmented serum levels of naturally-occurring IgG antibodies to hCG and hCGβ. Here we further characterise these antibodies in patients with ovarian cysts. IgG and IgM antibody binding to whole hCG, hCGβ, hCGα, hCGβ C-terminal peptide (hCGβCTP), and the hCGβ core fragment (hCGβCF) were measured in the sera from 36 patients with ovarian cysts and 12 healthy non-pregnant women using a standard ELISA. IgG subclass usage and affinity was also determined together with cross-binding to whole hCG and its subunits of four selected commercial monoclonal antibodies generated against ovarian cyst mucins. Our results showed that 91.7% of the sera tested contained elevated IgG, but not IgM antibodies to one or several antigens, with an overwhelming prevalence of high affinity IgG2 indicating their binding to carbohydrate epitopes and possibly ovarian cyst mucins. Anti-mucin commercial antibody ab212418 (Abcam) produced against Gal1-3GalNAc, exhibited strong cross-binding to hCGαβ, hCGβ, hCGα and hCGβCTP. The protective anti-cancer potential of these antibodies will be further investigated and could lead to the development of novel treatment strategies for ovarian cancer.
Topics: Female; Humans; Prevalence; Chorionic Gonadotropin; Enzyme-Linked Immunosorbent Assay; Ovarian Cysts; Neoplasms; Immunoglobulin G
PubMed: 36088866
DOI: 10.1016/j.imbio.2022.152273 -
Acta Obstetricia Et Gynecologica... Oct 2020Mitotane is an adrenolytic drug that is used as an adjuvant to treat adrenocortical carcinoma. This study aimed to evaluate the clinical course and pathogenetic...
INTRODUCTION
Mitotane is an adrenolytic drug that is used as an adjuvant to treat adrenocortical carcinoma. This study aimed to evaluate the clinical course and pathogenetic mechanisms underlying ovarian cyst formation in women of reproductive age diagnosed with adrenocortical carcinoma and being treated with mitotane as an adjuvant to surgery.
MATERIAL AND METHODS
Five women presented with stage III-IV adrenocortical carcinoma and ovarian cyst formation during mitotane treatment. The clinical course of the disease was followed during and after treatment. The effects of mitotane on progesterone production and cell proliferation were studied in cultured human ovarian granulosa cells.
RESULTS
Computed tomography and vaginal ultrasonography during mitotane treatment repeatedly demonstrated ovarian cysts of varying size without solid intralocular structures. Two women became amenorrheic during the treatment period. After mitotane cessation, the ovarian cysts disappeared and normal menstrual cycles resumed. One woman had an uncomplicated pregnancy two years after mitotane treatment. In one woman, who underwent salpingo-oophorectomy, histological analysis demonstrated benign ovarian cysts. Mitotane impeded the synthesis of progesterone, reduced the stimulatory effect of gonadotropins on progesterone formation, and reduced labeling with [ H]thymidine in cultured granulosa cells.
CONCLUSIONS
Therapeutic concentrations of mitotane are associated with the formation of benign ovarian cysts and amenorrhea. Mitotane-induced suppression of ovarian steroidogenesis and impediment of the proliferative capacity of steroid-producing cells are suggested potential pathogenetic mechanisms underlying mitotane-induced ovarian dysfunction and cyst development. Mitotane treatment does not compromise future ovarian function.
Topics: Adrenal Cortex Neoplasms; Adrenocortical Carcinoma; Adult; Amenorrhea; Antineoplastic Agents, Hormonal; Female; Humans; Middle Aged; Mitotane; Ovarian Cysts; Tomography, X-Ray Computed; Ultrasonography; Young Adult
PubMed: 32282928
DOI: 10.1111/aogs.13869 -
Ceska Gynekologie 2017The study was designed to prove the safety of simple cyst aspiration instead of the current treatment by laparoscopy.
OBJECTIVE
The study was designed to prove the safety of simple cyst aspiration instead of the current treatment by laparoscopy.
DESIGN
Retrospective analysis.
SETTING
Fertimed Olomouc, Infertility Center.
METHODS
We are presenting our experience with the aspiration of follicles (group A) and a functional cyst (group B, C). We are evaluating a number of complications in all groups, anaesthesia versus analgesia in group B, C and the cytological examination of fluid from the function cyst in group C.
RESULTS
In 2,744 aspirations we detected 0.0004% small complications (vaginal wall bleeding) and 0.0004% major complications (laparoscopy, cystoscopy). No single cytological examination was suspect in the simple ovarian function cyst.
CONCLUSION
Aspiration of a simple functional cyst is the first step of the treatment. It is a simple procedure. For patients it is comfortable and safe. In a simple cyst, we do not find suspect cells.
Topics: Female; Humans; Laparoscopy; Minimally Invasive Surgical Procedures; Ovarian Cysts; Retrospective Studies
PubMed: 29302978
DOI: No ID Found -
Journal of Infection and Public Health Jan 2021In order to explore the accuracy of computed tomography (CT) and type-B ultrasonography in the examinations infection of ovarian cyst, the computed tomography and type-B...
In order to explore the accuracy of computed tomography (CT) and type-B ultrasonography in the examinations infection of ovarian cyst, the computed tomography and type-B ultrasonography were used for the examinations of 50 patients with infection of ovarian cysts, whose results were analyzed to determine the accuracy. Results have shown that the misdiagnosis rates of CT for patients with infection of ovarian cyst reached 18%, in which the misdiagnosis rate of small lesion 2.1×1.5×1.8cm was relatively higher; in addition, the misdiagnosis rates of type-B ultrasonography reached 26%, in which the misdiagnosis rate of large lesion 2.6×1.6×1.5cm was relatively higher; however, the misdiagnosis rates of the joint examination of these methods were only 2%. In summary, the deficiencies of CT and type-B ultrasonography may lead to misdiagnosis; therefore, in the clinical practices, the examinations of patients with infection of ovarian cyst should combine CT and type-B ultrasonography together to avoid the misdiagnosis and obtain the most accurate results as much as possible, which is important to both the patients and the development of medical examinations.
Topics: Female; Humans; Ovarian Cysts; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31455597
DOI: 10.1016/j.jiph.2019.08.003 -
Journal of Pediatric and Adolescent... Jun 2021To investigate the clinical and computed tomography (CT) characteristics of ovarian lesions in infants, children, and adolescents.
STUDY OBJECTIVE
To investigate the clinical and computed tomography (CT) characteristics of ovarian lesions in infants, children, and adolescents.
DESIGN, SETTING, AND PARTICIPANTS
A retrospective analysis of the clinical and CT data was performed in 222 patients who were 20 years or younger with ovarian lesions. Patients' age, medical history, symptoms, tumor marker levels, and CT imaging findings were recorded.
INTERVENTIONS
None.
MAIN OUTCOME MEASURES
Identification of the clinical and CT features of ovarian lesions in infants, children, and adolescents.
RESULTS
A total of 136 patients had abdominal pain, and 73 patients had palpable abdominal mass. The β-HCG was elevated in 4 and AFP was elevated in 16 of the 222 cases. A total of 235 lesions were found in 222 cases, including 75 non-neoplastic and 160 neoplastic lesions. Ovarian cyst exhibited homogeneous low density. The torsion of a normal-sized ovary demonstrated mild or no enhancement. The torsion associated with an ovarian mass demonstrated a thickened, hyperdense wall. Mature teratoma presented as a cystic mass, with bulk fat and coarse calcification. Immature teratoma appeared as a solid mass with foci of fat and fine calcification. Yolk sac tumor was shown as cystic-solid mass with intense enhancement of solid component. Wall and septation of benign epithelial tumors were relatively uniform in thickness; mural nodule was detected in borderline tumor; and malignant epithelial tumor was predominantly a solid mass with intense enhancement.
CONCLUSION
Ovarian cyst is the most common non-neoplastic lesion. Torsion of a normal-sized ovary was the second most common non-neoplastic lesion, almost always causing abdominal pain. Germ cell tumor has the highest incidence among neoplastic lesions. Fat and calcification are highly specific for germ cell tumor. The elevation of AFP and HCG levels in serum indicates germ cell tumor. Ovarian epithelial tumor is usually large, benign, and predominantly cystic. The combination of clinical and imaging features is helpful for correct diagnosis.
Topics: Adolescent; Child; Female; Humans; Infant; Ovarian Cysts; Ovarian Neoplasms; Ovarian Torsion; Retrospective Studies; Teratoma; Tomography, X-Ray Computed
PubMed: 33144230
DOI: 10.1016/j.jpag.2020.10.007 -
Borderline ovarian cyst treated by laparoscopic surgery: clinical case report and literature review.Romanian Journal of Morphology and... 2015Borderline ovarian serous tumors are a rare distinct category of epithelial ovarian tumors, distinguished from both benign and invasive ovarian tumors. As borderline... (Review)
Review
Borderline ovarian serous tumors are a rare distinct category of epithelial ovarian tumors, distinguished from both benign and invasive ovarian tumors. As borderline ovarian cysts are only a small part of the gynecological conditions of children, the therapeutic approach to this special type of tumor has not been standardized yet. Despite the technological breakthroughs that we have witnessed lately, the positive diagnosis of ovarian tumors is possible only by surgery and histopathological examination, and laparoscopic surgery has become the golden standard in the management of this condition. The aim of this case report is to demonstrate a very good long-term evolution after minimal invasive treatment and minimal damage to the reproductive apparatus in children with borderline ovarian tumors. The case reported in this paper is that of a 17-year-old adolescent with borderline serous papilliferous cystadenoma diagnosed by ultrasound and computed tomography (CT) scanning, whose CA-125 biomarker had normal values. As the purpose was to preserve the patient's reproductive function, we chose to remove and excise the cyst by laparoscopic surgery, without removing the ovaries. The patient's subsequent evolution was positive and at 19-year-old, she gave natural birth to a healthy baby girl. Nevertheless, as relapses are possible after many years, the patient's long-term monitoring is necessary.
Topics: Adolescent; Antigens, CD; Carcinoma, Papillary; Female; Humans; Ki-67 Antigen; Laparoscopy; Ovarian Cysts; Tomography, X-Ray Computed
PubMed: 26743305
DOI: No ID Found -
International Journal of Clinical... Jan 2020Endometriosis is a risk factor for ovarian cancer. Endometriosis-associated ovarian cancer (EAOC), most commonly clear cell carcinoma, is believed to develop from... (Review)
Review
BACKGROUND
Endometriosis is a risk factor for ovarian cancer. Endometriosis-associated ovarian cancer (EAOC), most commonly clear cell carcinoma, is believed to develop from ovarian endometrial cysts. In this study, we reviewed published cases of EAOC considered to have developed from endometrial cysts, and focused on the observation period.
METHODS
We searched for articles published since January 2000 that reported cases of ovarian cancer thought to have originated from endometrial cysts using PubMed, Web of Science, and Ichushi-Web. The period from the start of follow-up of the endometrial cyst to the diagnosis of ovarian cancer was calculated.
RESULTS
Seventy-nine cases were identified from 32 articles. The median period from the diagnosis of endometrial cysts to the diagnosis of ovarian cancer was only 36 months. Approximately 75% of cases developed into cancer within 60 months and most cases developed within 120 months.
CONCLUSION
Our results suggest that clinically detectable cysts subsequently diagnosed as ovarian cancer might already have contained cancer cells. Therefore, the mechanism of EAOC development needs to be re-examined and appropriate management guidelines need to be developed.
Topics: Adult; Carcinoma, Endometrioid; Carcinoma, Ovarian Epithelial; Endometriosis; Female; Follow-Up Studies; Humans; Middle Aged; Ovarian Cysts; Ovarian Neoplasms
PubMed: 31473885
DOI: 10.1007/s10147-019-01536-5