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Ovarian Cystic Teratoma


Presentation

  • CASE: A 9-year-old girl presented with acute onset of abdominal pain. Under a radiological diagnosis of cystic ovarian teratoma, she underwent laparoscopic cystectomy, preserving as much ovarian tissue as possible.[ncbi.nlm.nih.gov]
Hyperactive Bowel Sounds
  • On physical examination, her abdomen was distended with hyperactive bowel sounds and dullness to percussion. Cancer antigen-125 was mildly elevated.[cancerjournal.net]
Bilious Vomiting
  • Case Report A 48-year-old woman (gravid 2, para 2) presented to the emergency room with complaining of nausea, non-bloody, non-bilious vomiting and diarrhea for 4 days and also complained of crampy abdominal pain and night sweats.[cancerjournal.net]
Ulcer
  • Endoscopic examination of the lower gastrointestinal tract to investigate diarrhea revealed an ulcerative lesion with hair in the rectal wall adjacent to the ovarian cyst, and formation of a fistula from the ovarian teratoma into the rectum was suspected[springerplus.springeropen.com]
Night Sweats
  • Case Report A 48-year-old woman (gravid 2, para 2) presented to the emergency room with complaining of nausea, non-bloody, non-bilious vomiting and diarrhea for 4 days and also complained of crampy abdominal pain and night sweats.[cancerjournal.net]
Hyperactivity
  • On physical examination, her abdomen was distended with hyperactive bowel sounds and dullness to percussion. Cancer antigen-125 was mildly elevated.[cancerjournal.net]
Adnexal Mass
  • Caption: Another view of the right adnexal mass Description: The cystic mass with the mobile contents seen again.[sonoworld.com]
  • We have 47-year-old woman who underwent total abdominal hysterectomy for right adnexal mass. As her ultrasound report revealed a right adnexal mass with solid and cystic components.[jnhrc.com.np]
  • The identification of fat via CT or MRI, tooth components with plain radiograph, or a cystic adnexal mass with some mural components using US, allow the diagnostic of mature cystic ovarian teratoma.[posterng.netkey.at]
  • Discussion: The laparoscopic approach to adnexal mass resection is considered the standard of care in the pediatric population. 5 There are cosmetic advantages as well as a decreased incidence of postoperative adhesion formation when compared with the[liebertpub.com]
  • Typically an ovarian dermoid is seen as a cystic adnexal mass with some mural components. Most lesions are unilocular.[radiopaedia.org]
Strangury
  • Patient may complaint of hematuria, pyuria and strangury. 4 Literature search highlights the sequence of events behind the fistulous communication in between dermoid cyst and visceral structures based on leak-adhesion-fistulation theory.[medcraveonline.com]

Workup

  • […] shadowing calcific or dental (tooth) components the presence of fluid-fluid levels 5 multiple thin, echogenic bands caused by the hair in the cyst cavity: the dot-dash pattern color Doppler: no internal vascularity internal vascularity requires further workup[radiopaedia.org]
  • WORKUP Lab Studies: Elevated serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCG) levels may be indicative of malignancy, as these values are within reference ranges in most patients with benign teratomas.[csh.org.tw]
  • […] torsion (detorsion with or without oophoropexy, transparietal cystectomy), including procedures those for associated lesions such as appendicectomy. [18], [19], [20], [21], [22] However, laparoscopy should be performed only after a careful preoperative workup[jiaps.com]
Pyuria
  • Patient may complaint of hematuria, pyuria and strangury. 4 Literature search highlights the sequence of events behind the fistulous communication in between dermoid cyst and visceral structures based on leak-adhesion-fistulation theory.[medcraveonline.com]
Ovarian Mass
  • A 55-year-old woman presented with an asymptomatic right ovarian mass, showing features of cystic teratoma according to preoperative computed tomography and magnetic resonance imaging.[ncbi.nlm.nih.gov]
  • Presentation A 42-year-old woman underwent an ultrasound for an ovarian mass. Caption: Sagittal image of the right adnexa Description: A complex cystic mass is seen in the right adnexa, replacing the entire right ovary.[sonoworld.com]
  • Ultrasonography revealed a cystic ovarian mass with internal echogenecity. Microscopic finding was consistent with that of usual mature cystic teratoma except for a 1.5 cm focus of prostatic and bladder tissues.[jpatholtm.org]
  • (c) Computed tomography of the abdomen and pelvis displays an ovarian mass about 20 cm 18 cm Click here to view A total hysterectomy and bilateral adnexectomy were performed.[tcmjmed.com]
  • masses, for example, Lacher et al. demonstrated the safety and feasibility of this technique without complications, conversions, or readmissions. 8 We believe that our video presentation is an important addition to the literature, given the impressive[liebertpub.com]

Treatment

  • Surgery remains the mainstay of treatment. Use of cisplatin and dacarbazine may be considered in a patient with metastatic disease.[ncbi.nlm.nih.gov]

Prognosis

  • Moreover, we review systematically the disease from the following aspects, that origin, clinical characteristics, accessory examination, pathological features, diagnosis, differential diagnosis, treatment, prognosis.[ncbi.nlm.nih.gov]
  • McNeish DOI: 10.1158/1078-0432.CCR-17-1789 Abstract Purpose: We sought to identify the genomic abnormalities in squamous cell carcinomas (SCC) arising in ovarian mature cystic teratoma (MCT), a rare gynecological malignancy of poor prognosis.[clincancerres.aacrjournals.org]
  • Several case reports show immature GP and immature teratomas can have an adverse prognosis [5], [10]. Previous reports showed good outcomes in patients with mature teratomas and GP [3], [9].[tcmjmed.com]

Etiology

  • The etiology of ectopic ovary is poorly understood. The ectopic ovaries may occur in two ways.[synapse.koreamed.org]

Epidemiology

  • Katsube Y, Berg J W, Silverberg S G 1982 Epidemiologic pathology of ovarian tumours: a histopathologic review of primary ovarian neoplasms diagnosed in the Denver Standard Metropolitan statistical Area, 1 July – 31 December 1969 and 1 July 31 December[cogprints.org]
  • Epidemiology of Benign Cystic Teratoma Sacrococcygeal teratomas are considered as the most common neoplasm in newborns, with an estimated incidence of 1 per 20,000 births.[lecturio.com]
  • Risk factors for benign, borderline and invasive mucinous ovarian tumors: epidemiological evidence of a neoplastic continuum? Gynecol Oncol 2007; 107:223–230.[clevelandclinicmeded.com]
  • Epidemiology Benign ovarian tumours occur in 30% of females with regular menses (eg, luteal cysts as incidental findings on pelvic scans) and 50% of females with irregular menses.[patient.info]
  • They used sophisticated cytogenetic techniques to demonstrate that these tumors are of germ cell origin and arise from a single germ cell after the first meiotic division. [8] Epidemiology Frequency Sacrococcygeal teratomas (SCT) are the most common tumors[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology of Benign Cystic Teratoma Teratomas are germ-cell tumors arising from one or more of the three germ-cell layers.[lecturio.com]
  • Removal of benign cysts does not decrease future mortality from ovarian cancer. 1,3-5 Back to Top Pathophysiology Provided below is a brief description of the pathophysiology of various types of physiologic and neoplastic ovarian cysts and the potential[clevelandclinicmeded.com]
  • Josep Dalmau and colleagues in the Department of Neurology at the University of Pennsylvania published a series of papers documenting a link between encephalitis and ovarian teratomas. 1-5 The pathophysiologic connection is thought to be the presence[mdedge.com]
  • Pathophysiology: Teratomas are made up of a variety of parenchymal cell types representative of more than a single germ layer, usually all 3. Arising from totipotential cells, these tumors typically are midline or para-axial.[csh.org.tw]
  • Teratomas, specifically solid teratomas, are essentially devoid of organization; thus, the presence of some degree of organization, a high degree of cellular differentiation, and cystic structure differentiates dermoids from teratomas. [3] Pathophysiology[emedicine.medscape.com]

Prevention

  • Ovarian dermoid cysts may be visible on plain abdominal radiograph, largely to the calcific 'tooth' component, with on occasion the subtle appearance of adjacent low density due to fat. 3 Treatment is typically surgical resection to prevent torsion or[apamedcentral.org]
  • 8084 IJRRT International Radiology & Radiation Therapy Case Report Volume 1 Issue 1 Pilimiction in ovarian cystic teratoma: a rare and diagnostic complication of a common entity Arjit Agarwal, 1 Regret for the inconvenience: we are taking measures to prevent[medcraveonline.com]
  • Watanabe et al. described a surgical technique to prevent spillage of cyst fluid during operation of cystic ovarian tumors in the pediatric population.[jiaps.com]
  • Back to Top Prevention and Screening Prevention Oral contraceptives may prevent new functional cysts from forming. 18-19 Oral contraceptives do not, however, hasten the resolution of preexisting cysts.[clevelandclinicmeded.com]
  • Conclusions In order to prevent residual disease, routine checking of the contralateral ovary during surgical resection of a recurrent lesion is necessary.[bmcwomenshealth.biomedcentral.com]

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