1,066 results on '"Ovarian Cysts complications"'
Search Results
52. Laparoscopic Ovarian Cystectomy in a Patient with Situs Inversus Totalis.
- Author
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Jin M, Sun W, Xie Z, Zhang D, Fei X, and Li J
- Subjects
- Abortion, Legal methods, Adult, Echocardiography, Female, Humans, Ovarian Cysts complications, Ovarian Cysts diagnosis, Pregnancy, Pregnancy Complications, Neoplastic diagnosis, Pregnancy Complications, Neoplastic surgery, Radiography, Thoracic, Situs Inversus complications, Situs Inversus diagnosis, Gynecologic Surgical Procedures methods, Laparoscopy methods, Ovarian Cysts surgery, Situs Inversus surgery
- Published
- 2019
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53. Iatrogenic Ureteral Obstruction During Transvaginal Oocyte Retrieval.
- Author
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Gurbuz AS and Cenker A
- Subjects
- Adult, Female, Humans, Iatrogenic Disease, Ovarian Cysts complications, Oocyte Retrieval adverse effects, Ultrasonography, Interventional adverse effects, Ureter injuries, Ureteral Obstruction etiology
- Abstract
Transvaginal oocyte retrieval is a crucial step in assisted reproductive technology. Various complications may arise during this procedure. Ureteral injury is a rare, but a serious complication in gynecological practice. During oocyte retrieval, ureteral injuries, detachment and obstruction can be seen, though rare. In this study, we will present ureteral obstruction that develops secondary to small hematoma, which mimics ovarian cyst torsion or ruptured ovarian cyst., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)
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- 2019
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54. Remission of diabetes mellitus after ovariohysterectomy in a guinea pig with ovarian cysts.
- Author
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Kreilmeier-Berger T, Guija-De-Arespacochaga A, Bilek A, and Künzel F
- Subjects
- Animals, Diabetes Mellitus physiopathology, Diabetes Mellitus surgery, Female, Ovarian Cysts complications, Ovarian Cysts surgery, Diabetes Mellitus veterinary, Guinea Pigs, Hysterectomy veterinary, Ovarian Cysts veterinary, Ovariectomy veterinary
- Abstract
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., Competing Interests: The authors confirm that they do not have any conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)
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- 2019
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55. Suggestive hypothesis on a case report: Patient presenting with cyclical ovarian cysts coupled to increased cholestatic enzymes.
- Author
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Conca P, Cafaro G, Savastano S, Coppola A, Cimino E, and Tarantino G
- Subjects
- Adult, Androgen Antagonists administration & dosage, Drug Therapy, Combination, Estradiol administration & dosage, Female, Humans, Androgen Antagonists pharmacology, Cholestasis drug therapy, Cholestasis enzymology, Cholestasis etiology, Estradiol pharmacology, Ovarian Cysts complications, Ovarian Cysts drug therapy, Ovarian Cysts enzymology
- Abstract
We describe the case of a childbearing-age woman presenting with spontaneous recurrent functional ovarian cysts and, more interestingly, chronic and asymptomatic elevation of cholestatic parameters. The patient showed no history of chronic viral infections, immunological and metabolic disorders, alcohol abuse and environmental toxins exposition. Hepatic ultrasonography and cholangio-pancreatography-magnetic-resonance excluded any morphological and structural abnormalities, while liver biopsy evidenced only minimal and not specific features of inflammation. Cholestasis indices obtained prompt recovery after each cycle of synthetic hormone therapy, implanted to treat functional ovarian cysts. She has continuously experienced the off-therapy asynchronous recurrence of liver laboratory abnormalities and functional ovarian cysts. The favorable effect of the synthetic hormone therapy to obtaining a stable recovery of this unexplained long-lasting cholestatic syndrome could be likely explained by downregulation of an endogenous ovarian overproduction, although estrogen-regulated local intracellular transduction pathways cannot be excluded., (© 2018 Japan Society of Obstetrics and Gynecology.)
- Published
- 2019
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56. An intriguing case of precocious puberty due to an ovarian mass in an infant.
- Author
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Dayal D, Seetharaman K, Menon P, Aggarwal A, Das G, and Srinivasan R
- Subjects
- Female, Humans, India, Infant, Ovarian Cysts diagnosis, Ovarian Cysts diagnostic imaging, Ovarian Cysts surgery, Puberty, Precocious diagnosis, Ovarian Cysts complications, Puberty, Precocious etiology
- Abstract
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.
- Published
- 2019
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57. Hemoperitoneum in a Peritoneal Dialysis Patient: Ruptured Ectopic Pregnancy.
- Author
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Kohn OF, Culbertson S, and Becker YT
- Subjects
- Adult, Female, Hemoperitoneum diagnostic imaging, Hemoperitoneum surgery, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic therapy, Ovarian Cysts complications, Ovarian Cysts surgery, Peritoneal Dialysis, Continuous Ambulatory methods, Pregnancy, Pregnancy Complications therapy, Pregnancy, Ectopic surgery, Risk Assessment, Rupture, Spontaneous complications, Rupture, Spontaneous surgery, Treatment Outcome, Hemoperitoneum etiology, Ovarian Cysts diagnostic imaging, Peritoneal Dialysis, Continuous Ambulatory adverse effects, Pregnancy Complications diagnosis, Pregnancy Outcome, Pregnancy, Ectopic diagnostic imaging
- Abstract
Hemoperitoneum is a well-recognized complication in female peritoneal dialysis (PD) patients of childbearing age. Bloody effluent is commonly of minor nature, presenting during menstruation or midcycle, resolving after a few rapid exchanges without a need for further intervention. One must remain vigilant, however, and consider a broader differential diagnosis when hemoperitoneum is persistent or severe, as it indicates a serious and potentially life-threatening etiology. We report 2 episodes of hemoperitoneum in a PD patient occurring more than 1.5 years apart, with different underlying etiologies. The more dramatic second episode was due to a ruptured ectopic pregnancy, a condition which had not been reported as a cause of hemoperitoneum in dialysis patients to date and requires a high index of suspicion and prompt surgical intervention., (Copyright © 2018 International Society for Peritoneal Dialysis.)
- Published
- 2018
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58. Van Wyk Grumbach Syndrome: A Rare Consequence of Hypothyroidism.
- Author
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Reddy P, Tiwari K, Kulkarni A, Parikh K, and Khubchandani R
- Subjects
- Child, Female, Hormone Replacement Therapy, Humans, Hypothyroidism complications, Intestinal Obstruction complications, Ovarian Cysts complications, Puberty, Precocious complications, Syndrome, Thyroiditis, Autoimmune complications, Thyroiditis, Autoimmune drug therapy, Thyroxine therapeutic use, Hypothyroidism diagnosis, Ovarian Cysts diagnosis, Puberty, Precocious diagnosis, Thyroiditis, Autoimmune diagnosis
- Abstract
Long standing hypothyroidism presenting as an ovarian mass has been well described in literature as the Van Wyk Grumbach syndrome (hypothyroidism, isosexual precocious puberty and ovarian mass). Here, authors report this entity in a 11 y 7 mo old girl child who was referred to a surgeon in view of intestinal obstruction along with a multiloculated ovarian cyst. On evaluation, she was found to have raised serum creatinine, short stature, delayed bone age and pituitary enlargement. She was diagnosed with autoimmune thyroiditis and was started on replacement therapy with thyroxine, after which the ovarian cysts regressed. This entity should be kept in mind in cases of ovarian cysts, especially those with isosexual precocity, to prevent unnecessary evaluation and surgical misadventures.
- Published
- 2018
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59. Cornual uterine diverticulum following a failed pregnancy.
- Author
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Babcock Gilbert S, Reading JI, Post MD, Alvero R, and Al-Safi ZA
- Subjects
- Abortion, Induced, Abortion, Spontaneous, Adult, Diverticulum pathology, Diverticulum surgery, Female, Humans, Laparoscopy, Ovarian Cysts complications, Ovarian Cysts surgery, Pelvic Pain, Pregnancy, Pregnancy, Tubal surgery, Salpingectomy, Ultrasonography, Uterine Diseases pathology, Uterine Diseases surgery, Diverticulum diagnosis, Uterine Diseases diagnosis, Uterus pathology, Uterus surgery
- Abstract
The discovery of a uterine diverticulum is a rare event. Diverticula can lead to outcomes including pelvic pain, ectopic pregnancy, and diverticula rupture and should be considered in cases of uterine cystic masses. We report a case of a 32-year-old G3P0030 with a complicated pregnancy and surgical history who presented to us following an abnormal laparoscopy for severe pelvic pain four years after salpingectomy for a tubal pregnancy. This laparoscopy reported a cornual uterine cystic structure. Saline infusion sonohysterography was performed with fluid filling a uterine cornual cystic mass. On hysteroscopy, no outpouching was identified. With chromopertubation on laparoscopy, methylene blue filled the diverticulum. The diverticulum was laparoscopically removed. Pathology examination was consistent with a diverticulum containing a placental implantation site and necrotic chorionic villi.
- Published
- 2018
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60. A Case of Unusual Clitoromegaly.
- Author
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Ch'ng TW and Umpaichitra V
- Subjects
- Adolescent, Female, Humans, Hypertrophy complications, Testosterone blood, Ultrasonography, Clitoris pathology, Hyperandrogenism complications, Ovarian Cysts complications, Polycystic Ovary Syndrome complications
- Abstract
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., (Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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61. Two abnormalities on diagnostic laparoscopy.
- Author
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Keedwell R and Byrne D
- Subjects
- Adult, Dyspareunia etiology, Female, Humans, Ovarian Cysts complications, Pelvic Pain etiology, Pregnancy, Pregnancy, Cornual pathology, Urogenital Abnormalities complications, Urogenital Abnormalities pathology, Uterus pathology, Laparoscopy, Ovarian Cysts diagnosis, Pregnancy, Cornual diagnosis, Urogenital Abnormalities diagnosis, Uterus abnormalities
- Abstract
Competing Interests: We have read and understood the BMJ policy on declaration of interests and declare no competing interests.
- Published
- 2018
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62. Barriers to healthcare for female patients in Papua New Guinea.
- Author
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Klaver R and Coe JR
- Subjects
- Adult, Developing Countries, Female, HIV Infections complications, Humans, Ovarian Cysts complications, Papua New Guinea, Sexism, Women's Rights, Delayed Diagnosis, HIV Infections diagnosis, Health Services Accessibility, Ovarian Cysts diagnosis
- Abstract
A 25-year-old woman presented to hospital in the remote highlands of Papua New Guinea (PNG) with a 3-year history of increasing abdominal distension, amenorrhoea and syncope. Ultrasound showed a large unilocular ovarian cyst. During her work-up, she was found to be HIV positive. She was treated with antiretroviral therapy, and once her CD4 count improved, she underwent a laparotomy and removal of the ovarian cyst with immediate improvement in symptoms. PNG has high levels of HIV particularly in young women and children.
1 This is partly due to a lack of screening and treatment facilities and partly due to significant gender discrimination. PNG is considered one of the most dangerous places in the world for females; women are treated as second-class citizens with few human rights or access to services such as healthcare.2 Rape, sexual assault and domestic violence are common, and their lives are dictated to them by their husbands or male relatives.2 3 The lack of healthcare resources and significant levels of gender discrimination meant that this patient had a delayed presentation resulting in potentially grave complications., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2018
- Full Text
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63. MRI versus laparoscopy to diagnose the main causes of chronic pelvic pain in women: a test-accuracy study and economic evaluation.
- Author
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Khan KS, Tryposkiadis K, Tirlapur SA, Middleton LJ, Sutton AJ, Priest L, Ball E, Balogun M, Sahdev A, Roberts T, Birch J, Daniels JP, and Deeks JJ
- Subjects
- Adaptation, Psychological, Adult, Chronic Disease, Cost-Benefit Analysis, Endometriosis complications, Endometriosis diagnosis, Female, Humans, Laparoscopy methods, Laparoscopy standards, Magnetic Resonance Imaging, Mental Health, Ovarian Cysts complications, Ovarian Cysts diagnosis, Pelvic Pain psychology, Personality, Physical Examination, Quality of Life, Reproducibility of Results, Sensitivity and Specificity, Severity of Illness Index, Socioeconomic Factors, Time Factors, Ultrasonography methods, Ultrasonography standards, United Kingdom, Laparoscopy economics, Pelvic Pain diagnostic imaging, Pelvic Pain etiology, Ultrasonography economics
- Abstract
Background: Chronic pelvic pain (CPP) symptoms in women are variable and non-specific; establishing a differential diagnosis can be hard. A diagnostic laparoscopy is often performed, although a prior magnetic resonance imaging (MRI) scan may beneficial., Objectives: To estimate the accuracy and added value of MRI in making diagnoses of (1) idiopathic CPP and (2) the main gynaecological causes of CPP. To quantify the impact MRI can have on decision-making with respect to triaging for therapeutic laparoscopy and to conduct an economic evaluation., Design: Comparative test-accuracy study with cost-effectiveness modelling., Setting: Twenty-six UK-based hospitals., Participants: A total of 291 women with CPP., Methods: Pre-index information concerning the patient's medical history, previous pelvic examinations and ultrasound scans was collected. Women reported symptoms and quality of life at baseline and 6 months. MRI scans and diagnostic laparoscopy (undertaken and interpreted blind to each other) were the index tests. For each potential cause of CPP, gynaecologists indicated their level of certainty that the condition was causing the pelvic pain. The analysis considered both diagnostic laparoscopy as a reference standard for observing structural gynaecological causes and consensus from a two-stage expert independent panel for ascertaining the cause of CPP. The stage 1 consensus was based on pre-index, laparoscopy and follow-up data; for stage 2, the MRI scan report was also provided. The primary analysis involved calculations of sensitivity and specificity for the presence or absence of each structural gynaecological cause of pain. A decision-analytic model was developed, with a 6-month time horizon. Two strategies, laparoscopy or MRI, were considered and populated with study data., Results: Using reference standards of laparoscopic and expert panel diagnoses, MRI scans had high specificity but poor sensitivity for observing deep-infiltrating endometriosis, endometrioma, adhesions and ovarian cysts. MRI scans correctly identified 56% [95% confidence interval (CI) 48% to 64%] of women judged to have idiopathic CPP, but missed 46% (95% CI 37% to 55%) of those considered to have a gynaecological structural cause of CPP. MRI added significant value, over and above the pre-index information, in identifying deep-infiltrating endometriosis ( p = 0.006) and endometrioma ( p = 0.02) as the cause of pain, but not for other gynaecological structural causes or for identifying idiopathic CPP ( p = 0.08). Laparoscopy was significantly more accurate than MRI in diagnosing idiopathic CPP ( p < 0.0001), superficial peritoneal endometriosis ( p < 0.0001), deep-infiltrating endometriosis ( p < 0.0001) and endometrioma of the ovary ( p = 0.02) as the cause of pelvic pain. The accuracy of laparoscopy appeared to be able to rule in these diagnoses. Using MRI to identify women who require therapeutic laparoscopy would lead to 369 women in a cohort of 1000 receiving laparoscopy unnecessarily, and 136 women who required laparoscopy not receiving it. The economic analysis highlighted the importance of the time horizon, the prevalence of CPP and the cut-off values to inform the sensitivity and specificity of MRI and laparoscopy on the model results. MRI was not found to be a cost-effective diagnostic approach in any scenario., Conclusions: MRI was dominated by laparoscopy in differential diagnosis of women presenting to gynaecology clinics with CPP. It did not add value to information already gained from history, examination and ultrasound about idiopathic CPP and various gynaecological conditions., Trial Registration: Current Controlled Trials ISRCTN13028601., Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 22, No. 40. See the NIHR Journals Library website for further project information., Competing Interests: Elizabeth Ball declares UK travel reimbursement from Shire Medical (Lexington, MA, USA) outside the submitted work. Jonathan J Deeks was Deputy Chairperson of the National Institute for Health Research Health Technology Assessment (HTA) Commissioning Board (2011–16) and the HTA Efficient Study Designs Board (2016).
- Published
- 2018
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64. [Hirsutism secondary to a luteal cyst of the right ovary at the department of internal medicine and endocrinology of the Mali Hospital].
- Author
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Sow DS, Traoré D, Bah M, Traoré B, Koné A, Djeugoué P, Mariko M, and Sidibé AT
- Subjects
- Adult, Endocrinology, Female, Hospital Departments, Humans, Internal Medicine, Mali, Ovarian Cysts pathology, Hirsutism etiology, Ovarian Cysts complications
- Abstract
The authors are reporting here for the first time a documented case of androgen-secreting luteal cyst responsible for primary sterility in Mali. A 26-year married woman with a history of familial hyper androgenia of diabetes and high blood pressure who consulted for hyper androgen syndrome and primary infertility. Hirsutism with the presence of hairs on her chin, upper lips, thorax, forearms, arms, and her legs under waxing which made a Ferriman and Galloway scoreof10. A pelvic ultrasound coupled with a laparoscopy allowed us to retain the diagnosis of luteal cyst., Conclusion: Hyper androgenicity in women is rare and the luteal cystis one of its multiple etiologies., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)
- Published
- 2018
65. Transplant with a twist: A pitfall in sonographic diagnosis of renal transplant torsion.
- Author
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Narasimhan E, Kennedy A, and Campsen J
- Subjects
- Adult, Diagnosis, Differential, Fallopian Tubes diagnostic imaging, Fallopian Tubes surgery, Female, Humans, Kidney diagnostic imaging, Kidney surgery, Kidney Diseases complications, Ovarian Cysts complications, Ovarian Cysts diagnostic imaging, Ovarian Cysts surgery, Ovary diagnostic imaging, Ovary surgery, Tomography, X-Ray Computed methods, Kidney Diseases diagnostic imaging, Kidney Transplantation, Postoperative Complications diagnostic imaging, Torsion Abnormality diagnostic imaging, Ultrasonography, Doppler, Color methods
- Abstract
Torsion is an uncommon cause of impaired function in a renal transplant. We present a case of intraperitoneal transplant torsion secondary to adhesions to the left fallopian tube and ovary. Inability to confirm renal venous flow with Doppler misled to the erroneous sonographic diagnosis of renal vein thrombosis, although end diastolic flow was absent rather than reversed. The correct diagnosis was made with CT. The combination of abnormal orientation of the graft on ultrasonography, acutely impaired renal function, and abnormal Doppler study should have led to a diagnosis of transplant torsion. The case is also unusual in that the lead point was adnexal pathology. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:528-530, 2017., (© 2017 Wiley Periodicals, Inc.)
- Published
- 2017
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66. Case Report of Clitoral Hypertrophy in 2 Extremely Premature Girls With an Ovarian Cyst.
- Author
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Nerré AL, Bétrémieux P, and Nivot-Adamiak S
- Subjects
- Female, Humans, Hyperandrogenism complications, Hyperandrogenism pathology, Hypertrophy etiology, Hypertrophy pathology, Infant, Extremely Premature, Infant, Newborn, Infant, Premature, Diseases pathology, Ovarian Cysts complications, Virilism pathology, Clitoris pathology, Hyperandrogenism diagnosis, Infant, Premature, Diseases diagnosis, Ovarian Cysts diagnosis, Virilism etiology
- Abstract
Neonatal clitoromegaly is mainly attributed to in utero androgen exposure secondary to congenital adrenal hyperplasia. We report on 2 extremely premature girls with clitoromegaly, increased androgen levels, no salt wasting syndrome, and ovarian cyst. In case 1, the cyst liquid was aspired during ovarian hernia surgery and revealed high androgen levels. After aspiration, serum androgen levels decreased, as did clitoral size. In case 2, an ovarian cyst was seen on pelvic ultrasound. Aspiration was not indicated. The cyst regressed spontaneously on iterative pelvic ultrasounds, and her clitoromegaly decreased. Case 1 demonstrates the ovarian origin of this transient virilization. Cyst formation seems to be linked to the physiologic maturation of the hypothalamic-pituitary-ovarian axis. Thirteen cases of clitoromegaly with hyperandrogenism, without salt wasting syndrome, have been reported in extremely premature infants. In the context of clitoromegaly, we recommend ruling out in utero androgen exposure, adrenal hyperandrogenism, and disorders of sex development. We further recommend affirming hyperandrogenism by androgen assay and confirming ovarian origin with gonadotrophin assays and pelvic ultrasound. Drug therapy abstention and clinical and ultrasound monitoring are recommended because spontaneous regression of clitoral hypertrophy seems to be the most common outcome in the literature, as it was in our 2 observations., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2017 by the American Academy of Pediatrics.)
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- 2017
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67. Phenotypic variation in anti-Mullerian hormone (AMH) production per follicle in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovarian morphology (PCOM): an observational cross-sectional study.
- Author
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Bhide P, Kulkarni A, Dilgil M, Dhir P, Shah A, Gudi A, and Homburg R
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- Adult, Anovulation etiology, Anovulation metabolism, Anovulation pathology, Anti-Mullerian Hormone metabolism, Biological Variation, Population, Cell Count, Cross-Sectional Studies, Female, Humans, Ovarian Cysts complications, Ovarian Cysts pathology, Ovarian Follicle metabolism, Ovarian Reserve, Phenotype, Polycystic Ovary Syndrome complications, Polycystic Ovary Syndrome pathology, Anti-Mullerian Hormone blood, Ovarian Cysts metabolism, Ovarian Follicle pathology, Polycystic Ovary Syndrome metabolism
- Abstract
This observational study compares the ratio of serum anti-Mullerian hormone (AMH) to the total antral follicle count (AFC) (as a marker of AMH production per follicle) in the various phenotypes of women with polycystic ovary syndrome (PCOS) and isolated polycystic ovarian morphology (PCOM). Two hundred and sixty-two women were recruited. Women with PCOS were divided into four phenotypes based on the diagnostic inclusion criteria of oligo-anovulation (OA), hyperandrogenism (HA) and polycystic ovarian morphology (PCOM). These included Group A (OA + HA + PCOM), Group B (OA + HA), Group C (HA + PCOM) and Group D (OA + PCOM). A ratio of serum AMH to total AFC was calculated and expressed as the AMH/AFC ratio which was compared in the phenotypes of PCOS and isolated PCOM. The median AMH/AFC ratios in PCOS-A, PCOS-D, PCOS-C and PCOM were 1.5, 1.6, 1.2 and 1.1, respectively. There were significant differences in the groups compared [F(3, 238) = 6.14, p = 0.000)]. The ratios were significantly higher in the oligo-anovulatory phenotypes PCOS-A and PCOS-D than the PCOM (p = 0.004 and 0.002, respectively). There was no significant difference in the ratio between ovulatory phenotype PCOS-C and PCOM (p = 0.59). The role of androgens and LH in per-follicle AMH production remains limited. The findings support the hypothesis of a key role for AMH in the mechanism of anovulation in PCOS.
- Published
- 2017
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68. Evaluation and Treatment Results of Ovarian Cysts in Childhood and Adolescence: A Multicenter, Retrospective Study of 100 Patients.
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Aydin BK, Saka N, Bas F, Yilmaz Y, Haliloglu B, Guran T, Turan S, Bereket A, Yesiltepe Mutlu G, Cizmecioglu F, Hatun S, Bezen D, Tutunculer F, Cebeci N, Isguven P, Memioglu N, Ercan O, Poyrazoglu S, Bundak R, and Darendeliler F
- Subjects
- Adolescent, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Ovarian Cysts complications, Ovarian Cysts therapy, Ovarian Neoplasms complications, Ovarian Neoplasms therapy, Puberty, Precocious therapy, Retrospective Studies, Treatment Outcome, Turkey, Ovarian Cysts diagnosis, Ovarian Neoplasms diagnosis, Puberty, Precocious etiology
- Abstract
Study Objective: To investigate the characteristics of children with ovarian cysts and evaluate treatment strategies., Design: Retrospective study., Setting: Eight pediatric endocrinology clinics, Turkey., Participants: A total of 100 children and adolescents with ovarian cysts., Interventions: Patient data collected via retrospective chart review. Patients were stratified according to age into 4 groups (newborns, 1-12 months, 1-8 years, and 8-18 years)., Main Outcome Measures: Special emphasis was given to torsion and tumor cases, concomitant diseases, treatment modalities, and problems during follow-up., Results: Most newborns and infants were asymptomatic with the cysts being discovered incidentally; in girls ages 1-8, symptoms were common, including breast budding (47.1%, 16 of 34) and vaginal bleeding (29.4%, 10 of 34). Girls older than 8 years mostly presented with abdominal pain (31.6%, 12 of 38) and menstrual irregularity (21.1%, 8 of 38). Most of our patients were diagnosed with a simple ovarian cyst, but 9 patients were found to have ovarian tumors. Ovarian torsion was detected in 7 patients; 5 with large and 2 with small cysts (<20 mm). Two patients had central precocious puberty (CPP) at presentation and 5 patients developed CPP during follow-up. The surgical intervention rate was high (38%, 38 of 100), but was associated with earlier treatment year, and this association remained significant after adjusting for confounders (P = .035)., Conclusion: Most girls have simple cysts, which have a favorable prognosis without intervention; however, there might be coexisting pathologies or complications such as tumors, torsion, and CPP; hence these patients should be evaluated accordingly and treated with a multidisciplinary approach., (Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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69. Van Wyk and Grumbach Syndrome: An Unusual Presentation of Hypothyroism.
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Chanda PK, Kamrul-Hasan M, Abu-Bakar M, Rahman M, Kader MA, Hossain MA, and Siddiqui NI
- Subjects
- Adolescent, Body Height, Female, Humans, Syndrome, Thyroxine therapeutic use, Hypothyroidism complications, Hypothyroidism diagnosis, Ovarian Cysts complications, Ovarian Cysts diagnosis, Puberty, Precocious
- Abstract
An 18 years-old-girl presented one and half years back with the complaints of short stature, retarded growth, and menorrhagia with sudden severe lower abdominal pain; was diagnosed as bilateral ovarian cysts and underwent bilateral ovarian cystectomy. Later on she was incidentally diagnosed as a case of hypothyroidism when she had been experiencing slowly enlarging left lower abdominal mass with dull ache for the 5 month and then was transferred to the department of Endocrinology for further evaluation. Detailed work up revealed her short stature with obesity, delayed bone age and other features of hypothyroidism which was confirmed by thyroid function testing. She had enlarged left ovary with multiple follicles as shown in ultrasonography. Magnetic resonance imaging (MRI) showed sellar mass which was suspicious of macroadenoma. Levothyroxine replacement was started and she had a dramatic improvement of her problems with disappearance of the ovarian cysts and sellar mass.
- Published
- 2017
70. Fetal Ascites Mimicking Maternal Ovarian Tumor: A Rare Cause of Obstructed Labour.
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Shrestha D, Baniya S, and Khatri RB
- Subjects
- Adult, Cesarean Section, Diagnosis, Differential, Dystocia etiology, Female, Humans, Infant, Newborn, Male, Ovarian Cysts complications, Pregnancy, Prenatal Diagnosis methods, Young Adult, Ascites diagnosis, Dystocia diagnosis, Ovarian Cysts diagnostic imaging, Ovarian Neoplasms diagnosis
- Abstract
Fetal ascites has been diagnosed more frequently these days because of routine ultrasound scanning in pregnancy. However as a cause of dystocia in labour, it is very rare. Twenty four years second gravida of 28 weeks 6 days of gestation presented to labour room with preterm obstructed labour. Abdominal examination revealed less readily palpable fetal parts and distantly localized fetal heart sounds. An urgent ultrasound showed huge maternal ovarian cyst. She then underwent emergency cesarean section; delivered a male baby with grossly distended abdomen. However, the ovaries were normal looking. Routine antenatal ultrasounds help in identifying maternal and congenital fetal anomalies. They also guide in planning the most appropriate management. Whenever fetal ascites is diagnosed antenatally, possibility of dystocia in labour should be kept in mind.
- Published
- 2017
71. Ruptured Corpus Luteal Cyst: Prediction of Clinical Outcomes with CT.
- Author
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Lee MS, Moon MH, Woo H, Sung CK, Jeon HW, and Lee TS
- Subjects
- Abdominal Pain etiology, Adult, Area Under Curve, Female, Hemoperitoneum complications, Hemorrhage etiology, Humans, Odds Ratio, Ovarian Cysts complications, Ovarian Cysts surgery, ROC Curve, Retrospective Studies, Rupture, Spontaneous, Statistics, Nonparametric, Young Adult, Hemoperitoneum pathology, Ovarian Cysts diagnostic imaging, Tomography, X-Ray Computed
- Abstract
Objective: To evaluate the determinant pretreatment CT findings that can predict surgical intervention for patients suffering from corpus luteal cyst rupture with hemoperitoneum., Materials and Methods: From January 2009 to December 2014, a total of 106 female patients (mean age, 26.1 years; range, 17-44 years) who visited the emergency room of our institute for acute abdominal pain and were subsequently diagnosed with ruptured corpus luteal cyst with hemoperitoneum were included in the retrospective study. The analysis of CT findings included cyst size, cyst shape, sentinel clot sign, ring of fire sign, hemoperitoneum depth, active bleeding in portal phase and attenuation of hemoperitoneum. The comparison of CT findings between the surgery and conservative management groups was performed with the Mann-Whitney U test or chi-square test. Logistic regression analysis was used to determine significant CT findings in predicting surgical intervention for a ruptured cyst., Results: Comparative analysis revealed that the presence of active bleeding and the hemoperitoneum depth were significantly different between the surgery and conservative management groups and were confirmed as significant CT findings for predicting surgery, with adjusted odds ratio (ORs) of 3.773 and 1.318, respectively ( p < 0.01). On the receiver-operating characteristic curve analysis for hemoperitoneum depth, the optimal cut-off value was 5.8 cm with 73.7% sensitivity and 58.6% specificity (Az = 0.711, p = 0.004). In cases with a hemoperitoneum depth > 5.8 cm and concurrent active bleeding, the OR for surgery increased to 5.786., Conclusion: The presence of active bleeding and the hemoperitoneum depth on a pretreatment CT scan can be predictive warning signs of surgery for a patient with a ruptured corpus luteal cyst with hemoperitoneum.
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- 2017
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72. Presacral mass in the setting of an ovarian cyst and abdominal pain.
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Gutierrez O, Haj-Ibrahim H, Griffiths E, and Olasky J
- Subjects
- Abdominal Pain etiology, Adult, Cysts complications, Female, Hamartoma complications, Humans, Ovarian Cysts complications, Tomography, X-Ray Computed, Abdomen pathology, Abdominal Pain diagnosis, Cysts diagnosis, Hamartoma diagnosis, Rectum, Sacrum
- Abstract
Tailgut cysts, also known as retrorectal hamartomas, are very rare neoplasms located in the presacral/retrorectal space that originate from the embryonic hindgut. Although a majority of lesions in this location are benign, 30% of the reported cases in the literature were found to be malignant. This report describes a case of a presacral mass found on CT of a 37-year-old woman who initially presented with worsening abdominal pain and a history of ovarian cyst rupture. This patient's clinical picture was complicated by an enlarging ovarian cyst. The risk of progression to malignancy warranted excision. She recovered well with resolution of her presenting symptoms. We report this case along with a brief review of the literature with a focus on the surgical considerations., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2017
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73. Adolescent Female With Abdominal Pain.
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Walsh D, Bloch RB, and Strout TD
- Subjects
- Cystadenoma, Mucinous diagnostic imaging, Cystadenoma, Mucinous surgery, Drainage methods, Female, Humans, Ovarian Cysts complications, Ovarian Cysts diagnostic imaging, Ovarian Cysts surgery, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms surgery, Tomography, X-Ray Computed, Young Adult, Abdominal Pain etiology, Cystadenoma, Mucinous complications, Ovarian Neoplasms complications
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- 2017
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74. Use of the Sufentanil Sublingual Tablet System for postoperative pain relief in a patient with chronic liver disease.
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Leykin Y and Laudani A
- Subjects
- Administration, Sublingual, Chronic Disease, Female, Humans, Liver Diseases complications, Middle Aged, Ovarian Cysts complications, Ovarian Cysts surgery, Tablets, Analgesics, Opioid administration & dosage, Pain, Postoperative drug therapy, Sufentanil administration & dosage
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- 2017
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75. Fetiform Teratoma in the Ovary of a 7-Year-Old Girl: A Case Report.
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Goldberg HR, Allen L, and Kives S
- Subjects
- Abdominal Pain etiology, Adnexal Diseases complications, Adnexal Diseases embryology, Child, Female, Humans, Ovarian Cysts complications, Ovarian Cysts embryology, Ovarian Neoplasms complications, Teratoma complications, Ovarian Neoplasms embryology, Teratoma embryology
- Abstract
Background: Fetiform teratoma, a highly differentiated mature cystic teratoma resembling a fetus, is rare and typically found in the ovaries of women of reproductive age. In this report we describe, to our knowledge, the youngest case of ovarian fetiform teratoma., Case: A 7-year-old girl presented with acute abdominal pain. Radiological examinations revealed a 5.2-cm ovarian complex cystic mass with fetal-like components in favor of fetus in fetu and teratoma. After surgical removal, the mass resembled a fetus consisting of a head, two eye slits, two small upper limb projections, and hair. Pathology indicated mature cystic teratoma supporting the diagnosis of fetiform teratoma., Summary and Conclusion: Although not commonly found in children, fetiform teratoma must be considered in the diagnosis of a child who presents with an adnexal mass resembling a fetus., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)
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- 2017
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76. Recurrence of Ovarian Endometrioma in Adolescents after Conservative, Laparoscopic Cyst Enucleation.
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Lee SY, Kim ML, Seong SJ, Bae JW, and Cho YJ
- Subjects
- Adolescent, Endometriosis etiology, Endometriosis surgery, Female, Follow-Up Studies, Humans, Laparoscopy methods, Ovarian Cysts complications, Ovarian Diseases complications, Ovarian Diseases surgery, Postoperative Complications etiology, Recurrence, Retrospective Studies, Time Factors, Treatment Outcome, Young Adult, Endometriosis pathology, Laparoscopy adverse effects, Ovarian Cysts surgery, Ovarian Diseases pathology, Postoperative Complications pathology
- Abstract
Study Objective: To evaluate the cumulative recurrence rate of endometriomas after a laparoscopic endometriotic cyst enucleation in adolescents and to find the factors associated with recurrence., Design: A multicenter retrospective cohort study., Setting: Three university hospitals., Participants: One hundred five patients surgically treated with laparoscopic enucleation of endometriotic cysts younger than 20 years of age were selected., Interventions: None., Main Outcome Measures: Endometrioma recurrence was considered when transvaginal or transrectal sonography indicated a cystic mass with a diameter of 20 mm or greater. Recurrence rate of endometrioma and median time to recurrence were evaluated., Results: In total, 105 patients were followed for 47.3 (±44.3) months (range, 3-161 months). Seventeen patients (16.2%) experienced recurrence after the first-line surgery and 8 patients (7%) underwent a second surgery. The median time to recurrence was 53.0 (±8.5) months (range, 8-111 months). Using Kaplan-Meier method, the cumulative recurrence rates of endometrioma per patient at 24, 36, 60, and 96 months after the first-line surgery were 6.4%, 10%, 19.9% and 30.9%, respectively. Surgical characteristics, such as the diameter of the cyst, revised American Society for Reproductive Medicine stage, unilateral or bilateral involvement, and coexistence of deep endometriosis were not associated with recurrence in this age group., Conclusion: Although the short-term recurrence rate in adolescents after first-line surgery is relatively low, the recurrence rate appears to be higher according to the follow-up duration. Long-term and continuous follow-up is needed for patients who have undergone surgical treatment for endometriosis in the adolescent period., (Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)
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- 2017
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77. Gynecological pelvic pain as emergency pathology.
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Rivera Domínguez A, Mora Jurado A, García de la Oliva A, de Araujo Martins-Romeo D, and Cueto Álvarez L
- Subjects
- Acute Pain etiology, Diagnosis, Differential, Emergencies, Endometriosis complications, Female, Genital Diseases, Female complications, Humans, Ovarian Cysts complications, Pelvic Inflammatory Disease complications, Pelvic Pain etiology, Pregnancy, Pregnancy, Ectopic, Torsion Abnormality complications, Acute Pain diagnostic imaging, Genital Diseases, Female diagnostic imaging, Pelvic Pain diagnostic imaging
- Abstract
Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management., (Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2017
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78. Atypical case of preterm ovarian hyperstimulation syndrome.
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Durst MA, Wicklow B, and Narvey M
- Subjects
- 17-alpha-Hydroxyprogesterone blood, Clitoris pathology, Dehydroepiandrosterone blood, Estradiol blood, Female, Humans, Infant, Infant, Newborn, Ovarian Cysts complications, Ovarian Hyperstimulation Syndrome diagnosis, Testosterone blood, Infant, Extremely Premature, Ovarian Hyperstimulation Syndrome blood, Ovarian Hyperstimulation Syndrome complications, Virilism etiology
- Abstract
Preterm ovarian hyperstimulation syndrome is a rare syndrome in which preterm infant girls have hypogastric, upper leg and labial swelling accompanied by elevated serum oestradiol levels and ovarian follicular cysts on ultrasound. Our case is an infant born at 23 weeks gestational age who at 30 weeks postconceptional age (PCA) developed elevated 17-hydroxyprogesterone on her newborn screen with associated clitoromegaly and a ventral groove on the inferior aspect of the erectile tissue. An initial pelvic ultrasound at 32 weeks PCA demonstrated a normal appearing uterus, but the ovaries were not visualised. At 39 weeks PCA, follicular ovarian cysts were noted bilaterally (31×26×21 mm on left and 38×25×36 mm on right). Without treatment, oestradiol and testosterone levels began normalising by 42 weeks PCA. After this point, the right ovarian cysts had resolved and the left ovarian cyst continued to diminish in size., (2017 BMJ Publishing Group Ltd.)
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- 2017
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79. Haemoperitoneum due to ruptured ovarian cyst in a 13-year-old girl with factor V deficiency- A case report.
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Aslam SL and Fareeduddin M
- Subjects
- Adolescent, Female, Humans, Rupture, Factor V Deficiency complications, Hemoperitoneum diagnosis, Hemoperitoneum etiology, Ovarian Cysts complications, Ovarian Cysts pathology
- Abstract
Factor V deficiency is a rare autosomal recessive coagulation disorder. We are reporting a case of a 13 year old girl with factor V deficiency presenting as life threatening haemoperitoneum, following bleeding from ruptured ovarian cyst. Prolonged Prothrombin Time, Activated Partial Thromboplastin Time and a normal platelet count pointed towards a disorder of coagulation. Mixing study with factor V deficient plasma and coagulation factor assay revealed markedly reduced plasma factor V clotting activity.
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- 2017
80. Malignant transformation in an atypical endometrial cyst of the ovary.
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Jain M and Sehgal S
- Subjects
- Adult, Biomarkers, Tumor analysis, Endometriosis complications, Female, Histocytochemistry, Humans, Immunohistochemistry, Microscopy, Ovarian Cysts complications, Receptors, Estrogen analysis, Receptors, Progesterone analysis, Endometrial Neoplasms diagnosis, Endometrial Neoplasms pathology, Endometriosis diagnosis, Ovarian Cysts diagnosis, Ovarian Neoplasms diagnosis, Ovarian Neoplasms pathology, Ovary pathology
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- 2017
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81. Torsion, infarction, and rupture of a nongravid uterus: a complication of a large ovarian cyst.
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Yap FY, Radin R, and Tchelepi H
- Subjects
- Contrast Media, Diagnosis, Differential, Female, Humans, Infarction surgery, Middle Aged, Ovarian Cysts surgery, Torsion Abnormality surgery, Uterine Diseases surgery, Uterine Rupture etiology, Uterine Rupture surgery, Infarction diagnostic imaging, Infarction etiology, Ovarian Cysts complications, Ovarian Cysts diagnostic imaging, Tomography, X-Ray Computed methods, Torsion Abnormality diagnostic imaging, Torsion Abnormality etiology, Uterine Diseases diagnostic imaging, Uterine Diseases etiology, Uterine Rupture diagnostic imaging
- Abstract
Torsion of a nongravid uterus is rare, as most cases of uterine torsion occur during pregnancy. We report a case of a large ovarian cyst causing uterine torsion, infarction, and rupture. A 57-year-old woman presented with acute-onset abdominal pain and increasing abdominal girth over the past year. Contrast-enhanced computed tomography (CT) demonstrated axial rotation and swirling of the uterus and the mesenteric fat, leading to a preoperative diagnosis of uterine torsion. Laparotomy confirmed that the uterine corpus had undergone a 180-degree axial rotation, and further revealed uterine wall infarction and rupture into the endometrium as well as partial decapitation of the uterus from the cervix. The swirled appearance of the uterus, radiologically similar to the "whirlpool sign" seen in bowel volvulus, is an important CT finding to recognize, especially in view of the risk of irreversible ischemic complications this uncommon entity may inflict on the uterus.
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- 2016
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82. One-trocar versus multiport hybrid laparoscopic appendectomy: What's the best option for children with acute appendicitis? Results of an international multicentric study.
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Esposito C, Escolino M, Till H, Bertozzi M, Riccipetitoni G, Settimi A, and Varlet F
- Subjects
- Acute Disease, Appendicitis complications, Carcinoid Tumor complications, Carcinoid Tumor surgery, Child, Europe, Female, Humans, Incidence, Intraoperative Complications epidemiology, Male, Meckel Diverticulum complications, Meckel Diverticulum surgery, Operative Time, Ovarian Cysts complications, Ovarian Cysts surgery, Pain Measurement, Pain, Postoperative physiopathology, Postoperative Complications epidemiology, Postoperative Period, Retrospective Studies, Safety, Abdominal Abscess epidemiology, Appendectomy methods, Appendicitis surgery, Laparoscopy methods, Pain, Postoperative epidemiology, Surgical Instruments
- Abstract
Background: One-trocar laparoscopic appendectomy (OTA) is routinely adopted in children with acute appendicitis. In case of a difficult appendectomy, it is necessary to add additional trocar/s to safely complete the procedure. This technique is called multiport hybrid laparoscopic appendectomy (HLA). We aimed to compare the outcome of multiport HLA versus OTA., Methods: We retrospectively reviewed the data of 1,092 patients underwent LA in 5 European centers of pediatric surgery in the last 5 years. We compared 2 groups: G1 of 575 patients (52.6 %) (average age 10 years) underwent OTA and G2 of 517 patients (47.4 %) (average age 8.2 years) underwent multiport HLA., Results: No intra-operative complications occurred in both groups. An additional pathology was treated in 12 cases (8 Meckel's diverticulum, 2 carcinoids, 2 ovarian cysts) in G2. Operative time was significantly shorter in G2 compared to G1 (47.8 vs 58.6 min; p < .001). The average analgesic requirement was significantly shorter in G2 compared to G1 (44 vs 56 h; p < .001). As for postoperative complications, the incidence of port-site infections was similar between the two groups, while the incidence of postoperative abdominal abscesses (PAA) was significantly higher in G1 compared to G2 (4.7 vs 0.2 %; p < .001). The cosmetic outcome was excellent in all patients of both groups. A subgroup analysis between complicated and uncomplicated appendicitis showed that only in complicated cases, the average operative time, the average VAS pain score, the average analgesic requirements and the incidence of PAA were significantly higher in OTA group compared to multiport HLA group (p < .001)., Conclusions: Our results suggest that OTA is a valid and safe procedure for the uncomplicated cases, while additional trocars are required in case of complicated appendicitis. Multiport HLA significantly reduces the operative time, the incidence of abdominal abscesses and the analgesic requirements compared to OTA.
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- 2016
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83. Sonographic Pitfall in Endometriotic Ovarian Cysts: A Rare Case of a Spontaneous Sigmoid Colonic Perforation in a Nonpregnant Woman.
- Author
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Mariani LL, Modaffari P, Mineccia M, and Biglia N
- Subjects
- Adult, Diagnosis, Differential, Endometriosis diagnostic imaging, Female, Humans, Ovarian Cysts diagnostic imaging, Colon, Sigmoid diagnostic imaging, Endometriosis complications, Intestinal Perforation diagnostic imaging, Intestinal Perforation etiology, Ovarian Cysts complications, Ultrasonography
- Published
- 2016
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84. A case of recurrent hyperreactio luteinalis in three spontaneous pregnancies.
- Author
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Bishop LA, Patel S, and Fries MH
- Subjects
- Adult, Female, Humans, Ovary diagnostic imaging, Pregnancy, Recurrence, Ultrasonography, Hyperandrogenism complications, Ovarian Cysts complications, Ovarian Cysts diagnostic imaging, Pregnancy Complications diagnostic imaging
- Abstract
Hyperreactio luteinalis is a rare condition in pregnancy characterized by enlarged ovaries with multiple theca luteal cysts, and recurrence of disease has seldom been documented in the literature. This is a case report of a woman who developed recurrent hyperreactio luteinalis with three spontaneous pregnancies. Endocrine evaluation was performed and revealed hyperandrogenism. Ultrasonography was used to assess the ovaries throughout each pregnancy. The ovarian cysts required drainage in the first pregnancy due to severe distention and shortness of breath. Cyst resolution occurred in the post-partum period following each pregnancy. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:502-505, 2016., (© 2016 Wiley Periodicals, Inc.)
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- 2016
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85. Role of benign ovarian cysts in the development of adenomyosis.
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Alam S, Ahmad S, Khan MM, Nasir S, Sharif N, Ziaullah S, Khalid A, and Rauf F
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Immunohistochemistry, Middle Aged, Prospective Studies, Receptors, Estrogen analysis, Adenomyosis complications, Ovarian Cysts complications
- Abstract
Objectives: To assess the association of adenomyotic foci with co-existing benign ovarian cysts. , Methods: This prospective cross-sectional study consisted of 100 consecutive hysterectomy specimens referred to Histopathology Section of Pathology Department, Peshawar Medical College, Peshawar, Pakistan by its attached teaching hospitals from January 2011 to December 2012. Hematoxylin and eosin stained sections were examined for adenomyotic foci and the presence of co-existent ovarian cysts. For evaluation of estrogen receptor (ER) status immunohistochemical stains were applied and H-scoring system was used with a score greater than 50 as positive. , Results: Out of the 100 hysterectomy specimens, 25 cases had both adenomyosis and ovarian cysts. The ER status of adenomyotic foci was positive in 20% cases and negative in 80% cases. The commonest type of ovarian cyst was hemorrhagic luteal cyst (28%), followed by serous and mucinous cystadenoma (20%) each. Out of the 28% cases of functional cysts, 71.5% were ER positive and 28.5% were ER negative. The p-value for association of ER status of adenomyotic foci with functional cysts was 0.0004; however, p-value was not significant in comparing cases with controls. All 72% cases of nonfunctional cysts were ER negative. However, 44% of functional cysts were not associated with adenomyotic foci. , Conclusion: This study concludes that besides functional ovarian cysts, other local factors may be responsible for the development of adenomyosis.
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- 2016
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86. Impact of Simple Ovarian Cysts on the Interpretation of Endometrial Thickness in Women with Postmenopausal Bleeding.
- Author
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Famuyide AO, Shazly SA, Makdisi PB, El-Nashar SA, Breitkopf DM, Hopkins MR, and Laughlin-Tommaso SK
- Subjects
- Aged, Endometrial Neoplasms pathology, Female, Humans, Hysteroscopy, Middle Aged, Minnesota, Multivariate Analysis, Ovarian Cysts diagnostic imaging, Ovarian Cysts pathology, Regression Analysis, Retrospective Studies, Ultrasonography, Uterine Hemorrhage etiology, Endometrial Neoplasms complications, Endometrium pathology, Ovarian Cysts complications, Postmenopause, Uterine Hemorrhage diagnosis
- Abstract
Background: There is evidence that premenopausal hormones may persist for variable time after menopause. Histological specimens from postmenopausal women support the presence of follicular growth at that age. Residual ovarian function may explain postmenopausal bleeding (PMB), which is not associated with endometrial pathology. Our objective was to evaluate the effect of sonographic diagnosis of simple ovarian cysts on the association between thickened endometrium and endometrial pathology in women with PMB., Materials and Methods: Data were retrospectively collected from medical records of women who underwent office hysteroscopy for PMB between January 2007 and October 2011. Women with sonographic reports within 3 months of presentation were included. Endometrial thickness and the presence of a simple ovarian cyst (≤5 cm) were documented by reviewing sonographic reports. Diagnosis of endometrial pathology was abstracted according to pathology reports or hysteroscopic impression. Endometria with hyperplasia, cancer, or polyps were considered pathological., Results: Of 836 women with PMB, 356 had recent transvaginal sonography and were included in the analysis. Pathological endometrium was documented in 129 (36.2%) women, including 29 (8.2%) with endometrial cancer. In women with PMB and no evidence of a simple ovarian cyst, endometrial thickness was an independent predictor of endometrial pathology and endometrial cancer with adjusted OR = 1.13 (95% CI = 1.07-1.19) and 1.16 (95% CI = 1.07-1.25), respectively. In the presence of simple ovarian cysts, the adjusted ORs for endometrial thickness as a predictor of endometrial pathology were 1.06 (95% CI = 0.90-1.25) and 0.84 (95% CI = 0.62-1.14), respectively., Conclusion: The presence of simple ovarian cysts (≤5 cm) tempers the value of endometrial thickness in predicting endometrial pathology in women with PMB.
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- 2016
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87. [Peripheral precocious puberty].
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Zvonařová Skalická J and Pilka R
- Subjects
- Female, Fibrous Dysplasia, Polyostotic complications, Granulosa Cell Tumor complications, Humans, Hypothyroidism complications, Ovarian Cysts complications, Ovarian Neoplasms complications, Puberty, Precocious etiology
- Abstract
Objective: To summarize literature data on peripheral precocious puberty., Design: A literature review., Setting: Středomoravská nemocniční a.s., hospital Šternberk, Department of Obstetrics and Gynaecology, University Hospital, Medical Faculty, Palacky University, Olomouc., Methods and Results: We searched in PubMed using the key words stated below according to date and published since 1980.Peripheral precocious puberty occurs in girls with the frequency 1:400-1000. It develops mainly because of peripheral estrogen secretion, the main cause of which are autonomous ovarian cysts. Other causes include McCune Albright syndrome, juvenile granulosa cell tumor and primary hypothyroidism. Typically, peripheral precocious puberty presents with early breast enlargement followed by development of other secondary sex characteristics. Initial treatment is usually conservative with the exception of juvenile granulosa cell tumor where surgery is warranted. Peripheral precocious puberty anti-estrogen therapy seems promising but neither data on its influence on fertility nor data comparing it to surgical treatment are available. Due to the risk of progression into central precocious puberty or McCune Albright syndrome, long-term follow-up is necessary., Conclusion: Peripheral precocious puberty should be managed in pediatric gynecology outpatient office and often subsides spontaneously. However, it can also be a sign of malignancy. In most cases, conservative therapy is preferred with medical treatment and surgery warranted in complicated cases. However, optimal treatment has not been established yet.
- Published
- 2016
88. Adnexal localization of Crohn's disease and recurrent massive ovary cysts.
- Author
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Ribaldone DG, Conti L, Resegotti A, and Astegiano M
- Subjects
- Crohn Disease surgery, Female, Humans, Neoplasm Metastasis, Neoplasm Recurrence, Local, Ovarian Cysts surgery, Young Adult, Crohn Disease complications, Crohn Disease pathology, Ovarian Cysts complications, Ovarian Cysts pathology
- Abstract
In a recent interesting case report, Saborit et al. reported three cases of ovarian involvement in Crohn's disease (CD). In the first two cases, there were pelvic abscesses due to fistulae of ileal loops affected by CD, with involvement of the right ovary, which also showed abscesses and typical granulomas. In the third case there was an ovarian abscess, extension of the process by contiguity. Granulomatous affectation of the ovaries is rare, with only 18 cases reported in the literature to date. Of this, in 17 cases the proposed mechanism of disease manifestation is direct fistulization between the small intestine and the ovary, which allows passage of vegetable material and results in the formation of reactive granulomas. In only one case a patient that did not demonstrate the histological features of either fistula-related disease (an intact ovarian capsule was found) or idiopathic granulomatous disease caused by the multiplicity of the granulomas and the presence of central necrosis has been reported. The authors therefore suggested that their findings were consistent with a diagnosis of metastatic CD of the ovary.
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- 2016
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89. Hydronephrosis caused by a giant ovarian cyst.
- Author
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Kim HY, Cho MK, Bae EH, Kim SW, and Ma SK
- Subjects
- Contrast Media, Female, Humans, Hydronephrosis diagnostic imaging, Middle Aged, Ovarian Cysts diagnostic imaging, Radiographic Image Enhancement methods, Tomography, X-Ray Computed, Hydronephrosis etiology, Ovarian Cysts complications
- Published
- 2016
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90. Theca lutein cysts and early onset severe preeclampsia.
- Author
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Sargin MA, Tug N, Tosun OA, Yassa M, and Bostanci E
- Subjects
- Adult, Chorionic Gonadotropin metabolism, Female, Humans, Luteal Cells pathology, Ovarian Cysts complications, Pre-Eclampsia physiopathology, Pregnancy, Pregnancy Complications pathology, Severity of Illness Index, Ovarian Cysts diagnosis, Pre-Eclampsia etiology, Pregnancy Complications diagnosis
- Abstract
Hyperreactio luteinalis (HL) is a rare condition that is characterized by bilateral ovarian enlargement and multiple thin walled cysts. Hypersensitivity of the ovary to circulating human chorionic gonadotropin (hCG) is playing the main role in pathophysiology. HL observed in cases where there is high serum ß-HCG levels, similarly to gestational trophoblastic disease, multiple pregnancies, hydrops fetalis and after fertiliy treatment. Most of HL are self limiting condition and patients are asymptomatic. Differentiation from ovarian malignancies is important. This is a case report of severe preeclampsia prior to 20 weeks gestation due to hyperreactio luteinalis.
- Published
- 2016
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91. Diagnosis of neonatal ovarian torsion: Emphasis on prenatal and postnatal sonographic findings.
- Author
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Kim HS, Yoo SY, Cha MJ, Kim JH, Jeon TY, and Kim WK
- Subjects
- Female, Humans, Infant, Newborn, Ovarian Cysts diagnostic imaging, Ovarian Cysts surgery, Ovarian Diseases surgery, Ovary diagnostic imaging, Ovary surgery, Pregnancy, Pregnancy Trimester, Third, Retrospective Studies, Torsion Abnormality surgery, Ultrasonography, Prenatal methods, Ovarian Cysts complications, Ovarian Diseases complications, Ovarian Diseases diagnostic imaging, Torsion Abnormality complications, Torsion Abnormality diagnostic imaging, Ultrasonography methods
- Abstract
Purpose: Our aim was to retrospectively review the imaging findings of patients with neonatal ovarian torsion, emphasizing prenatal and postnatal sonographic findings., Methods: Eleven patients who had had neonatal ovarian torsion diagnosed surgically (n = 9) or clinicoradiologically (n = 2) were enrolled. Prenatal and postnatal sonographic features, including sequential postnatal change, were reviewed. Clinical and pathologic features were also investigated., Results: All patients except one had a fetal ovarian cyst (mean, 5.3 cm) detected on third-trimester sonography, either simple (n = 6) or complex (n = 4). In all 11 patients, initial postnatal sonography had revealed a complex cyst (mean, 4.7 cm) with intracystic clot or debris, the double-wall sign, a fluid-fluid level, and multiple septation. None of the patients had had symptoms or signs related to the ovarian torsion. Follow-up sonography in seven patients had revealed increased echogenicity of the cyst wall with frequent calcification and a decrease in size of the cyst. In two patients, the interval of the change in cyst position was noted, and autoamputation of the torsed ovary had been surgically confirmed. Serous cystadenoma had been identified in one patient., Conclusions: Neonatal ovarian torsion most commonly manifests as an asymptomatic complex cyst on sonography due to torsion of a fetal ovarian cyst. Serial monitoring of a fetal ovarian cyst for its resolution or changes in its appearance is mandatory for making an early diagnosis of torsion. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:290-297, 2016., (© 2016 Wiley Periodicals, Inc.)
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- 2016
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92. The Japanese Breast Cancer Society clinical practice guidelines for epidemiology and prevention of breast cancer, 2015 edition.
- Author
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Taira N, Arai M, Ikeda M, Iwasaki M, Okamura H, Takamatsu K, Nomura T, Yamamoto S, Ito Y, and Mukai H
- Subjects
- Breast Neoplasms etiology, Contraceptives, Oral adverse effects, Diabetes Mellitus etiology, Estrogens therapeutic use, Exercise, Feeding Behavior, Female, Genetic Counseling, Humans, Japan epidemiology, Lactation, Ovarian Cysts complications, Risk Factors, Smoking adverse effects, Breast Neoplasms epidemiology, Breast Neoplasms prevention & control
- Published
- 2016
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93. Ovarian cysts and cancer in pregnancy.
- Author
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Mukhopadhyay A, Shinde A, and Naik R
- Subjects
- Antineoplastic Agents administration & dosage, Biomarkers, Tumor blood, Female, Gestational Age, Humans, Laparoscopy, Magnetic Resonance Imaging, Ovarian Cysts complications, Ovarian Cysts pathology, Ovarian Neoplasms complications, Ovarian Neoplasms pathology, Ovariectomy, Perioperative Care, Pregnancy, Pregnancy Complications, Neoplastic pathology, Salpingectomy, Ultrasonography, Ovarian Cysts diagnostic imaging, Ovarian Cysts therapy, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms therapy, Pregnancy Complications, Neoplastic diagnostic imaging, Pregnancy Complications, Neoplastic therapy
- Abstract
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., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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94. The Etiology and Clinical Features of Non-CAH Gonadotropin-Independent Precocious Puberty: A Multicenter Study.
- Author
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Atay Z, Yesilkaya E, Erdeve SS, Turan S, Akin L, Eren E, Doger E, Aycan Z, Abali ZY, Akinci A, Siklar Z, Ozen S, Kara C, Tayfun M, Sari E, Tutunculer F, Karabulut GS, Karaguzel G, Cetinkaya S, Saglam H, Bideci A, Kurtoglu S, Guran T, and Bereket A
- Subjects
- Child, Child, Preschool, Female, Humans, Male, Puberty, Precocious diagnosis, Symptom Assessment, Turkey, Cafe-au-Lait Spots complications, Fibrous Dysplasia of Bone complications, Fibrous Dysplasia, Polyostotic complications, Ovarian Cysts complications, Puberty, Precocious etiology
- Abstract
Aim: The causes of gonadotropin-independent precocious puberty are diverse, and often have overlapping clinical and biochemical features. With the exception of congenital adrenal hyperplasia (CAH), disorders that cause gonadotropin-independent precocious puberty (GIPP) are uncommon. The literature is devoid of any large-scale studies on the etiologic distribution of GIPP. The aim of this study was to determine the frequency of each etiology in a cohort of patients with GIPP (excluding those with CAH), and to evaluate the clinical and laboratory features of these patients., Materials and Methods: This multicenter, nationwide web-based study collected data on patients who presented with non-CAH GIPP in Turkey., Results: Data were collected for 129 patients (102 girls and 27 boys) from 29 centers. Based on the data collected, the estimated prevalence of non-CAH GIPP in the studied population was 14 in 1 000 000 children. Functional ovarian cyst was the most common etiology, accounting for 37% of all cases, followed by McCune-Albright syndrome (MAS) (26%). Among the patients with MAS, 11.7% had fibrous dysplasia, 32.3% had café-au-lait spots, and 52.9% had both. Human chorionic gonadotrophin-secreting tumors included choriocarcinoma of the liver, hepatoblastoma, and germ cell tumors of the sellar-suprasellar region and mediastinum. Patients with adrenocortical tumors presented at an earlier age than those with other etiologies. Ovarian tumors included mature cystic teratoma, dysgerminoma, juvenile granulosa tumor, and steroid cell tumor. Despite overlapping features, it was possible to identify some unique clinical and laboratory features associated with each etiology., Conclusion: This largest cohort of patients with non-CAH GIPP to date yielded an estimation of the frequency of non-CAH GIPP in the general pediatric population and showed that girls were affected at a rate 4-fold greater than that of boys owing to functional ovarian cysts and MAS, which were the two most common etiologies. The data collected also provided some unique characteristics associated with each etiology.
- Published
- 2016
- Full Text
- View/download PDF
95. Abdominal pain and nausea in a 12-year-old girl.
- Author
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Walters R and Bowen DJ
- Subjects
- Child, Female, Humans, Ovarian Cysts diagnostic imaging, Ovarian Diseases diagnostic imaging, Torsion Abnormality diagnostic imaging, Abdominal Pain etiology, Nausea etiology, Ovarian Cysts complications, Ovarian Diseases complications, Torsion Abnormality complications
- Abstract
Girls presenting with lower abdominal pain have a broad differential diagnosis. Transabdominal ultrasound should be performed in all girls presenting in the ED with lower abdominal pain. If ovarian torsion is suspected, surgical intervention should be initiated quickly to preserve the viability of the ovary.
- Published
- 2016
- Full Text
- View/download PDF
96. Laparoscopic Appendectomy for Chronic Right Iliac Fossa Pain: Correlating Histology with Outcome.
- Author
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Pardy C, Rajwani K, Lahiri R, and Mahomed A
- Subjects
- Adolescent, Appendicitis complications, Appendicitis pathology, Appendicitis surgery, Child, Child, Preschool, Chronic Pain etiology, Chronic Pain surgery, Female, Humans, Laparoscopy, Male, Ovarian Cysts complications, Ovarian Cysts diagnosis, Ovarian Cysts surgery, Peritoneum abnormalities, Peritoneum surgery, Reoperation, Treatment Outcome, Young Adult, Abdominal Pain etiology, Abdominal Pain surgery, Appendectomy methods, Appendix pathology, Appendix surgery
- Abstract
Background: Chronic right iliac fossa (CRIF) pain in children is associated with repeated hospital attendance, inconclusive investigations, and missed school days. There is increasing evidence for the role of laparoscopic appendectomy for the management of CRIF pain. However, currently there is no substantial evidence to correlate histological changes identified in the appendixes removed with resolution of pain., Method: This study collected prospective data for a single surgeon's series of laparoscopic appendectomy performed for CRIF pain between 2003 and 2014., Results: Forty patients with a median age of 13 years (range 5-19 years) underwent laparoscopic appendectomy for CRIF pain. Twenty-nine patients (73%) had macroscopically normal appendixes, but histological changes were identified in 28 patients (70%). Other findings at laparoscopy included gynecological pathology (ovarian/para-ovarian cysts), unfixed mobile caecum, and a well-defined peritoneal band extending from the caecum to the anterolateral abdominal wall (caeco-peritoneal band). Patients were followed up for a median of 2 months (range 1-15 months). All patients reported resolution of CRIF pain., Discussion: Laparoscopic appendectomy appears to be an effective treatment for CRIF pain, while also providing the opportunity to diagnose and treat potential sources of CRIF pain other than the appendix. Consistent with the literature, a small number of patients appear to have resolution of pain, despite no histological change being identified in the appendix removed and no other pathology having been identified. The same histological changes commonly seen have also been demonstrated in appendixes removed incidentally. Caution therefore should be applied when interpreting the significance of histological changes seen.
- Published
- 2016
- Full Text
- View/download PDF
97. Minimally Invasive Management of Ovarian Cysts During Pregnancy Using Ethanol Sclerosis.
- Author
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Kole MB, Frishman GN, and Werner EF
- Subjects
- Abdominal Pain etiology, Adult, Diarrhea etiology, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Female, Humans, Nausea etiology, Ovarian Cysts complications, Ovarian Cysts pathology, Pregnancy, Pregnancy Complications etiology, Pregnancy Complications pathology, Pregnancy Outcome, Recurrence, Ethanol therapeutic use, Ovarian Cysts therapy, Pregnancy Complications therapy, Sclerosing Solutions therapeutic use, Sclerotherapy methods
- Abstract
Traditionally, the management of symptomatic ovarian cysts in pregnancy has been limited to laparoscopy or laparotomy with the associated morbidity. However, in select patients requiring intervention, the risks of surgery may be minimized with sclerotherapy. We present the first case report, to our knowledge, of ethanol sclerosis of an ovarian cyst during pregnancy. A description of the surgical technique to complete such a procedure is provided as well as a brief review of the current literature with respect to the use of sclerotherapy for the management of ovarian cysts., (Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
98. Diffusion-weighted imaging in hemorrhagic ovarian cysts.
- Author
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Sivrioglu AK and Ozturker C
- Subjects
- Female, Humans, Diffusion Magnetic Resonance Imaging, Hemorrhage complications, Hemorrhage pathology, Ovarian Cysts complications, Ovarian Cysts pathology
- Published
- 2016
- Full Text
- View/download PDF
99. Ruptured Hemorrhagic Corpus Luteum Cyst in an Undescended Ovary: A Rare Cause of Acute Abdomen.
- Author
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Suh DS, Han SE, Yun KY, Lee NK, Kim KH, and Yoon MS
- Subjects
- Abdomen, Acute diagnostic imaging, Adolescent, Diagnosis, Differential, Female, Hemorrhage diagnostic imaging, Hemorrhage pathology, Humans, Ovarian Cysts diagnostic imaging, Ovarian Cysts pathology, Ovary diagnostic imaging, Pelvis diagnostic imaging, Rupture, Spontaneous, Ultrasonography, Abdomen, Acute etiology, Hemorrhage etiology, Ovarian Cysts complications, Ovary abnormalities
- Abstract
Background: Undescended ovaries are typically detected during infertility evaluations and are frequently associated with uterine malformations. Ruptured hemorrhagic corpus luteum cyst of an undescended ovary is an unusual cause of acute abdomen in an adolescent., Case: A 15-year-old girl presented with right lower quadrant pain, nausea, and vomiting, and transabdominal sonography and magnetic resonance imaging of the pelvis showed a 10 cm × 5 cm sized cystic mass at the level of the pelvic brim, anterior to the psoas muscle suggestive of a retroperitoneal hemorrhagic cyst. At surgery, the uterus and left adnexa appeared normal, but the right ovary was not visible within the pelvic cavity, and the right pelvic retroperitoneum was distended. After opening the retroperitoneum and aspirating blood clots, the undescended ovary with a ruptured cyst was visualized within the retroperitoneum. Right ovarian wedge resection was performed and the right ovary was repositioned in the pelvic cavity., Summary and Conclusion: Rupture of a corpus luteum cyst in an undescended ovary should be included in the differential diagnosis of acute abdomen in adolescents., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
100. Borderline Brenner tumors associated with ovarian cyst - case presentation.
- Author
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Albu DF, Albu CC, Gogănău AM, Albu ŞD, Mogoantă L, Edu A, DiŢescu D, and Văduva CC
- Subjects
- Brenner Tumor pathology, Female, Humans, Middle Aged, Neoplasm Proteins metabolism, Ovarian Cysts pathology, Stromal Cells pathology, Brenner Tumor complications, Ovarian Cysts complications
- Abstract
Borderline Brenner tumors represent quite a rare entity of ovarian tumors (about 2%) that develop from the surface ovarian epithelium. They are formed from papillary structures made of fibrovascular conjunctive axes covered by a transition epithelium, similar to the urinary bladder epithelium. According to the WHO classification, Brenner tumors present the following forms: benign, borderline and malignant. The benign ones are the most frequent, representing about 95%, the borderline represent about 5%, and the malignant ones less than 1%. We present the case of a 64-year patient who was diagnosed with right ovary cyst. The histopathological examination highlighted the presence of a borderline Brenner tumor at the same time with the cystic lesion, on the same ovary. The surgical treatment led to a complete cure of the patient, so that the yearly ultrasound reexamination did not trace the presence of any tumoral relapse.
- Published
- 2016
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