Corpus Luteum Cyst Research Articles

Role of ultrasound and color Doppler in diagnosis of ectopic pregnancy and to differentiate from corpus luteum cyst of pregnancy

Background: Ectopic pregnancy is the leading cause of direct maternal deaths. Ectopic pregnancy and corpus luteum cyst are two most common differential diagnoses in a patient with urine pregnancy test (UPT) positive and no sonographic evidence of intrauterine pregnancy. Internal echotexture and color Doppler features of the cyst wall are also considered in an attempt to differentiate the tubal ring of an ectopic pregnancy from that of a corpus luteum. Aims and Objectives: The aim of this study was to diagnose the presence of ectopic pregnancy and to differentiate ectopic pregnancy from corpus luteum cyst using grayscale ultrasound and color Doppler findings. Materials and Methods: The prospective study was conducted in 46 patients who were referred to the Department of Radiodiagnosis in R.L Jalappa Hospital with UPT positive and clinical features suggestive of ectopic pregnancy. Results: Out of 46 patients, 33 were diagnosed with ectopic pregnancy and 13 with corpus luteum cyst. Ectopic pregnancies had thicker walls as compared to corpus luteum cysts. Most of the ectopic pregnancies had hyperechoic walls as compared to ovaries (63.6%) and endometrium (60.6%). Free fluid with echoes was seen in the pelvis in 59.4% ectopic pregnancies whereas most of the corpus luteum cysts (69.2%) had no free fluid. Most of the corpus luteum cysts (61.5%) had clear internal echotexture whereas ectopic pregnancies were mostly lacy or solid. Yolk sac was seen exclusively in ectopic pregnancy (30.3%). RI 0.7 was found to be highly specific for diagnosing ectopic pregnancy. Conclusion: Significant ultrasound parameters that aid in differentiating between the two include the thickness of the mass’s wall, the wall’s echogenicity in relation to the ovary and endometrium, the internal echotexture of the cystic mass, the presence of the yolk sac, and the presence of free fluid with echoes. It was shown that RI 0.7 has a very good specificity in identifying ectopic pregnancy.

The Application Value of Ultrasound in the Diagnosis of Ovarian Torsion

In a study of 80 patients suspected of ovarian torsion and necrosis admitted to our hospital between January and December 2023, we analyzed the results of abdominal and vaginal ultrasounds with surgical diagnoses as the reference. Of the 80 cases, 74 were confirmed as ovarian torsion, accounting for 92.50%, while the remaining diagnoses included ruptured corpus luteum cysts, periapendiceal abscesses, and ruptured ectopic pregnancies, each with 2 cases. Abdominal ultrasound identified 63 cases of ovarian torsion and 17 cases of non-ovarian torsion, whereas vaginal ultrasound identified 73 cases of ovarian torsion and 7 cases of non-ovarian torsion. The sensitivity, specificity, and accuracy of abdominal ultrasound were 82.43%, 66.67%, and 78.75%, respectively, while those of vaginal ultrasound were 94.59%, 50.00%, and 91.25%. Although there was no statistical difference in specificity between the two methods (P > 0.05), vaginal ultrasound demonstrated significantly higher sensitivity and accuracy compared to abdominal ultrasound (P < 0.05). Thus, vaginal ultrasound is a more reliable diagnostic tool for ovarian torsion, providing valuable information for clinicians and improving diagnostic accuracy.

Do we more often opt for conservative management of ovarian tumors after changing the Dutch national guideline on enlarged ovaries? A nationwide cohort study.

Increasing evidence shows that conservative management of ovarian tumors classified as benign, based on ultrasound assessment, is safe. Therefore, conservative management has been adopted as the preferred strategy for certain ovarian tumors assessed as benign in the Dutch national guideline on enlarged ovaries in 2013. The aim of this study was to examine whether implementation of this guideline has led to changes in the number of women/100 000 women undergoing surgery for an ovarian tumor in the Netherlands. Histopathology reports were requested for all examinations of ovarian and fallopian tube specimens (including cyst enucleations) registered in Palga, the Dutch nationwide pathology databank, from 2011 (before guideline adaptation) and 2019 (after guideline adaptation). Reports on prophylactically removed adnexa, removal for other primary tumors (e.g., endometrial carcinoma), and for patients under 18 years of age, were excluded from the analysis. Interobserver agreement for the inclusion and classification of reports was assessed using Cohen's Kappa analysis. A total of 34 932 reports were retrieved, 13 917 of which were included in the analysis. In 2011 and 2019, respectively, 96.3/100 000 versus 68.8/100 000 women aged ≥18 underwent surgery for benign ovarian tumors, and 19.6/100 000 versus 18.3/100 000 for borderline and malignant tumors combined. The number of women/100 000 who had surgery for a benign ovarian tumor per 100 000 women declined by 28.5% (p < 0.001) between 2011 and 2019. The largest difference between 2011 and 2019 was observed in the number of women per 100 000 women who underwent surgery for a serous cystadenoma (-40.7%; 20.8/100 000 vs. 12.3/100 000), followed by endometrioma (-33.2%; 14.7/100 000 vs. 9.8/100 000), simple epithelial cyst (-57.3%; 8.4/100 000 vs. 3.6/100 000), and corpus luteum cyst (-57.0%; 4.0/100 000 vs. 1.7/100 000). Cohen's Kappa for the interobserver agreement was 0.96. The number of women/100 000 undergoing surgery for a benign ovarian tumor has substantially decreased in the Netherlands when comparing data before and after implementation of the national guideline in 2013, while the number of women/100 000 undergoing surgery for a malignant or borderline tumor remained the same. These findings suggest successful implementation of the updated guideline, and a measurable effect on increased adoption of conservative management for benign-looking ovarian tumors.

Surgical outcomes of transvaginal natural orifice transluminal endoscopy in treating ovarian cysts and risk factors for surgical conversions

ObjectiveThis study aimed to assess the surgical outcomes and identify the conversion risk factors of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) in treating ovarian cyst. MethodsThis was a retrospective study of 505 patients who underwent vNO TES for treating ovarian cyst from March 2019 to February 2022 wherein the patients were classified into “converted” or “nonconverted” groups. T-tests, χ2 tests, and logistic regression were used for statistical analyses. ResultsThere were 16 (3.17 %) surgical conversions and 12 (2.38 %) other surgical complications in our study cohort. Teratomas accounted for 56.8 % of complications in nonconverted cases and 18.8 % in converted cases. Adenocystomas were found in 12.3 % of nonconverted cases and 18.8 % of converted cases. Other types included paraovarian cysts (3.3 % and 0 %), fibroma, granulosa cell tumor, Brenner tumor (1.2 % and 0 %), corpus luteum cysts, follicular cysts (7.6 % and 6.3 %), old abscess (0.2 % and 0 %), and simple cysts (17.6 % and 12.5 %) in the nonconverted and converted groups, respectively. The converted group included more cases of endometriotic cysts (43.8 % vs 12.3 %, p = 0.023), bilateral cysts (37.5 % vs 8.2 %, p < 0.001), severe pelvic adhesion (68.8 % vs 3.3 %, p < 0.001), deep endometriosis (12.5 % vs 0.4 %, p < 0.001), and at least two cysts (37.5 % vs 8.81 %; p < 0.001). Severe pelvic adhesion (adjusted odds ratio [OR], 86.96; range, 18.33–431.77; p < 0.001), bilateral cysts (adjusted OR, 4.75; range, 1.05–21.57, p = 0.043) and endometriotic cysts (adjusted OR, 7.69; range, 3.11–17.08; p < 0.001) were also predictors of surgical conversion. ConclusionvNOTES demonstrates low complication and conversion rates in treating ovarian cyst compared with TU-LESS. Surgical conversion is associated with severe pelvic adhesions, bilateral cysts, and endometriotic cysts.

Post molar choriocarcinoma with solitary renal metastasis in the absence of primary uterine tumor: a case report and review of the literature

BackgroundChoriocarcinoma is a rare and highly malignant form of gestational trophoblastic disease that may develop following pregnancy, abortion, or a hydatiform mole. Renal metastatic involvement by post molar choriocarcinoma is even rarer. In this case report, we describe a unique case of post molar choriocarcinoma with a solitary renal metastasis in the absence of a primary uterine tumor and metastases in other sites, which presented with urological symptoms and spontaneous renal hemorrhage.Case presentationA 41-year-old Persian woman with history of complete hydatiform mole presented with severe flank pain, nausea, vomiting, gross hematuria, and vaginal bleeding. Laboratory tests demonstrated a serum beta human chorionic gonadotropin hormone level of 60,000 mIU/mL. Imaging studies showed a lesion at the lower pole of the left kidney with active bleeding surrounded by hematoma, as well as an empty uterine cavity. Additionally, bilateral pleural effusion was detected without any lesion within the lungs. Subsequently, the patient underwent laparotomy, partial nephrectomy, and left para-ovarian cystectomy. Endometrial curettage was also carried out. The histopathology report revealed choriocarcinoma renal metastasis with high expression of beta human chorionic gonadotropin, cytokeratin 7, and Ki 67. Moreover, there were no malignant cells in the endometrial curettage specimens, and a corpus luteum cyst was found within the para-ovarian cyst. Further investigations revealed that the pleural effusion was free of malignant cells, and there was no evidence of metastatic lesions in the brain. As a result, the patient was referred to the oncology department to receive chemotherapy, and the beta human chorionic gonadotropin levels dropped to 5 mIU/mL after receiving courses of a standard regimen of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine/oncovin over 3 weeks. Finally, monthly measurements of beta human chorionic gonadotropin levels for 6 months indicated that levels have constantly remained within normal ranges, showing no evidence of recurrence or new metastasis.ConclusionsUrological symptoms such as hematuria or spontaneous renal hemorrhage might be the only presentation of post molar choriocarcinoma with renal involvement. Thus, it can be beneficial to measure serum beta human chorionic gonadotropin levels among females of childbearing age who present with unexplained urological symptoms, especially if there is a history of prior hydatiform mole.

Hormone-producing Ovarian Tumors in Children. Literature Review

Hormone-producing ovarian tumors in girls are an actual problem in modern gynecology, which is associated with certain difficulties in managing patients. Firstly, it is worth taking into account the higher anatomical mobility of tumors in girls than in adults, due to the high location of the ovaries, weakness of the ligamentous apparatus and the active lifestyle of the child, which causes a higher incidence of torsion of the volumetric mass in children. Secondly, surgical treatment of hormone-producing ovarian tumors leads to a decrease in ovarian reserve and irreversible consequences in the reproductive health of patients in the future, which is an extremely undesirable complication in childhood. Therefore, methods of fertility preservation should be discussed with girls and their parents. It is also important to note that hormone-producing ovarian tumors have a certain degree of malignancy and a tendency to recur. Thus, the relevance of this topic lies in the complexity of management of pediatric patients with this pathology due to the clinical features of the course and a higher probability of complications. Hormone-producing ovarian masses should also include follicular cysts and corpus luteum cysts, but the above structures are excluded from the discussion in this article.

18F-FDG PET/CT findings of endometriosis and corpus luteum cyst.

SynopsisPET/CT can differentiate between endometriosis, the malignant progression of endometriosis, and ovarian cysts.

Diagnosis and Management of a Ruptured Corpus Luteum Cyst: A Case Report from a Resource-Limited Setting

Diagnosis and Management of a Ruptured Corpus Luteum Cyst: A Case Report from a Resource-Limited Setting

SAT360 Ovarian Vein Sampling in a Pre-menopausal Woman with Hyperandrogenism: Characterization of Hormonal Profiles

Abstract Disclosure: T.Y. Hu: None. M.E. Babey: None. I. Niu: None. S.M. Nanavati: None. E.J. Murphy: None. Background: Serum estradiol levels have been studied in pre-menopausal and post-menopausal women. There is limited literature on ovarian vein estradiol concentrations. Most data are from sampling done in the setting of hyperandrogenism and primarily in post-menopausal women. This case illustrates hormone concentrations in a pre-menopausal woman who underwent ovarian vein sampling in the workup of hyperandrogenism. Clinical Case: A 33-year G1P1 woman with hypertension and prediabetes presented with three years of menstrual irregularity and infertility after IUD removal. She reported rapid weight gain and hirsutism over one year. Exam was consistent with hyperandrogenism with virilization (modified Ferriman-Gallwey score of 30). Labs showed elevated total testosterone ranging from 144-208 ng/dL (ref 2-45 ng/dL), free testosterone 32.7-35 pg/mL (ref 1.3-9.2 pg/mL), and androstenedione 2.053 ng/ml (ref 0.26-2.14 ng/ml). Cortisol post 1 mg dexamethasone suppression test, 24-hour urine free cortisol, and DHEA-S were normal. Morning unstimulated 17-hydroxyprogesterone was 80.41 ng/dL (ref follicular phase 15-70 ng/dL, luteal phase 35-290 ng/dL). Given normal DHEA-S, an adrenal etiology such as adrenocortical carcinoma was less likely. CT showed no adrenal or ovarian masses. Transvaginal ultrasound revealed numerous bilateral peripheral follicles without adnexal masses or evidence of hyperthecosis and appearance suggestive of PCOS. While the testosterone elevation could be consistent with PCOS, the clinical picture was more concerning for an androgen-secreting tumor. Given the concern for ovarian etiology and patient’s desire for fertility, ovarian vein sampling was performed by a radiologist experienced with adrenal vein sampling to localize a suspected tumor. The right ovarian vein is generally harder to sample than the left. Results were consistent with androgen hypersecretion on the right (right: total testosterone 5,817 ng/dL, androstenedione &amp;gt;40 ng/mL, DHEA-S 20.084 ng/mL; left: total testosterone 189 ng/dL, androstenedione 1.798 ng/mL, DHEA-S 1.893 ng/mL). Estradiol levels were notably elevated on the right at 1945 pg/mL compared to 70 pg/mL on the left. The patient underwent right oophorectomy with pathology showing nodular stromal hyperthecosis and a large corpus luteum cyst. Hyperandrogenism resolved post-operatively with total testosterone 14 ng/dL. Conclusion: We report hormonal profiles from ovarian vein sampling in a pre-menopausal woman with unilateral stromal hyperthecosis. There is limited literature on ovarian vein in this entity and no prior data on estradiol levels. We hypothesize estradiol levels were elevated due to aromatase activity in the right ovary. Testing from the presumably unaffected left ovarian vein helps to characterize ovarian vein estradiol levels in a pre-menopausal woman with suspected hyperandrogenic anovulation. Presentation Date: Saturday, June 17, 2023

Transcriptome and Metabolome Analyses Reveal the Mechanism of Corpus Luteum Cyst Formation in Pigs.

Corpus luteum cysts are a serious reproductive disorder that affects the reproductive performance of sows. In this study, transcriptome and metabolome datasets of porcine normal and cyst luteal granulosa cells were generated to explore the molecular mechanism of luteal cyst formation. We obtained 28.9 Gb of high-quality transcriptome data from luteum tissue samples and identified 1048 significantly differentially expressed genes between the cyst and normal corpus luteum samples. Most of the differentially expressed genes were involved in cancer and immune signaling pathways. Furthermore, 22,622 information-containing positive and negative ions were obtained through gas chromatography-mass spectrometry, and 1106 metabolites were successfully annotated. Important differentially abundant metabolites and pathways were identified, among which abnormal lipid and choline metabolism were involved in the formation of luteal cysts. The relationships between granulosa cells of luteal cysts and cancer, immune-related signaling pathways, and abnormalities of lipid and choline metabolism were elaborated, providing new entry points for studying the pathogenesis of porcine luteal cysts.

Approach to ovarian torsion with corpus luteum removal in early pregnancy

The ovary’s Torsion is the adnexa’s total or partial rotation around its vascular axis or pedicle. Complete torsion causes venous and lymphatic blockade leading to stasis, venous congestion, hemorrhage, and necrosis. If neglected, it may result in permanent loss of the affected ovary. Ovarian torsion is one of the most critical gynecological surgical emergencies. Therefore, it requires urgent surgical intervention. It is mainly diagnosed by clinical examination and ultrasound. Ovarian torsion is primarily seen in the first trimester of pregnancy. Infertility treatment is a significant risk factor due to ovarian stimulation. We present a case of acute abdominal pain who came to the emergency department of Al Ahli Hospital, diagnosed as right adnexal torsion with viable intrauterine pregnancy at six weeks. Laparoscopic oophorectomy was done by removing the corpus luteum cyst, which supports early pregnancy. Despite its disposal, the pregnancy continued because the hormonal therapy started in doses higher than recommended for threatened abortion. Eventually, she gave birth to a healthy baby boy at 35 weeks.

The 10 "Cardinal Sins" in the Clinical Diagnosis and Treatment of Endometriosis: A Bayesian Approach.

Evidence-based data for endometriosis management are limited. Experiments are excluded without adequate animal models. Data are limited to symptomatic women and occasional observations. Hormonal medical therapy cannot be blinded if recognised by the patient. Randomised controlled trials are not realistic for surgery, since endometriosis is a variable disease with low numbers. Each diagnosis and treatment is an experiment with an outcome, and experience is the means by which Bayesian updating, according to the past, takes place. If the experiences of many are similar, this holds more value than an opinion. The combined experience of a group of endometriosis surgeons was used to discuss problems in managing endometriosis. Considering endometriosis as several genetically/epigenetically different diseases is important for medical therapy. Imaging cannot exclude endometriosis, and diagnostic accuracy is limited for superficial lesions, deep lesions, and cystic corpora lutea. Surgery should not be avoided for emotional reasons. Shifting infertility treatment to IVF without considering fertility surgery is questionable. The concept of complete excision should be reconsidered. Surgeons should introduce quality control, and teaching should move to explain why this occurs. The perception of information has a personal bias. These are the major problems involved in managing endometriosis, as identified by the combined experience of the authors, who are endometriosis surgeons.

Histopathologic Examination of Ovarian Lesions: A Prospective Observational Study in Women from Central India

Background: There is age related increase in the incidence of ovarian cancer. Most Indian population-based cancer registries have reported a gradual rise in the ovarian cancer incidence over the years. Since ovary is composed of totipotent gametocytes and multipotent mesenchymal tissues, almost any type of tumor can arise from these tissues. Therefore, their proper recognition and classification is important for appropriate therapy and better prognosis.Aim: to look at the histopathological profile of various ovarian lesions in the local female subjects from central India.Methods: A prospective observational study was carried out on the surgically resected ovarian samples that were referred to the Pathology department over two and half year. A total of 100 ovarian cases were included. Histopathological examination of the specimen was done using standard protocols.Results: On gross examination, majority of non-neoplastic specimen showed unremarkable findings. Microscopic examination of non-neoplastic cases revealed that most of the cases were of follicular cyst followed by corpus luteum cyst. On the contrary, majority of neoplastic specimen showed cystic external surface on gross examination. Surface epithelial tumor was the most common histologic type amongst neoplastic cases. Most common histologic subtype amongst the surface epithelial tumors was found to be benign simple serous cystadenoma. Conclusion: In women from central India, commonest non-neoplastic lesion of ovary is follicular cyst whereas most common neoplastic lesion is surface epithelial tumor (benign simple serous cystadenoma).

Cases of cow reproductive disorders at The Northern Bandung Dairy Farmer Cooperative by using Geographic Information System (GIS) approach

&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to determine the percentage of reproductive disorders in dairy cows at The Northern Bandung Dairy Farmer Cooperative (KPSBU Lembang) based on body condition score (BCS) and season factor and determined the distribution map.&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The object of this study was secondary data on dairy cows from 2019 to 2021 registered on the cooperative database. The parameters of this study were type, case percentage, risk factor, and distribution of reproductive disorders. The data were analyzed descriptively based on BCS and season factors.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;The percentage results were presented in tables and figures after being processed using Microsoft Excel, while the distribution maps were processed using the QGIS application. The percentages of reproductive disorders in KPSBU Lembang in 2019–2021 respectively as follows: Retained placenta were 11.5%, 14.9%, and 14.4%; Dystocia were 11.5%, 12.6%, and 14.2%. Ovarian function disorders (follicular cyst and corpus luteum cyst) were 10.2%, 8.8%, and 9.9%; Endometritis was 9.3%, 9.5%, and 10.4%. Based on the distribution maps of reproductive disorders, it was known that all villages in Lembang District in 2021 had cows with reproductive disorders.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The reproductive disorders in dairy cows at KPSBU Lembang had retained placenta, dystocia, ovarian function disorder (follicular cyst and corpus luteum cyst), and endometritis. Dystocia and retained placenta are the highest cases in KPSBU Lembang during the dry and rainy seasons. Areas that had dairy cows with unideal BCS became the highest area of each type of reproductive disorder cases.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to determine the percentage of reproductive disorders in dairy cows at The Northern Bandung Dairy Farmer Cooperative (KPSBU Lembang) based on body condition score (BCS) and season factor and determined the distribution map.&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The object of this study was secondary data on dairy cows from 2019 to 2021 registered on the cooperative database. The parameters of this study were type, case percentage, risk factor, and distribution of reproductive disorders. The data were analyzed descriptively based on BCS and season factors.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;The percentage results were presented in tables and figures after being processed using Microsoft Excel, while the distribution maps were processed using the QGIS application. The percentages of reproductive disorders in KPSBU Lembang in 2019–2021 respectively as follows: Retained placenta were 11.5%, 14.9%, and 14.4%; Dystocia were 11.5%, 12.6%, and 14.2%. Ovarian function disorders (follicular cyst and corpus luteum cyst) were 10.2%, 8.8%, and 9.9%; Endometritis was 9.3%, 9.5%, and 10.4%. Based on the distribution maps of reproductive disorders, it was known that all villages in Lembang District in 2021 had cows with reproductive disorders.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="MDPI17abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The reproductive disorders in dairy cows at KPSBU Lembang had retained placenta, dystocia, ovarian function disorder (follicular cyst and corpus luteum cyst), and endometritis. Dystocia and retained placenta are the highest cases in KPSBU Lembang during the dry and rainy seasons. Areas that had dairy cows with unideal BCS became the highest area of each type of reproductive disorder cases.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Histological Estimation of Ovaries Cystic Lesions in Iraqi Patients’ Women

Ovarian cystic lesions are one of the most common pathologic disorders in gynecology and a common reason for surgery. The purpose of the study was to determine the histopathologic characteristics of benign cystic ovarian lesions and their correlation to age, type, laterality, locularity, and size of ovarian cystic lesions. This is a retrospective study carried out on 100 cases from the archive in the Imam Kadhimian medical city and the educational laboratories of Baghdad medical city, out of 100 patients, the most common age group that underwent cystectomy was 20-40 years old. The vast majority of the cysts were non-neoplastic (67%) while the neoplastic cysts occupy 33% of all cysts. The most common non-neoplastic cyst was corpus luteum cyst (49 (49%) out of 100), subsequently follicular cyst (11 cases (11%) out of 100) and they are most commonly encountered in the age group (20 to 40) years while the most common neoplastic cyst was matured cystic teratoma (17 cyst (17%) out of 100) in the age group (20 to 40) years subsequently serous cystadenoma (12 cysts (12%) out of 100) in the age group (41-60) years. Most of the non-neoplastic cyst (58 out of 67) was measured less than 6 cm while most of the neoplastic cyst (22 out of 33) measured more than 6 cm and both appear slightly more frequent in the age group (20-40) years.

Selection of embryo recipients, a real challenge in cows embryo transfer programs

This article comes as a response to a clinical situation that the members of our team found at an embryo transfer program. At the moment of insemination, day 7 after estrus period, a high number of untransferable recipients was found after ovaries ultrasonography. From 54 animals synchronized, just in 5 (9.25 %) cases was performed the embryo insemination. The embryo transfer was performed in cases where a corpus luteum (CL group) higher than 17 mm was found on the ovary, corpus luteum with a cavity of a maximum 10 mm and without a follicle higher than 10 mm on the ovary with the corpus luteum or on the other ovary. The rest of heifers were classified into the next groups: Hollow corpus luteum (HCL Group), 11 cases (20.37%), Lutheal cyst (LC Group), 5 cases (9.25%), No corpus luteum (NCL Group), 4 cases (7.40%), Corpus luteum and follicle (CLF Group), Small corpus luteum (SCL Group). Cystic corpus luteum seems to be a good variant for performing the Embryo Transfer. Even if the level of P4 concentrations in the case of a luteal cyst is highest, the embryo transfer in these cases is with a high level of risk and should be avoided.

Exophytic interstitial ectopic pregnancy removal: novel use of Endoloop for uterine cavity preservation

Exophytic interstitial ectopic pregnancy removal: novel use of Endoloop for uterine cavity preservation

The Effect of Tamoxifen Citrate on Granulosa Cells of Ovarian Follicles in Adult Female Rats: Light Microscopic Study.

Tamoxifen is a drug that has been used extensively as a chemotherapeutic agent for breast cancer. It should be taken for a long period, from few weeks up to many years, so it can induce gynecological and nongynecological complications. Present study was conducted to clarify the histopathological effects of tamoxifen intake on the ovarian follicles of rats and evaluate the promising recovery after drug withdrawal. Adult female albino rats (n = 24) were randomly divided into four groups. Group I: Control rats without treatment. Group II: Rats received olive oil vehicle. Group III: Rats received 5 mg/kg daily of tamoxifen dissolved in olive oil by oral administration for 4 weeks. Group IV: Rats received tamoxifen as in Group III then will be kept for another 4 weeks without treatment for recovery. Then, the rats were anaesthetized and the ovaries were removed and prepared for histological assessment by light microscope. The ovarian histological findings in the ovary of Group III revealed an increase in atretic ovarian follicles, appearance of cystic ovarian follicles, and cystic corpus luteum. The granulosa cells of ovarian follicles were disorganized with vacuolation of their cytoplasm, increased number of pyknotic nuclei, fragmented nuclei, and apoptotic bodies. After the withdrawal of drug, the ovarian tissue showed slight improvement with the appearance of some atretic follicles with degenerated oocyte and stromal hyperplasia. Based on the results, tamoxifen induced marked histological changes in the ovary. If tamoxifen is mandatory for the prevention of breast cancer, frequent gynecological examination should be carried out to detect any side effects.

LBODP097 Malignant Struma Ovarii: Long Term Successful Treatment. Outcome

Abstract 18 year old African American female saw her GYN in 9/2008 for abdominal pain. CT: bilateral adnexal masses (10×8 cm left; 6.3×3.1 cm right). Surgical pathology reported a left benign cystic teratoma and right corpus luteum cyst. Pain recurred in 2010. MRI showed: 9×7.5×4 cm right adnexal mass. Repeat surgery was done. Pathology: benign cystic teratoma with focal thyroid tissue - "Struma Ovarii". Abdominal pain recurred yet again in 2012. Sonography revealed a mixed solid/cystic pelvic mass measuring 10.6×7.9×7.6 cm. Exploratory laparotomy 9/2012 revealed a right adnexal mass and widespread peritoneal nodules. Pathology reported follicular tissue with colloid in the nodules - "Peritoneal Strumatosis" suggesting benignity. Upon further review was reclassified as metastatic well differentiated follicular thyroid cancer of ovarian origin with follicular thyroid tissue identified in peritoneal lymph nodes, spleen, bladder and rectal wall. The patient was then referred to endocrinology at our facility. On exam she was clinically euthyroid without thyromegaly or nodularity. Thyroid hormone levels were normal. Antithyroid antibodies were absent. Serum Thyroglobulin (Tg): elevated (229; normal 2-35 ng/ml) as was CA125 (64; normal &amp;lt;21 U/ml). Immunohistochemistry: positive for Tg and Thyroid transcription factor-1. Molecular markers: no mutations in BRAF, RAS, or TP53. In preparation for radioactive iodine (RAI) therapy, total thyroidectomy was performed 4/13/2013 and reported as normal thyroid tissue. Dosimetry findings: very iodine avid tissue with prolonged retention (33% at 6 days). Maximum tolerated dose: 200 mCi. A 62.8 mCi RAI was administered 7/13/2013. Post RAI whole body scan (WBS): numerous focal areas of increased uptake in abdomen and pelvis consistent with metastatic disease. Treatment with L-thyroxine was given to suppress TSH. Follow up WBS 12/26/2013 showed persistent increased uptake in abdomen and pelvis. Serum Tg was high (198. 0). A second RAI dose of 104.8 mCi was given. Post RAI WBS confirmed multiple areas of metastatic disease in abdomen and pelvis. Subsequent serum Tg levels down trended. WBS 11/12/2014: only two residual abnormal foci in the lower neck and one inferior to the liver without abdominal or pelvic foci. Given the dosimetry issue and the reassuring serum Tg levels, surveillance was continued. WBS 9/25/2015: unchanged. Now age 27, WBS 1/26/2022: only residual faint lower neck uptake, resolution of the focus inferior to the liver and no distant foci. Stimulated Tg was normal at 2.2 ng/ml with stimulated TSH &amp;gt;110. 0 uIU/ml. Presentation: No date and time listed

A “Two-bal” Pregnancy: A Case Report on Heterotopic Pregnancy

Heterotopic pregnancy is defined as the combination of an intrauterine pregnancy and a concurrent pregnancy with an ectopic location, often the fallopian tube. Implantation can also occur in the cervix, ovary, cornua, abdomen, and previous Cesarean scar . While heterotopic pregnancy is considered a rare finding, the incidence is increasing due to the increased use of Assisted Reproductive Technology (ART). Heterotopic pregnancy is suspected when an ultrasound reveals an intrauterine pregnancy in addition to a complex adnexal mass. Differential diagnoses include: threatened abortion, ruptured corpus luteum cyst, and isolated ectopic pregnancy. Correct diagnosis can be difficult to attain due to nonspecific symptoms and findings such as: free fluid in the abdomen, abdominal pain, and vaginal bleeding. Patients are often diagnosed later than in an isolated tubal pregnancy due to these nonspecific symptoms and confirmation of an intrauterine pregnancy . Delayed diagnosis often leads to greater risk of rupture, an acute abdomen, and hemodynamic instability. Since the extrauterine pregnancy is non viable, salpingectomy is the surgical standard and first line treatment . However, other treatment modalities such as local feticidal injection have been performed depending on the clinical status of the patient and physician expertise. Finally, an ultrasound is to be performed after the procedure to confirm viability of the intrauterine pregnancy. During this case study, the patient presentation, diagnosis, and treatment of heterotopic pregnancy will be discussed in detail. The objective of this case study is to review the events and management of this unique patient presentation and discuss the recommended diagnosis and treatment options, as well as the incidence and prognosis of patients with this rare diagnosis.