Ovarian Dermoid Cyst Research Articles

Ovarian Dermoid Cyst Causing Distal Ureteral Obstruction.

A case of a 45-year old woman with an ovarian dermoid cyst causing ureteric colic secondary to distal ureteral obstruction is reported. The dermoid cyst was observed on computed tomography to be adjacent to and compressing the distal left ureter and this was confirmed at surgical exploration. Following oophorectomy, the patient's symptoms completely resolved and the excised ovarian cyst was confirmed on pathological evaluation to be a dermoid cyst. This appears to be the first reported case of ureteral obstruction caused by an ovarian dermoid cyst in the English medical literature.

Laparoscopic treatment of 1522 adnexal masses: an 8-year experience.

Objective. To reevaluate the long-term effectiveness and safety of laparoscopy in benign ovarian pathology. Materials and Methods. 1522 women with benign adnexal cysts, laparoscopically treated in the 3rd Department of Ob/Gyn, General University hospital “Attikon” and “Lito” Maternity Hospital between July 1998 and December 2006, were included. Results. The diagnosis in 1222 (80,6%) cases was endometriosis of the ovary, 60 (4%) hydrosalpinx, 51 (3,3%) serous cystadenomas, 44 (2,9%) dermoid ovarian cyst, 38 (2,5%) borderline tumors, 35 (2,3%) unruptured follicles, and 33 (2,2%) paraovarian cysts. In 174 cases (11,5%) laparoscopy was converted to laparotomy due to technical difficulties or suspicion of cancer. In particular, laparotomy was performed in 119 (8%) women due to severe adhesions and 18 (1,2%) women due to bleeding that could not be controlled safely by laparoscopy. In 36 (2,4%) women frozen section during operation revealed malignancy and laparoscopy was converted to laparotomy. A few operative complications were recorded like post-op fever, small hematomas at the trocar entries. Conclusions. Laparoscopic surgery seems to offer significant advantages such as reduced hospital stay, less adverse effects, better quality of life, and superior vision especially on surgical treatment of cases like endometriosis.

Removal of Ovarian Dermoid Cyst via Posterior Cul-de-Sac

Background: Most women who develop dermoid cysts are of reproductive age and require conservative fertility-sparing surgery. The surgical approach to a dermoid cyst was cystectomy via laparotomy until the laparoscopic surgery was developed. However, this approach may induce spillage of cyst contents into the peritoneal cavity, although risk of this complication has been reduced with technical advances. The vagina offers direct access to the peritoneal cavity and to any existing ovarian cyst. One vaginal approach is via the posterior cul-de-sac. Objective: The aim of this retrospective study was to investigate surgical management of ovarian dermoid cysts via the posterior cul-de-sac. Materials and Methods: This study was conducted in a gynecologist's private clinic. Thirty women with dermoid cysts were operated on vaginally via the posterior cul-de-sac without laparoscopic assistance. Preoperatively, the patients were counseled and written content was obtained for the surgery to be performed vaginally unless required otherwise, with preparations made to utilize laparoscopic assistance or, if necessary, even open the abdomen. After careful clinical examination and assessment under anesthesia, each patient's dermoid cyst was accessed via the posterior cul-de-sac and excised. Results: The vaginal route without laparoscopic assistance was successful in 29 women; 1 woman required laparoscopic assistance through a single port to push her dermoid cyst into the pouch of Douglas to make it accessible. To conserve the women's fertility, ovarian cystectomies were performed and healthy ovarian tissue was preserved. The postoperative hospital stay was 24 hours. No disposable equipment or instruments were used in the surgery. Conclusions: The vaginal route offers an excellent alternative to laparoscopic surgery and eliminates, in most cases, the need for invasive laparotomy. The vaginal route has the advantages of minimal invasion, shorter hospital stay, rapid recovery, and being the most economical option. (J GYNECOL SURG 31:8)

Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients.

ObjectiveThe aim of the present study was to determine the prevalence and reporting rate of incidental findings (IF) in adult outpatients undergoing lumbar magnetic resonance imaging (MRI).Materials and MethodsRe-evaluation of a total of 1278 lumbar MRI images (collected from patients with a mean age of 50.5 years, range 16-91 years) captured between August 2010-August 2011 was done by a neuroradiologist and a musculoskeletal radiologist. IFs were classified according to organ or system (liver, gallbladder, kidney, bladder, uterus, ovary, lymph node, intestine and aorta). The rate of reporting of a range of IF was examined. The outcome of each patient's treatment was evaluated based on review of hospital records and by telephone interviews.ResultsA total of 253 IFs were found in 241 patients (18.8% of 1278). Among these, clinically significant IFs (n = 34) included: 2 renal masses (0.15%), 2 aortic aneurysms (0.15%), 2 cases of hydronephrosis (0.15%), 11 adrenal masses (0.86%), 7 lymphadenopathies (0.55%), 6 cases of endometrial or cervical thickening (0.47%), 1 liver hemangioma (0.08%), 1 pelvic fluid (0.08%) and 2 ovarian dermoid cysts (0.15%). Overall, 28% (71/253) of IFs were included in the clinical reports, while clinically significant findings were reported in 41% (14/34) of cases.ConclusionExtraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant. However, IFs including clinically important findings are occasionally omitted from formal radiological reports.

Subtle Presentation of Bilateral Ovarian Dermoid Cysts With Unilateral Torsion: A Case Report

Subtle Presentation of Bilateral Ovarian Dermoid Cysts With Unilateral Torsion: A Case Report

Structure of teeth in mature ovarian teratoma

The authors investigated three mature ovarian dermoid cysts that were found to contain atypically developed teeth (one tooth in one cyst; 2 teeth in another cyst, and a set of 8 teeth with jawbone fragments in the third one). Their structure was examined using the epoxy resin plastination technique to obtain plastinated sections. Some of these teratomous teeth have obvious signs of alteration in both dentin and enamel, which may be referred to as fluorosis or macular enamel hypoplasia in one case whereas other sections indicate a caries lesion. These facts are contradictory to the concept of the exogenous nature of dental caries, which is accepted in dentistry.

Single-port compared with conventional laparoscopic cystectomy for ovarian dermoid cysts

ObjectiveWe compared the immediate surgical outcomes of single-port laparoscopic cystectomy (SLC) and conventional laparoscopic cystectomy (CLC) for managing ovarian dermoid cysts. Materials and methodsA retrospective case-control study was conducted to enroll 71 patients with dermoid cysts, including 34 patients in the SLC group and 37 patients in the CLC group. The outcome measures included operative time, blood loss, postoperative pain, analgesic use, and serum levels of hormones, including estrogen (E2), follicle-stimulating hormone, luteinizing hormone, and anti-Mullerian hormone. ResultsSLC was associated with less time required for specimen retrieval (1.3 ± 0.8 vs. 12.0 ± 3.4 minutes, p < 0.001), fewer ruptured bags (0% vs. 10.8%, p = 0.049), and less need of additional wound elongation (0% vs. 27.0%, p = 0.001) when respectively compared with CLC. Additionally, patients who underwent SLC reported lower postoperative lower abdominal pain and less accumulated postoperative analgesics when respectively compared with patients who underwent CLC. There was no significant difference of hormones between two groups. ConclusionOur study demonstrated the feasibility of using the single-port method in place of CLC in the management of ovarian dermoid without increased difficulty of techniques or risk of ovarian damage.

Torsion, Autoamputation, and Reimplantation of Viable Ovarian Dermoid Cyst

Torsion, Autoamputation, and Reimplantation of Viable Ovarian Dermoid Cyst

Pure primary ovarian squamous cell carcinoma: A case report and review of the literature.

Pure primary ovarian squamous cell carcinoma (SCC) is a rare lesion that usually arises from the malignant transformation of an existing ovarian dermoid cyst. The de novo occurrence of an ovarian SCC in the absence of a prior ovarian dermoid cyst, Brenner tumor or endometriosis is extremely rare. At present, no effective therapy exists for treating pure primary ovarian SCC. The present case study describes a patient that presented with progressive coughing, who was diagnosed with an International Federation of Gynecology and Obstetrics stage IV pure primary ovarian SCC with lung metastases. The patient received postoperative chemotherapy, however, the patient succumbed to the disease. The current study also presents a review of the literature.

A hairy intruder into colon

AbstractOvarian dermoid cysts are benign tumors, which develop from totipotent germ cells and grow into mature tissue types consisting of hair, teeth, fat and neural tissue. Ovarian dermoid cyst fistulizing to the sigmoid is rare and presenting with bleeding per rectum is extremely rare. We present a case of middle-aged woman with bleeding per rectum who had the right adnexal tumor fistulating to sigmoid.

The value of ultra sonogram in the diagnosis of ovarian dermoid cysts

Mature cystic teratoma often referred to as dermoid cysts have been diagnosed using all imaging modalities. Dermoid cysts present various and complex ultrasonographic aspects. At times diagnosis may be difficult and lead to confusion due to its complex solid and cystic nature. The specificity for diagnosis of fat and calcification makes computed tomography (CT) scan the modality of choice. But CT scan is high technique equipment, expensive and may not be affordable or available at all places. Advances in the quality of USG machines, better experiences of ultrasound operators and thorough analysis of all ultrasound features that characterise dermoid cysts have resulted in an increased accuracy of exact ultrasonographic diagnosis of dermoid cysts in the vast majority of the cases and now used as the first preoperative work-up method of choice for the assessment of adnexal masses in clinical practices. DOI: http://dx.doi.org/10.3126/jkmc.v3i1.10920Journal of Kathmandu Medical CollegeVol. 3, No. 1, Issue 7, Jan.-Mar., 2014, Page: 26-31

Modified Novel Technique for Improving the Success Rate of Applying Seprafilm by Using Laparoscopy

Study ObjectiveTo describe a modified surgical procedure for applying the adhesion barrier Seprafilm laparoscopically. DesignRetrospective analysis with videos and illustrations showing laparoscopic application of Seprafilm. SettingUniversity hospital. PatientsWomen undergoing fertility-sparing laparoscopic surgery (myomectomy, endometriotic ovarian cyst or dermoid cyst enucleation, and tuboplasty) via a modified technique. InterventionTwo layers of Seprafilm with plastic covering were rolled together and delivered through a 10-mm trocar, and an irrigation tube was used to moisten the Seprafilm and cover the irregular postoperative rough surface of the organ. After application of Seprafilm, the patient was placed in a reverse Trendelenburg position to check whether the Seprafilm remained in situ on the target surgical surface to act as a physical barrier to adhesion development. Measurements and Main ResultsAfter changing the patient's position, illustrations and videos showed that the Seprafilm remained on the postoperative surgical surface, creating a site-specific physical barrier. On day 4 after myomectomy, second-look laparoscopy in 2 patients showed that the Seprafilm had become gel-like and remained between the intestine and posterior rough surface of the uterus. There were no systemic second-look laparoscopic data. ConclusionIt is feasible and easier to apply Seprafilm adhesion barrier laparoscopically using the modified technique. Further studies are warranted to prove its efficacy after such use.

The Recurrence Rate of Ovarian Dermoid Cysts in Pediatric and Adolescent Girls

Study ObjectiveTo assess the rate of recurrence of ovarian dermoid cysts in pediatric and adolescent girls at the Hospital for Sick Children. DesignA retrospective chart review of all dermoid cysts surgically managed at the hospital for Sick Children from January 2003 to June 2012. SettingThe Hospital for Sick Children, Toronto, Canada. Participants66 adolescent and pediatric patients <18 years old treated with ovarian cystectomy of their dermoid cysts by either laparoscopy (n = 40) or laparotomy (n = 26). Main Outcome MeasuresTotal dermoid cyst recurrence, recurrence after laparoscopy versus laparotomy, follow-up imaging completed and ultrasonographic identification of other ovarian cysts in follow-up. Data was assessed with Fisher exact test where appropriate (P < .05). ResultsThe mean age of patients at time of surgery was 12.9 years (range 2.5-18.1). 25/66 (38%) of patients received no follow-up, 6/66 (9%) were followed by a single ultrasonography and 35/66 (53%) were followed with annual ultrasonography for up to 5 years. 35 patients completed their initial ultrasonography where 19/35 (54%) patients had new ovarian cysts diagnosed including: 6 functional/hemorrhagic, 3 dermoid, and 10 unspecified cysts. All new dermoids were suspected at first follow-up ultrasonography (6/35), but 3 required a second follow-up ultrasonography for confirmation. Overall, 7/66 (11%) patients had recurrent or persistent dermoid cysts of which 2 (3%) required repeat surgery. There was no significant impact on the type of surgery and dermoid recurrence. ConclusionThe incidence of recurrent dermoid cysts in a pediatric and adolescent population following ovarian cystectomy is 10.6% where only 3% will recur and require further surgical management.

Plasminogen activators are involved in angiostatin generation in vivo in benign and malignant ovarian tumor cyst fluids

In many tumor types, angiogenesis is the net result of pro- and anti-angiogenic mediators and correlated with metabolic activity, growth, and degree of malignancy. One of the first discovered anti-angiogenic compounds is angiostatin, a proteolytic fragment of plasminogen. The requirements for in vivo angiostatin generation have not yet been determined. We investigated the levels of plasminogen and angiostatin by western blotting and of components of the plasminogen activator complex by ELISA in cyst fluid derived from benign and malignant ovarian tumors. Fluid samples from functional ovarian follicles, dermoid cysts and endometriotic lesions were evaluated separately. When no or minimal amounts of plasminogen were present in the cyst fluids, angiostatin was generally absent as well, irrespective of plasminogen activator concentrations. When plasminogen was present, the degree of conversion of plasminogen to angiostatin was significantly correlated with the level of uPA, and, to a lesser extent, to the tPA level. However, angiostatin was also found in a number of cyst fluid samples with minimal or no plasminogen activators, suggesting the involvement of other angiostatin generating proteases in these samples. Conversely, no angiostatin was observed in a number of cyst fluid samples containing both plasminogen and plasminogen activators. The presence of an inhibitor of the enzymatic activity of uPA and/or tPA, like PAI-1, may explain this finding. Our data show that plasminogen activators are clearly involved in in vivo angiostatin formation in ovarian cysts. Most likely, however, other proteases, as well as inhibitors of plasminogen activators, are involved as well.

Bilateral dermoid cyst of ovary

A dermoid cyst (also called as mature teratoma) is a sac-like growth that may be present at birth. It contains structures such as hair, fluid, teeth or skin glands that can be found on or in the skin. In some cases, especially when in the ovary, it also contains thyroid or brain tissue. Ovarian dermoid cysts, which not uncommonly are found in both ovaries, can develop in a woman during her reproductive years. The word teratoma is derived from Greek work teraton meaning monster. It was initially used by Virchow in 1863. The term dermoid cyst was coined by Leblanc in 1831.

Extragonadal omental teratoma: A case report

Mature cystic teratomas or dermoid cysts are among the most common ovarian tumors; however, teratomas of extragonadal origin are extremely rare. The most common extragonadal site of these teratomas is the omentum. It is generally accepted that teratomas arise from germ cells that originate in the mature gonads. Of the three proposed causes of omental teratoma, auto-amputation and subsequent re-implantation of gonadal teratoma is the most likely preceding event. A review of the published reports reveals that only 31 cases of teratoma of the greater omentum have been published to date and three cases reported wherein omental teratoma and dermoid of the ovary were coexisting. We report a rare case of an omental teratoma in a 26-year-old woman who underwent ovarian cystectomy for dermoid cyst. This is the fourth case of an omental mature teratoma with coexisting ovarian dermoid cyst.

Coexistence Of Squamous Cell CarcinomaWith Dermoid Cyst Of Ovary:A Case Report

Ovarian squamous cell carcinoma is a rare malignancy and the occurrence is attributable to malignant transformation of an existing ovarian dermoid cyst. The de novo occurrence of squamous cell carcinoma of the ovary, in the absence of an antecedent ovarian dermoid, is extremely rare. A 40- years- old female presented with pain and enlargement of abdomen since last 4 months. A mass was felt over right iliac fossa. Ultrasonography showed partly cystic and solid area in mass arising from ovary. A tooth- like structure was also seen. Dermoid cyst was the diagnosis offered. Laparotomy was performed. Ovarian mass with hair, a tooth and putty-like material was present. Solid white area with thickened wall was found. Histopathology confirmed the findings of dermoid cyst and the thickened area showed squamous cell carcinoma with areas showing keratinous and giant cell reaction which was also seen at the periphery of tumor areas. Left ovary was normal and no deposits of tumor were seen. Postoperative period was uneventful.

Ovarian dermoid cyst serendipitously detected by pelvic radioiodine-(131)I uptake and by diffusion weighted MRI in a post-thyroidectomy case of papillary thyroid carcinoma.

Ovarian dermoid cyst serendipitously detected by pelvic radioiodine-(131)I uptake and by diffusion weighted MRI in a post-thyroidectomy case of papillary thyroid carcinoma.

The Recurrence Rate of Ovarian Dermoid Cysts in Pediatric and Adolescent Girls

The Recurrence Rate of Ovarian Dermoid Cysts in Pediatric and Adolescent Girls

Increased levels of oxidative stress markers in the peritoneal fluid of women with endometriosis

ObjectiveTo evaluate 8-hydroxy-2-deoxyguanosine (8-OHdG) and 8-isoprostane levels in the peritoneal fluid (PF) of women with endometriosis. Study designOne hundred and ten women with laparoscopically and histopathologically confirmed endometriosis and, as reference groups, 119 patients with simple serous (n=78) and dermoid (n=41) ovarian cysts were studied. Peritoneal fluid 8-OHdG and 8-isoprostane concentrations were evaluated by enzyme-linked immunosorbent assays. Results8-OHdG and 8-isoprostane levels in peritoneal fluid were significantly higher in patients with endometriosis compared with the reference groups. Higher PF 8-OHdG and 8-isoprostane concentrations were observed in patients with advanced stages of endometriosis. A statistically significant positive correlation was found between 8-OHdG and 8-isoprostane levels in peritoneal fluid. ConclusionEndometriosis induces greater oxidative stress and frequent DNA mutations in peritoneal fluid than nonendometriotic ovarian cysts. The most severe oxidative stress occurs in the peritoneal cavity of women with more advanced stages of the disease.