Presentation of case A 54-year-old postmenopausal woman presented with a 2-week history of metrorrhagia and a large pelvic mass associated with dull lower abdominal pain. [ncbi.nlm.nih.gov]

• Pain

  On each occasion, the patient complained of intermittent abdominal pain. On physical examination there was no rebound tenderness and no palpable mass. No signs of precocious puberty were observed. At 15 years of age, the pain became intense. [fortunejournals.com]

  In these cases symptoms may include: Abdominal pain Trouble urinating or frequent urination Low back pain Pain with sexual intercourse Bad cramps with a woman’s periods Feeling full quickly after eating, or no appetite Nausea or vomiting. [cancer.coloradowomenshealth.com]

  Instead, the goal is to treat any symptoms and manage pain. For example, many women with ovarian cysts experience more significant pain during their periods, so home ovarian cyst treatment often focuses on managing period pain. [medicalnewstoday.com]

  Approximately 90% of women with pain associated with endometriosis will experience relief of their chronic pelvic pain. After definitive surgery, consider adjuvant therapy. [emedicine.medscape.com]

  If a cyst does cause symptoms, you may have pressure, bloating, swelling, or pain in the lower abdomen on the side of the cyst. This pain may be sharp or dull and may come and go. If a cyst ruptures, it can cause sudden, severe pain. [womenshealth.gov]

• Ascites

  The authors also summarized other cases of Meigs' syndrome with elevated CA 125, and reviewed the mechanism of elevation of CA 125, ascites, and pleural effusion. [ncbi.nlm.nih.gov]

  This is of interest because this benign tumor presented with ascites and elevated CA 125 level. [archivesofpathology.org]

  A moderate amount of ascites was also noticed around the liver, spleen, and lower quadrants. [hindawi.com]

  Proposed mechanisms for the ascites in Meigs syndrome are production of ascitic fluid by the tumor; lymphatic obstruction; hormonal stimulation; release of inflammatory mediators; and tumor torsion. [jpatholtm.org]

  Abdominal examination may reveal a tumour arising from the pelvis but this may be obscured by ascites. The features of ascites include a fullness of the flanks and shifting dullness. Pelvic examination may reveal an ovarian mass. [patient.info]

• Swelling

  They vary in size and may occur at different sites in the ovary; the most common type develops when an egg-producing follicle does not rupture and release the egg but instead swells with fluid and forms a follicular cyst. [hopkinsmedicine.org]

  If this happens, the follicle can get bigger as it swells with fluid. The fluid-filled follicle becomes a follicular ovarian cyst. Usually, only one cyst appears at a time and it will often disappear without treatment after a few weeks. [hse.ie]

  The third event – February 2017 She presented to the emergency department after 2 years with severe right lower limb swelling that involved the whole limb accompanied with right lower quadrant abdominal and right flank pain. [dovepress.com]

  Your doctor may do a pelvic exam to feel for swelling of a cyst on your ovary. If a cyst is found, your doctor will either watch and wait or order tests to help plan treatment. Tests include: Ultrasound. [womenshealth.gov]

  In some cases, some or all of the following symptoms may be experienced: Pressure, swelling or pain in the abdomen or pelvic area Dull ache in the lower back and thighs Pain during your period or during sex Breast tenderness Abnormal bleeding Weight gain [summahealth.org]

• Pathologist

  Volk, MD William Beaumont Hospital Troy, MI College of American Pathologists 2004. More information Cytopathology Case Presentation #8 Cytopathology Case Presentation #8 Emily E. Volk, MD William Beaumont Hospital, Troy, MI Jonathan H. [docplayer.net]

  Etiology Thecoma-fibroma tumors are a closely related group of benign tumors that arise from ovarian stroma and are often difficult for the imager and even pathologist to distinguish. [clinicalgate.com]

  The pathology has been reviewed by expert pathologists, and the diagnosis of benign fibrothecomas has been confirmed. Fibrosarcomas are very rare ovarian sarcomas. [dovepress.com]

  Fresh specimens were sent for intra-operative examination separated by five minutes, and one senior pathologist with more than five years' experience reported on them within 30 minutes. Another pathologist reported on the paraffin sections. [jcancer.org]

  However, the presence of certain histological criteria can help pathologists to differentiate between the two tumors. [hindawi.com]

• Surgical Procedure

  Laparoscopy This minimally invasive surgical procedure allows your doctor to see and remove the cyst by making a small incision in the abdomen rather than a long cut. [hopkinsmedicine.org]

  This is a surgical procedure using a thin, light-tipped device inserted into the abdomen. During this surgery, cysts or tumors can be detected and a small piece of tissue can be removed (biopsy) to test for cancer. Blood test. [summahealth.org]

  Selecting the appropriate surgical procedure is essential to preserve future fertility. [fortunejournals.com]

  Laparoscopy: A surgical procedure in which an instrument called a laparoscope is inserted into the pelvic cavity through a small incision. The laparoscope is used to view the pelvic organs. Other instruments can be used with it to perform surgery. [m.acog.org]

  Correct diagnosis of these benign tumours can greatly affect the patient's management, especially avoiding unnecessary invasive surgical procedures. [birpublications.org]

• Pleural Effusion

  After the surgery, the pleural effusion disappeared spontaneously and the CA 125 became normal. [ncbi.nlm.nih.gov]

  Atypical Meigs' syndrome consists of a benign pelvic mass with a right-sided pleural effusion but no ascites present. This is rare. The pleural effusion resolves after resection of the tumour. [patient.info]

  Origin of pleural effusion The etiology of pleural effusion is unclear. Efskind and Terada et al theorize that ascitic fluid is transferred via transdiaphragmatic lymphatic channels. [emedicine.medscape.com]

  Associations They are associated with ascites in 40% of cases and with pleural effusions in a small percentage of cases. [radiopaedia.org]

  Pleural effusion is thought to be caused by the migration of fluid and protein—perhaps by lymphatic channels— across the diaphragm [ 6 ]. [jpatholtm.org]

• Pelvic Mass

  Although rare, ovarian fibrothecoma should be considered in patients presenting with a large pelvic mass and postmenopausal bleeding. [ncbi.nlm.nih.gov]

• Abdominal Pain

  Case Report An eight-year-old female presented with abdominal pain and fever. Ultrasound revealed a ruptured appendix. Emergency appendectomy was successful. [fortunejournals.com]

  We report a case of ovarian torsion in a 47-year-old postmenopausal woman who came to the emergency department with acute abdominal pain. [doczz.biz.tr]

  The clinical presentation of ovarian fibrothecoma is relatively nonspecific such as pelvic and abdominal pain or distension; however, ovarian fibromas may be accompanied by two associations. [semanticscholar.org]

  Patients may be asymptomatic or may present with pelvic/abdominal pain and/or distension and, occasionally, with post-menopausal bleeding. Large tumors (>10cm) are often associated with pleural effusion and ascites (the Meigs syndrome triad). [orpha.net]

• Abdominal Distension

  Case Report: A case of ovarian fibrothecoma in a postmenopausal woman who presented with complains of something coming out of vagina (uterine prolapse), abnormal uterine bleeding and abdominal distension for 6 months. CA 125 levels were also raised. [jmscr.igmpublication.org]

  Fibrothecoma with abdominal distension and raised CA125 must be differentiated from the edema of the ovary, ovarian myxoma and sclerosing stromal tumor. [ispub.com]

  Case report A 15 years old young unmarried girl suffering from abdominal distension and lower abdominal pain of short duration, approximately one month. [orion-group.net]

  She did not experience any scalp hair loss, acne, voice change, galactorrhea, abdominal pain, abdominal distension, symptoms of raised intra-cranial tension and change in appetite or weight. There was no history of diabetes or hypothyroidism. [ijem.in]

  […] and abdominal distension was noticed in both dysgerminoma and mature teratoma patients. [journals.lww.com]

• Stroke

  J Stroke Cerebrovasc Dis. 24(2):431-9, 2015. Noguchi T, Kawashima M, Nishihara M, Egashira Y, Azama S, Irie H. Noninvasive method for mapping CVR in moyamoya disease using ASL-MRI. Eur J Radiol. 84(6):1137-43, 2015. [hosp.ncgm.go.jp]

• Adnexal Mass

  The presence of interface vessels between the uterus and the adnexal mass can help differentiate a uterine leiomyoma from an ovarian fibromous tumor. The images above show a hypoechoic right adnexal mass. [roentgenrayreader.blogspot.com]

  Adnexal masses in children, adolescents and women of reproductive age. Adnexal Masses in Children, Adolescents, Women of Reproductive, Age. Part 3 2018;Enschede: Ipskamp Printing, 7–92. [2]. Hermans AJ, Kluivers KB, Janssen LM, et al. [journals.lww.com]

  Several ovarian and/or adnexal masses have specific ultrasound features. [appliedradiology.com]

  There is a left sided adnexal mass - lobulated, well circumscribed and encapsulated with heterogenous structure. Signs of internal fibrosis, small cystic changes and peripheral hemorrhage. No signs of intratumoral fat. [radiopaedia.org]

  Solid Adnexal Masses When a solid adnexal mass is detected sonographically, a pedunculated leiomyoma must be excluded 24. Color Doppler can be utilized in an attempt to find the stalk between the uterus and the adnexal mass. [iame.com]

• Vaginal Bleeding

  PMB is vaginal bleeding that occurs at least 12 months after your periods have stopped. [e-jmm.org]

  The thecoma component of a fibrothecoma can secrete estrogen, and the patient may present with abnormal vaginal bleeding and endometrial hyperplasia. [radiopaedia.org]

  Irregular vaginal bleeding Dyspareunia Urinary symptoms Palpable adnexal mass Pre-menopausal: 5% risk of malignancy Post-menopausal: 30-60% risk of malignancy Paraneoplastic presentation (rare): Leser-Trelat Sign – Sudden multiple seborrheic keratoses [en.wikibooks.org]

  Generally, pelvic pain or distention and irregular vaginal bleeding are the main patient symptoms (3,5,7). Estrogenic effects, such as endometrial hyperplasia, endometrial cancer and postmenopausal bleeding, commonly accompany fibrothecomas. [spandidos-publications.com]

• Irregular Menstruation

  They occur in about 50 percent of women with irregular menstruation and in about 30 percent of women with regular menstruation. [cancer.coloradowomenshealth.com]

  Amenorrhoea or irregular menstruation. Examination Reduction in lung capacity may produce tachypnoea and tachycardia. Examination of the chest will reveal dullness to percussion over the effusion. [patient.info]

  Clinically, most patients present amenorrhea, irregular menstruation or atypical postmenopausal vaginal bleeding. [e-jmm.org]

  The frequencies of the individual patient's symptoms at presentation were as follows: routine screen (9/26, 34.6%), post-menopausal bleeding (7/26, 26.9%), acute abdominal pain (4/26, 15.4%), abdominal distention (2/26, 7.7%), irregular menstruation [birpublications.org]

• Enlarged Uterus

  […] ago 00:08:57 RETAINED PRODUCT OF CONCEPTION 16 days ago 00:15:37 SUBTOTAL HYSTERECTOMY:FULL PROCEDURE-DR LAILA CHOUHOU 17 days ago 00:12:30 simple laparoscopic myomectomy, dr laila chouhou, morocco 19 days ago 00:24:16 LAPAROSCOPIC HYSTERECTOMY FOR ENLARGED [viveos.net]

• Mass of Ovary

  AJR 198:296-303 (PMID: 22358029) [5] Saksouk FA, Johnson SC (2004) Recognition of ovaries and ovarian origin of pelvic masses. [eurorad.org]

[…] to CT Classic TVU finding is a “complex” cyst, defined as containing both solid and cystic components "Simple" cyst, defined as having thin walls, fluid-filled, without a mass component, septations, or internal echogenicity is frequently benign but workup [en.wikibooks.org]

The initial laboratory workup revealed anemia (hemoglobin was 10.4 g/dl). Cancer antigen 125 (CA-125) was measured 64.37 IU/ml (normal range <35 IU/ml). Grey scale transvaginal ultrasonography scan showed a solid mass arising from the left ovary. [doczz.biz.tr]

Case Report An 80-year-old woman with abdominal distention was admitted to our hospital for a workup for her abdominal masses, which had been detected on MRI. She had no history of malignancy. [casereports.in]

[…] used to determine the extent of its spread (which is a form of tumor staging).[16] Risk scoring[edit] A widely recognized method of estimating the risk of malignant ovarian cancer is the risk of malignancy index (RMI), calculated based on an initial workup [en.wikipedia.org]

• Ovarian Mass

  We report a rare case of ovarian fibrothecoma with massive edema. The patient was a 59-year-old woman with a left ovarian mass measuring 11 x 10 x 7 cm. [ncbi.nlm.nih.gov]

  Differentiation from uterine leiomyomata can be made by noting that ovarian masses are usually supplied by ovarian arteries or by the ovarian branches of the uterine arteries that course along the fallopian tubes. [roentgenrayreader.blogspot.com]

  MR findings of ovarian fibromatosis. Bilateral ovarian masses are seen on T2-weighted coronal image (A). [dokumen.tips]

  An ovarian mass in a premenopausal girl or a post-menopausal woman is abnormal. In the reproductive age group, an ovarian mass may be malignant, but it is more likely benign. [iame.com]

• Pleural Effusion

  After the surgery, the pleural effusion disappeared spontaneously and the CA 125 became normal. [ncbi.nlm.nih.gov]

  Atypical Meigs' syndrome consists of a benign pelvic mass with a right-sided pleural effusion but no ascites present. This is rare. The pleural effusion resolves after resection of the tumour. [patient.info]

  Origin of pleural effusion The etiology of pleural effusion is unclear. Efskind and Terada et al theorize that ascitic fluid is transferred via transdiaphragmatic lymphatic channels. [emedicine.medscape.com]

  Associations They are associated with ascites in 40% of cases and with pleural effusions in a small percentage of cases. [radiopaedia.org]

  Pleural effusion is thought to be caused by the migration of fluid and protein—perhaps by lymphatic channels— across the diaphragm [ 6 ]. [jpatholtm.org]

Since the surgery remains the primary treatment for ovarian carcinoma, there are only a few reports describing the effects of radiation and chemotherapy treatment on histology of ovarian tumors (2,3,6,7). [jcancer.org]

Ovarian tumor removal and treatment In some cases, benign tumors need no treatment; doctors may simply use “watchful waiting” to make sure they cause no problems. [cancer.coloradowomenshealth.com]

Treatment Generally, no treatment is required, and many of these cysts resolve spontaneously within 6-12 weeks. [emedicine.medscape.com]

Treatment of polycystic ovaries includes: hormone therapy with progestins oral contraceptives infertility treatments for women who want to get pregnant [cancer.ca]

Even when they persist, treatment is safe and reliable and can prevent the cysts from causing serious harm. Home treatment for ovarian cysts will not make the cysts go away but can ease any pain or discomfort. [medicalnewstoday.com]

Does it carry a good or poor prognosis? Her2/neu oncogene- poor prognosis *****T/F: The BRCA-1 & 2 mutation only increases risk of developing breast cancer; the chance of developing ovarian cancer is rare. FALSE! [quizlet.com]

Radical surgical excision is the preferred treatment for postmenopausal women and is associated with a good prognosis. Conflict of interest statement The authors declare no conflicts of interest. [ncbi.nlm.nih.gov]

In this case this etiology was unlikely because of low estradiol and AMH levels. Surgical exploration revealed a 10 cm mass of the left ovary proven histologically to be an ovarian fibrothecoma (OFT). [ncbi.nlm.nih.gov]

Multiple Fibrothecomas of Bilateral Ovaries: An Unusual yet Important Etiology of Multiple T2-Shortening Adnexal Lesions on MRI ventolin over the counter usa ventolin over the counter uk Takaaki Nakashima1, Tsuyoshi Tajima1, Tomoyuki Noguchi1, Toshifumi [casereports.in]

Etiology Thecoma-fibroma tumors are a closely related group of benign tumors that arise from ovarian stroma and are often difficult for the imager and even pathologist to distinguish. [clinicalgate.com]

Origin of pleural effusion The etiology of pleural effusion is unclear. Efskind and Terada et al theorize that ascitic fluid is transferred via transdiaphragmatic lymphatic channels. [emedicine.medscape.com]

Epidemiology [ 2, 3 ] Meigs' syndrome is rare. Fibromas account for around 3% of all ovarian tumours, and Meigs' syndrome for 1-2% of those. [patient.info]

Jump to navigation Jump to search Ovarian Cancer Overview Epidemiology [ edit ] Median age 60's, peak incidence 80's 22K cases per year in US; 4th most common cancer in women 14K deaths per year in US; 5th most common cause of cancer death in women Risk [en.wikibooks.org]

Epidemiology studies have shown a correlation between increased risk of ovarian epithelial tumours with increased number of ovulation cycles. [atlasgeneticsoncology.org]

[…] differentiate benign fibroma from diffuse adult type granulosa cell tumor, a potential mimic ICD coding D27.9: Ovarian fibroma D27.1: Ovarian fibroma, left D27.0: Ovarian fibroma, right D27.9, R18.8, J90: Ovarian fibroma with ascites and pleural effusion Epidemiology [pathologyoutlines.com]

In: Pharmacotherapy: A pathophysiologic approach.8th ed. Dipiro JT, Talbert RL, Yee GC et al., New York: McGraw-Hill; 2008: 2361-75. [en.wikipedia.org]

Pseudo-pseudo Meigs syndrome includes patients with systemic lupus erythematosus and enlarged ovaries. [5] Pathophysiology Ascites is present in 10-15% of cases, and hydrothorax is found in only 1% of cases. [6, 7] Etiology of ascitic fluid The pathophysiology [emedicine.medscape.com]

[…] category Cellular fibromas represent ~10% of all fibromas Occur in patients 20 - 80 years, with an average age of ~50 Often discovered incidentally Conventional fibromas are bilateral in 5 - 10% of cases, whereas cellular fibromas are invariably unilateral Pathophysiology [pathologyoutlines.com]

View Article : Google Scholar : PubMed/NCBI 7 Ferenczy A: Pathophysiology of adenomyosis. Hum Reprod Update. 4:312–322. 1998. [spandidos-publications.com]

[…] cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. [nccn.org]

It may prevent the development of further cysts and help combat insulin resistance. 4. Heat Heat increases blood flow, helping to reduce pain. [medicalnewstoday.com]

Colombo, on behalf of the ESMO Guidelines Committee These updated guidelines on non-epithelial ovarian cancer cover prevention, diagnosis, treatment and follow-up for early and advanced stages and recurrences of germ cell tumours, sex cord-stromal tumours [esmo.org]

Can I prevent ovarian cysts? No, you cannot prevent functional ovarian cysts if you are ovulating. If you get ovarian cysts often, your doctor may prescribe hormonal birth control to stop you from ovulating. [womenshealth.gov]

Conclusion: The accurate preoperative diagnosis of ovarian fibrothecoma with cystic changes could have prevented the extensive surgical intervention such as bilateral salpingo- oopherectomy with hysterectomy. [thieme-connect.com]