Simple Ovarian Cysts Research Articles

A Five-Year Review of Ovarian Torsion Cases: Lessons Learnt.

The aim of the study was to analyse risk factors, surgical findings, ovarian salvage rate and histology of ovarian mass. We reviewed 81 cases of surgically proven ovarian torsion retrospectively from June 2014 to June 2019 at a tertiary care referral centre in South India. Demographic, clinical and surgical details of all patients were noted from the medical records. Mean age of the patients was 26years. Most of the patients were nulliparous and had a pre-existing ovarian mass of size > 5cm. Ovarian salvage rate was 43.2%. Concomitant cystectomy with detorsion was done in 30 patients without increase in blood loss or complications. Extensive necrosis was present in 78.2% of oophorectomy specimens. Most common histology of ovarian mass in cystectomy specimens was simple ovarian cyst.

Single-center experience with laparoscopic management of pediatric ovarian masses

To evaluate our single-center experience and results in management of children diagnosed with ovarian masses using minimal access surgery. Retrospective data review (2014–2016) of patients with adnexal disease was performed. Institutional ethical committee approval was obtained for this analysis. Twenty-one girls aged 9–18 years with 12 right, 7 left and 2 bilateral ovarian masses were analyzed. Of these 16 girls, 15 were operated laparoscopically based on clinical findings, ultrasound reports, computed tomography and/or magnetic resonance imaging, and tumor marker levels. There was a significant difference observed in the size of ovarian masses between operated versus non-operated group (87.1 vs. 31.8 mm; p < 0.05). The most common histological diagnosis was simple (functional) ovarian cyst, (n = 10, 66.7%). Except in two girls with dysgerminoma and immature teratoma, respectively, ovaries were preserved in all other that were operated. There was one conversion. There were two ovarian torsions, in both girls the ovaries could be preserved. Although our series is small, outcomes of minimal access surgery to pediatric ovarian masses are favorable as we carefully select patients based on international recommendations with pre-operative assessments and apply ovarian-preserving techniques whenever possible.

Histopathological study of ovarian lesions at a tertiary rural hospital

Background:Ovaries are the third leading site of cancer among women trailing behind cervical and breast cancer according to the Indian cancer registries. The spectrum of ovarian lesions is wide with harmless simple cystic lesions at one end and the fatal aggressive malignant lesions at the other end. Thus, ovarian neoplasm offers a good field for research. The present study is aimed to observe the frequency of neoplastic and non-neoplastic lesions in a tertiary care centre of rural India. Methods: This was a prospective two years observational study and was conducted at the Department of Pathology SRTR GMC, Ambajogai, including 185 ovarian lesions. Result: Total 185 ovarian lesions were studied, 101 cases were non-neoplastic while 84 cases were neoplastic. The most common non-neoplastic lesion was corpus luteal cyst (27.7%) followed by simple ovarian cyst (24.7%) and follicular cyst (21.8%). Among 84 neoplastic cases, 74 cases (88.1%) were benign,02 cases (2.4%) were borderline tumours and 08 cases (9.5%) were diagnosed malignant. Surface epithelial tumours contributed 75% cases, while germ cell tumours and sex-cord stromal tumourcontributed 20.8% and 4.8% respectively. Conclusions: Both non-neoplastic as well as neoplastic lesions of ovary often present with similar clinical and radiological features. So histopathological study is essential to diagnose ovarian tumours and predict their prognosis.

Survey of females at school age group between 10-15 years old to study the prevalence of ovarian cysts among them using pelvic ultrasound

Abstract Background Ovarian cyst is a common gynecological problem.The great majority of ovarian cysts are asymptomatic functional (physiological) cysts with simple appearance and small size. Ultrasonography (US) is the imaging modality of choice in the evaluation of cystic ovarian lesions in adolescent females. Aim of the Work To document ovarian cyst frequency and characteristics in females at school age group between 10-15 years old to study the prevalence and characteristics of ovarian cysts among them. Patient and Methods Our study was done on 52 girls aged between 10-15 years old presented and referred to our Radio-diagnosis department at Mataria teaching hospital from different outpatient clinics for pelvic US examination in a period of six months from May 2018 to November 2018. Results In our study the mean age 12.87±1.79, while age of start of menstruation (menarche) ranged from 10-14 with mean value 11.94±0.88. Regarding their menstrual pattern, girls with regular menstruation were (65.6 %) while those with irregular menstruation were (34.4%). Ovarian cystic lesions were founded in 9 girls (17.3%) while 43girls (82.7%) have normal ovaries. Simple ovarian cyst was the most frequent lesion which was seen in 8 girls(15.4%) followed by hemorrhagic cyst in one girl (1.9%). Conclusion Cystic lesions of the ovary are a common gynecological finding. They are very common and mostly benign during adolescence. Many ovarian cysts are asymptomatic and found incidentally on routine pelvic examination.

SONOGRAPHIC FINDINGS IN FEMALES OF REPRODUCTIVE AGE WITH ACUTE PELVIC PAIN

Background: Acute pelvic pain can result from the gynecological, urological systems and/or gastrointestinal. Ultrasound can be used as an initial imaging modality in the evaluation of acute pelvic pain. To determine sonographic findings in females of reproductive age coming with acute pelvic pain. Objective: To determine Sonographic findings in females of reproductive age with acute pelvic pain. Methodology: Toshiba Xario ultrasound machine with a standard gray scale and Doppler ultrasound convex probe of 3.5 MHz – 7.5 MHz or trans-vaginal probe of 5 MHz - 7.5MHz is used. Both transvaginal and trans-abdominal probes were used in this study. The study was conducted at Ultrasound University Clinic, Township, Lahore. Data of 163 patients was collected through convenient sampling. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Results: A total of 163 patients were examined in the study. The age incidence of the cases in this study varied between 15 years to 45 years. The mean age of the patients in the study was 29.8712 years. The uterine fibroid is most commonly involved in acute pelvic pain and is seen in 30.1% cases followed by simple ovarian cyst in 20.2% cases, hemorrhagic cyst in 14.1% cases. 8.6% cases with pelvic pain have no abnormal sonographic findings. Adenomyosis, PID and endometrial polyp in 4.3% each. Endometrial hyperplasia in 3.1%. Follicular cyst, simple adnexal cyst and complex adnexal cyst in 1.8% each, followed by ovarian endometrioma in 0.6% cases and dermoid cyst in 0.6%. In obstetric patients of acute pelvic pain; RPOCs are most common, constituting 1.8% of total acute pelvic pain, molar pregnancy in 1.2%, ectopic pregnancy in 0.6% patients, subchorionic bleed in 0.6% cases. Conclusion: Ultrasound is a very good modality for acute pelvic pain, as it can easily diagnose and characterize the causes of pelvic pain. The wide availability, radiation free and cost effectiveness makes it a first line investigation in acute pelvic pain. In the present study, the most common cause of pelvic pain is uterine fibroid. Key words: Ultrasound (US), Pelvic inflammatory disease (PID), acute pelvic pain, retained products of contraceptives (RPOCs), pouch of Douglas (POD). DOI: 10.7176/JHMN/71-14 Publication date: February 29 th 2020

Multiple Keratocyst Glimpses Falx Cerebri and Bifid Rib- A Case of Gorlin-Goltz Syndrome

Multiple Odontogenic keratocysts with multi-organ abnormalities are a feature of Gorlin-Goltz Syndrome (GGS) which is an autosomal dominant inherited disorder. The most common oral manifestation of GGS is odontogenic keratocyst. Early diagnosis of GGS without cutaneous manifestations is important as this syndrome has basal cell carcinoma as one of its major criteria. This paper includes a case report of a 24-year-old female who reported with swelling and pus discharge in lower right posterior region. The swelling was clinico-radiologically diagnosed as odontogenic keratocyst on a panoramic radiograph which revealed the presence of multiple cystic lesions in symphysis, parasymphysis, and bilateral maxillary region. Postero-Anterior (PA) chest showed bifid ribs and PA skull showed calcification of falxcerebri. Histopathological diagnosis confirmed the Odontogenic keratocyst. Ultrasonography (USG) abdomen revealed a simple ovarian cyst on the right side. Clinical examination findings and radiological imaging evaluation with histopathological examination of cystic lesion confirms Gorlin-Goltz. Surgical enucleation of the keratocyst, peripheral ostectomy followed by bone graft substitute, and primary closure under General Anaesthesia (GA) were done in the Department of Oral and Maxillofacial Surgery. Follow-up healing was uneventful after one month.

Identification of differentially expressed proteins associated with recurrence in ovarian endometriotic cysts

ABSTRACTThe objective of this study was to identify proteins that are differentially expressed in the cystic wall tissues of ovarian endometriotic cysts, simple ovarian cysts, and in normal ovarian tissues. Specimens of ovarian endometriotic cyst wall tissue, simple ovarian cyst wall tissue, and normal ovarian tissue (six specimens per group) were collected from patients who received gynecologic surgery, respectively. Differentially expressed proteins related to the ovarian endometriotic cysts were screened by use of isobaric tags for relative and absolute quantitation (iTRAQ) combined with functional annotation and bioinformatics analyses. All differentially expressed proteins related to cysts were validated using immunohistochemistry methods in recurrent and non-recurrent ovarian endometriotic cyst. A total of 359 proteins were identified as up-regulated in ovarian endometriotic cyst groups when compared with both the normal ovary and simple ovarian cyst groups. The levels of 27 proteins were >two-fold higher in the ovarian endometriotic cyst group than that in the other two groups. Of note, the five most significantly upregulated proteins were Charcot-Leyden Crystal Galectin (CLC), Defensin, alpha 1 (DEFA1), S100 calcium-binding protein A9 (S100A9), S100 calcium-binding protein A8 (S100A8), and Ferritin Light Chain (FTL). Immunohistochemistry results showed that the changes of S100A9 and S100A8 were consistent with the results shown by iTRAQ. However, no similarity of CLC, DEFA1, and FTL proteins was found between iTRAQ and immunohistochemistry. The ratio of patients with abnormally high S100A9 and S100A8 expression in the recurrent ovarian endometriotic cyst group was significantly higher than that in the non-recurrent group (P < 0.05). Our data identify differentially expressed proteins S100A9 and S100A8, and suggest they may serve as novel molecular markers to predict postoperative recurrence of an ovarian endometriotic cysts.Abbreviations: iTRAQ: isobaric tags for relative and absolute quantitation; HPRD: Human Protein Reference Database; GO: Gene Ontology; KEGG: Kyoto Encyclopedia of Genes and Genomes; EM: Endometriosis; COX-2: cyclooxyenase-2; NF-kB: nuclear factor kappa-B; PR-B: progesterone receptor type B.

Retrospective analysis of transvaginal ultrasound-guided aspiration of simple ovarian cysts.

The widespread availability of ultrasonography means that transvaginal ultrasonography has become a routine procedure during gynecological examinations, even in asymptomatic patients. Nowadays the imaging technology offered by ultrasonography and tumor biomarkers give us an opportunity to implement transvaginal ultrasound-guided aspiration as a less radical treatment of simple ovarian cysts (SOC). The aim of the study was a retrospective evaluation of the diagnostic and therapeutic efficacy of transvaginal ultrasound-guided aspiration of SOC in postmenopausal and premenopausal patients. A total of 84 women, divided into a premenopausal group (38/84) and a postmenopausal group (46/84), underwent transvaginal ultrasound-guided aspiration of small SOC (40-80 mm in diameter). Simple cysts were defined ultrasonographically according to the International Ovarian Tumor Analysis (IOTA) guidelines as cysts with negative risk of ovarian malignancy algorithm (ROMA) scores and CA125 levels. Simple ovarian cyst-related data was obtained from medical documentation (diagnostic tests, medical reproductive and surgical history, and clinical status during SOC aspiration). Follow-up data was collected by means of a telephone interview and medical database. The survey included questions focused on cyst recurrence during the 24-month period following the aspiration of SOC. We had 100% compatibility with ultrasound diagnosis and cytological examination of aspirated fluid. The cumulative rate of cyst recurrence among 84 patients was 20.2% (17/84). There was a higher percentage of cyst recurrence in the premenopausal group: 27% (10/38) vs 15.2% (7/46) in the postmenopausal group, but the difference was not statistically significant (hazard ratio (HR) = 1.89, 95% confidence interval (95% CI) = 0.72-4.97; p = 0.19). Recurrent cysts were treated with laparoscopic cystectomy, adnexectomy or a second aspiration in accordance with individual indications. Ultrasound-guided aspiration of small (<80 mm) adnexal SOC is a diagnostic and alternative therapeutic procedure, which allows cytological examination and may reduce the need for surgery, which is especially beneficial for women of reproductive age.

A Simple Method For Ovarian Approximation and Hemostasis Cystectomy following

Video Objective This video describes a simple method for ovarian approximation and hemostasis following cystectomy. Setting A 31 year old patient with 1 year history of LLQ pelvic pain, deep dyspareunia and nausea. She has had a simple left ovarian cyst that was managed conservatively for several years, but recently increased in size. Ultrasound showed a large cyst in the midline measuring 9.2 × 6.3 × 9.1 cm. Laparoscopy showed a large 10 cm left ovarian mass that is cystic with serous fluid. A laparoscopic cystectomy was performed. Interventions A laparoscopic cystectomy was performed with ovarian approximation and hemostasis with polysorb endoloops. Conclusion This video demonstrates a simple and efficient method for approximating the ovarian tissue after large cystectomy, that provides adequate hemostasis without excessive thermal damage to the ovarian tissue, as well as potentially minimizing the risk of postoperative adhesions.

Ovarian torsion of a term pregnancy – a new twist: review of the literature and management

Abstract Background Ovarian and adnexal torsions are gynecologic emergencies [Li Q, Li X, Zhang P. Ovarian torsion caused by hyperreactio luteinalis in the third trimester of pregnancy: a case report. Int J Clin Exp Med. 2015;8:19612–5; Ssi-Yan-Kai G, Rivain AL, Trichot C, Morcelet MC, Prevot S, Deffieux X. What every radiologist should know about adnexal torsion. Emerg Radiol. 2018;25:51–9; Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol. 2010;150:8–12]. Case presentation Though rare in pregnancy, this case report describes a 32-year-old G0 at 39 + 3/7 weeks with a history of kidney stones and a simple ovarian cyst that presented to the labor floor with left lower quadrant pain. She underwent an induction of labor for persistent pain and had a subsequent primary section for a category II tracing. Conclusion During the section, a torsion x3 of the left infundibular ligament was noted. The pathology indicated an acute infarct – only one other case of a full-term torsion was found in the literature (Li Q, Li X, Zhang P. Ovarian torsion caused by hyperreactio luteinalis in the third trimester of pregnancy: a case report. Int J Clin Exp Med. 2015;8:19612–5).

Clinico-pathological features of gynecological myopericytoma: a challenging diagnosis in an exceptional location.

Myopericytomas (MPC) are rare mesenchymal tumors, originating from the perivascular myoid cells. They predominantly occur in the skin and superficial soft tissues of the extremities, while visceral involvement is rare. Histological features and clinical course are usually benign. To the best of our knowledge, MPC is still an uncharacterized tumor entity of the female internal genital tract. We describe three MPC cases involving the female internal genital tract: (1) a uterine wall MPC arising in a 49-year-old woman with progressive pelvic/abdominal pain; (2) a cervix MPC of a 49-year-old woman who presented with metrorrhagia, and (3) a MPC presenting as a simple ovarian cyst in a 26-year-old woman with pain located in the left iliac fossa. All patients were surgically treated, and recurrence occurred in two cases. The histological and immunohistochemical findings, supporting the diagnosis of MPC, are presented; in particular, one case showed characteristics pointing towards an uncertain biological behavior/low-grade malignancy. A literature search was conducted to identify previous reports of gynecological MPC and for possible alternative diagnoses. Leiomyoma, epithelioid leiomyoma, angioleiomyoma, perivascular epithelioid cell tumor, solitary fibrous tumor, and low-grade endometrial stromal sarcoma should be considered in the differential diagnosis. Awareness of possible occurrence of this rare neoplasm in the female genital tract is important to reach a correct diagnosis in the spectrum of mesenchymal tumors. Considering the risk of recurrence, we recommend careful evaluation of surgical margins and complete surgical removal whenever possible.

Ovarian Cysts in Menopausal Women (Literature Review)

Introduction. The incidence of ovarian cyst amounts to 5–17 % in postmenopausal women. Currently monitoring of or screening for ovarian cysts in menopausal patients is not regimented in the Russian Federation at all. This situation warrants a review.Materials and methods. In this paper the authors review retrospective and prospective studies concerning outcomes in patients with ovarian cysts in menopause published in the last 5 years. Results. The retrospective and prospective studies analysed show that the risk of malignancy of this type of benign neoplasm is low, on average 0.7%. The results of a large prospective study prove that there is no need for surgical treatment in 80% of patients.Discussion. There is now doubt that patients with this disorder should be followed up in accordance with an algorithm that clearly defines the criteria for surgical treatment and the follow up length. Surgical treatment should be indicated when there is at least one of the signs of an ovarian cyst: symptomatic, texture not smooth, over 50 mm in diameter, multilocular, bilateral. A positive CA-125 in combination with ultrasound, MRI and CT imaging make it possible to calculate the risk index with the use of a particular formula and determine the indications for a risk-reducing bilateral salpingo-oophorectomy. The follow up of BRCA1/2 mutation-free patients with a benign ovarian neoplasm should include a close step-by-step monitoring and all the necessary examinations performed in a timely manner.Conclusion. The risk of a malignant transformation of an ovarian cyst in menopause is rather low (about 0.7%); following up patients with simple ovarian cysts in menopause is possible and should be carried out in strict compliance with the algorithm; the preventive bilateral salpingo-oophorectomy in patients presenting no signs of ovarian pathology is indicated only for the high risk group (BRCA1/2 mutations confirmed or there is family history).

A retrospective study of surgical treatment and outcome among women with adnexal torsion in eastern Taiwan from 2010 to 2015.

BackgroundAdnexal torsion is a gynecologic emergency that requires surgical treatment. In this study, we reviewed the surgical outcomes of women with adnexal torsion in eastern Taiwan (Hualien county, area 4,629 km2, 330,000 residents).MethodsThis retrospective study included 42 women diagnosed with surgically-proven adnexal torsion from January 1, 2010, to September 31, 2015. We compared the symptoms, objective findings, and surgical outcomes of patients who underwent laparotomy or laparoscopy.ResultsThe laparoscopy and laparotomy groups included 27 and 15 patients, respectively. The most common symptom and sign was abdominal pain, followed by nausea and vomiting. In all patients, an adnexal tumor was detected through ultrasound. The median and range of time from admission to surgery was 1.5 (1–11.5) and 1.0 (1–11) hours in the laparotomy and laparoscopy groups, respectively. Compared with those undergoing laparotomy, the smaller tumor size [7 (4.2–10) vs. 10 (7–17) cm] and shorter hospital stay [4 (2–8) vs. 6 (3–9) days] in patients undergoing laparoscopy were significantly noted, respectively (P < 0.01). No differences were observed in age, operative time, and blood loss between both groups. The surgeries performed were mostly detorsion with cystectomy and adnexectomy. The most common pathology was a simple ovarian cyst, followed by teratoma. Regarding the surgical types, older age is the only risk factor for radical surgery.DiscussionAcute onset of abdominal pain with a presenting ovarian tumor is the most common feature of adnexal torsion. Laparoscopic surgical group showed a small tumor size and a short ER hospital stay than laparotomy. Older age is the risk factor for radical surgery.

PECULIARITIES OF SURGICAL TREATMENT OF OVARIAN CYSTS IN NEWBORNS

The aim of the work is to improve the results of the surgical treatment of congenital ovarian cysts in newborns. Material and methods. From 1982 to 2017, 147 newborns with simple ovarian cysts were treated at the clinic. The main diagnostic method was clinical - ultrasound. Two groups of patients were compared: with access according to Pfannenstiel incision and paraumbilical access. The technology of surgical intervention with paraumbilical access is described in detail. Results. In comparative studies, the benefits of parumbilical access are fully in line with the requirements of modern “open” pediatric surgery for the removal of ovarian cysts (OC) in newborns. There was noted a unique feature of the torsion of simple congenital OK: the emerging ischemia of the cysts leads only to the development of aseptic necrosis without purulent-inflammatory changes in the cyst itself and the adhesive process around. Conclusion. Para-umbilical access during surgical removal of OC may be an alternative to laparoscopic when the latter can not be used. Bearing in mind the torsion of most simple OC to occur in the antenatal period, as well as the asymptomatic course of the disease in the neonatal period, we consider it necessary to operate children with this pathology in the first 2 days after birth.

The effects of sclerotherapy with 5% trichloroacetic acid on the cyst diameter and ovarian tissue in the rat ovarian cyst model

The aim of this study was to compare the effects of only aspiration with aspiration and 5% trichloroacetic acid (TCA) application on ovarian cyst size and ovarian reserve. The ovarian cysts of 14 rats that were divided into two groups randomly were investigated after total salpingectomy procedure. G1 was the group of saline application after cyst aspiration, while in G2, after aspiration 5% TCA at half amount of aspiration volume was injected into the cyst and re-aspirated after five minutes. The abdomens of the rats were closed and re-explored after 1 month. The cyst diameters of the rats in each group were measured. Ovaries were removed for histopathological examination. There was no significant difference in cyst diameter in G1 before and after aspiration. In G2, there was a significant decrease in cyst size after TCA application. Ovarian follicle counts were not significantly different between the two groups. In conclusion, application of 5% TCA to the ovarian cysts for five minutes significantly reduces the cyst size.Impact StatementWhat is already known on this subject: Minimally invasive therapies come into prominence to avoid surgical complications and diminished fertility in the treatment of ovarian cysts. USG-guided aspiration and sclerosis has been reported as cost-efficient and effective treatment methods for localised benign cysts in other organs such as the thyroid, parathyroid, liver, kidney and spleen. It has been shown that sclerotherapy applied to infertile women with ovarian cysts reduces pelvic pain without affecting the number of follicles, term pregnancy and abortion rates, extracted oocytes, embryo quality or hormonal levels when compared to non-ovarian cystic infertile women. TCA is a chemical agent that is topically applied, not systemically absorptive, which causes denaturation of proteins and structural cell death, resulting in coagulation necrosis after chemical cauterisation. For this reason, we used 5% TCA to treat simple ovarian cysts on a rat model.What the results of this study add: In this experimental study, we showed that the application of 5% TCA into the cyst for five minutes – then aspirated – significantly reduced the size of the ovarian cysts. Five percent TCA application did not affect the ovarian reserve.What the implications are of these findings for clinical practice and/or further research: Our study is original because of the fact that to the best of our knowledge, this is the first study about the use of 5% TCA in treatment of ovarian cysts in the literature.

Evaluation of Patients Having Ovarian Cysts, Reporting in One Year: An Observational Study

Background: : Since the natural history of simple ovarian cysts is not completely understood, the proper treatment of incidental simple cysts amongst the postmenopausal women has always been uncertain. The aim of the present study was to evaluate the subjects reporting to the hospital with ovarian cysts. Materials & Methods: The present study was conducted in the prospective manner in the department of Obstetrics& Gynecology, Zanana Hospital, R.B.M. Hospital, Bharatpur, and Rajasthan. Subjects younger than 55 years of age with any other co morbidities were excluded from the study. A predesigned and pre-tested questionnaire was given to all the subjects. Their frequency of visit to the gynecologist was also obtained. All the data was arranged in a tabulated form and analyzed using SPSS software. Results: The study enrolled 160 females with the mean age of 66.53+/- 5.22 years. There were 36.9 %(n=59) subjects between 55-60 years of age. There were 30 %(n=48) subjects between 61-66 years of age. About 90% (n=144) had no such history. History was not known to 1.9% subjects. There were majority of subjects (60%) who had never smoked. Conclusion: In our study, there were majority of subjects between 55-60 years of age. The various aggressive surgical approaches for management of simple cyst have paved a way towards careful monitoring.

Causes and Management of Ovarian Cysts

An ovarian cyst is a sac filled with liquid or semiliquid material that arises in an ovary. While the discovery of an ovarian cyst causes considerable anxiety in women owing to fears of malignancy, the vast majority of these lesions are benign. Most patients with ovarian cysts are asymptomatic, with the cysts being discovered incidentally during ultrasonography or routine pelvic examination. Some cysts, however, may be associated with a range of symptoms, sometimes severe. Many patients with simple ovarian cysts found through ultrasonographic examination do not necessitate treatment. In a postmenopausal patient, a persistent simple cyst smaller than 10 cm in dimension in the presence of a normal CA125 value may be monitored with serial ultrasonographic examinations. When ovarian cysts are large, persistent, painful or have concerning radiographic or exam findings, surgery may be required, sometimes resulting in removal of the ovary. We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane database of systematic reviews and Cochrane central register of controlled trials from January 1, 1995, through January 1, 2017.

Ovarian lesions among pediatric patients: A tertiary center experience (1997-2016).

IntroductionOvarian lesions are not commonly seen in pediatric females; however, there are some reported cases among different pediatric age groups. Ovarian lesions can show, clinically, in many diverse presentations, and the treatment chosen may be conservative or surgical, accordingly. In this study, we aim to find ovarian lesions commonly operated on and their histopathological and clinical characteristics among pediatric patients at tertiary center in Riyadh, Saudi Arabia.Material and methodsA retrospective review of medical records of all pediatric patients (aged 14 or younger) who underwent surgical removal of ovarian lesions from January 1997 to August 2016 at King Abdulaziz Medical City, Riyadh, Saudi Arabia was conducted.ResultsRecords for a total of 14 girls with a mean age of 5.7 ± 5.1 years were reviewed. The most common clinical presentation was acute abdominal pain (n = 5, 35.7%). There were four patients without any complaints who were diagnosed incidentally (28.6%). More than half of the patients underwent laparoscopy (n = 8, 57.1%) and cystectomy procedures were performed on 50% of the patients (n = 7). Simple ovarian cysts (n = 5) were the most common ovarian lesions followed by mature cystic teratomas (n = 3) with 35.7% and 21.4%, respectively. Furthermore, simple ovarian cysts were more common among infants. There was only one death reported and she had been diagnosed with a mixed germ cell tumor.ConclusionThe majority of ovarian lesions in the studied pediatric patients were benign. The most common lesions were simple ovarian cysts. Abdominal pain was the most common presenting symptom.

Analysis of the ectoenzymes ADA, ALP, ENPP1, and ENPP3, in the contents of ovarian endometriomas as candidate biomarkers of endometriosis.

The diagnosis of endometriosis, a prevalent chronic disease with a strong inflammatory component, is usually delayed due to the lack of noninvasive diagnostic tests. Purinergic signaling, a key cell pathway, is altered in many inflammatory disorders. The aim of the present work was to evaluate the levels of adenosine deaminase (ADA), alkaline phosphatase (ALP), ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), and ENPP3, elements of purinergic signaling, as biomarker candidates for endometriosis. A case-control comparative study was conducted to determine ADA, ALP, ENPP1 and ENPP3 levels in echo-guided aspirated fluids of endometriomas (case group) and simple ovarian cysts (control group) using the ELISA technique. Adenosine deaminase, ALP, ENPP1, and ENPP3 were present and quantifiable in the contents of endometriomas and simple cysts. There were significant differences in ADA and ENPP1 levels in endometriomas in comparison with simple cysts (2787U/L and 103.9ng/mL more in endometriomas, for ADA and ENPP1, respectively). Comparisons of ALP and ENPP3 levels between the two groups did not reveal significant differences. The ectoenzymes ADA and ENPP1 are biomarker candidates for endometriosis.

Study the effect of a single dose long acting progesterone in prevention of post hysterectomy functional ovarian cysts

Background: Approximately 600,000 hysterectomies are performed annually in the United States, and more than one-third of women have had a hysterectomy by age 60 years. The most common diagnoses among women undergoing hysterectomy are uterine leiomyomata, adenomyosis, uterine prolapse and cancer or hyperplasia.Functional cysts may be single or multiple, may be bilateral and vary in size but generally do not exceed 5.0 cm in diameter. They are the result of failure of absorption of the fluid in an incompletely developed follicle or anovulation. They are usually asymptomatic unless hemorrhage, rupture or torsion supervenes, in which case symptoms and signs of acute abdomen develop. A progestogen-only injectable contraceptive is a long-acting, reversible contraceptive. A synthetic progesterone, or progestogen, is slowly released into the systemic circulation following intramuscular (IM) or subcutaneous (SC) injection. Methods: The study included 68 cases who were subjected to open hysterectomy without oophorectomy for benign gynecologic conditions, cases are randomly selected and divided into 2 groups. Group A: 34 cases received a single dose of 150 mg intramuscular depot medroxyprogesterone acetate as Depoprovera® within 7 to 10 days postoperative and Group B: 34 cases did not receive any medications. A post operative follow up was done every one month for six months postoperative to exclude the development of ovarian cyst by transvaginal and trans-abdominal ultrasound examination. Result: the statistical analysis of the collected data showed a statistical significance regarding the development of ovarian cysts in the control group. Conclusion: Single dose long acting progesterone after hysterectomy without oophorectomy is beneficial in prevention of development of simple functional ovarian cysts in women with hormonally active ovaries.