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Massive Ovarian Edema: A Case Report
M Monajemzadeh,H Nahvi,M Mehdizadeh
Iranian Journal of Pediatrics , 2006,
Abstract: Background: Massive ovarian edema is a rare condition that affects young women. Its cause is not clearly understood but some suggest recurrent ovarian torsions to be responsible. This disease is reported in 1969 for the first time and until recently only 80 cases are reported. Clinical presentation usually is recurrent abdominal pain. Microscopic examination shows severe edema which involves ovarian tissue especially in medulla. Rapid growth, large size of the ovary and absence of true neoplastic changes are characteristic of this disorder. Case Report: Our case showed itself by intermittent abdominal pain in a 10-year-old girl. Sonography revealed an ovarian enlargement measuring 10×7×7 cm in diameter and CT scanning showed a mass with water density in the ovary. It was grossly pale, soft and encapsulated. Frozen section histology revealed ovarian edema. The patient underwent partial oopharectomy. Permanent sections confirmed the diagnosis. Discussion: The most important differential diagnosis is fibroma and myxoma of the ovary. This disorder is benign and current therapeutic modalities include partial oopharectomy and fixation of ovaries to prevent recurrent torsions. When an ovarian mass is found in a young woman, a frozen section examination can be helpful in diagnosis and to avoid unnecessary oophorectomy. Awareness of surgeons and pathologists is essential to achieve this goal.
Minilaparotomy a Good Option in Specific Cases: A Case Report of Bilateral Ovarian Germ Cell Tumor
D. Bolla,N. Dese ,A. Sturm,A. Sch ning,C. Leimgruber
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/589568
Abstract: Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.
Minilaparotomy a Good Option in Specific Cases: A Case Report of Bilateral Ovarian Germ Cell Tumor  [PDF]
D. Bolla,N. Dese?,A. Sturm,A. Sch?ning,C. Leimgruber
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/589568
Abstract: Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6?cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue. 1. Introduction Mature cystic teratomas (MCTs) of the ovary, also known as dermoid cysts, represent 44% of ovarian neoplasmas. They are benign tumors containing mature tissue from all of the three germ-cell layers. MCT represents up to 52% of all ovarian tumors diagnosed in women younger than 40 years. Malignant transformation is rare and occurs in 1–3% of cases [1]. The surgical approach is particularly important in young women who wish the best cosmetic results after the operation. Nowadays most surgeries for ovarian benign disease can be performed laparoscopically [2]. Another approach in special cases is the minilaparotomy (ML), which is considered by some surgeons as a minimally invasive procedure [3]. We present a case in which a woman affected from a bilateral dermoid cyst was operated with a minimal invasive procedure allowing, in this way, the preservation of their fertility. 2. Case Report A 39-year-old woman was referred to our hospital with an acute abdominal pain. Five months before the time of admission, an uncomplicated spontaneous vaginal delivery occurred. During this pregnancy, a 6?cm bilateral adnexal mass was incidentally discovered by a routine gynecological check up. The ultrasound examination and its followup described these findings as a bilateral multicystic teratoma. Because of
Laparoscopic approach for very large benign ovarian cyst in young woman  [cached]
Tagliabue Fulvio,Acquaro Paola,Confalonieri Gianmaria,Spagnolo Salvatore
Journal of Minimal Access Surgery , 2009,
Abstract: Ovarian cysts are the most common cause of pelvic masses in women, and in the majority of the cases, women are in their fertile age. Today, the surgical treatment has become more conservative and less invasive; hence, a laparoscopic approach in the presence of benign cysts has become a gold standard. Herein, we report a case of a 21-year-old woman referred to our Surgical Department for an abdominal mass, discovered with a computerised tomographic scan, of 20x10 x 25cm arising from the left ovary, treated with the laparoscopic approach.
Breast and Ovarian Cancer in Young Women of the Arabian Gulf Region: Relationship to Age  [PDF]
Sarah Al-Gahtani, Suhair Abozaid, Elham Al-Nami, Leen Merie, Ayana Al-Yousef, Mohamed M. Shoukri
Open Journal of Epidemiology (OJEpi) , 2016, DOI: 10.4236/ojepi.2016.63019
Abstract: It is widely known that cancer is a disease of “old-age”. However available data show that this is not the case for many types of cancers. Incidences of breast and ovarian cancers have varying rates of change with age. Breast cancer data of Arabian-gulf women, show that the incidence rates increase with age and reach a maximum at 39 year. It then declines linearly with age to about 55 years. The rate of increase and its changes with age are similar to those of many other countries. In the premenopausal phase the relationship between incidence and age could be adequately modeled using a linear model for the logarithmic transformations of age and incidence. Similar observations are made for the ovarian cancer incidences. Results: It is shown that the rate of increase in breast and ovarian cancer incidence with respect to age is increasing in the premenopausal ages. Moreover, the burden of the disease with respect to mortality and “Disability Adjusted Life Years” or DALY, varied considerably among the six gulf countries. Conclusions: We conclude, based on the age incidence relationship that the number of cancer cases may double in the next period that follows our study period (1998-2009). Moreover, if the six countries have identical relationship between age and the two types of cancer, there should be an integrated and unified effort to have a common strategy for prevention and control.
Clinical and Radiologic Signs of Relapsed Ovarian Germ Cell Tumor: Tissue Is the Issue  [PDF]
M. Y. V. Homs,H. W. R. Schreuder,G. N. Jonges,P. O. Witteveen
Case Reports in Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/984524
Abstract: Malignant ovarian germ cell tumor is a rare disease, but with current treatment strategies including surgery and platinum based chemotherapy survival is excellent. After treatment, intensive followup is indicated to encounter tumor relapse at an early stage. This case describes a 22-year-old female with a history of common variable immune deficiency (CVID) who underwent a resection of a large ovarian germ cell tumor followed by 4 cycles of cisplatin and etoposide resulting in clinical complete remission. During followup, she developed a mass at the umbilicus and ascites. Initially, the cytology of the ascites was interpreted as tumor positive, suspicious of relapse of the disease, but tumor markers remained negative. However, during laparoscopy it turned out to be a mature teratoma, which can develop after chemotherapy, the so called growing teratoma syndrome. In retrospect, the ascites was false positive. This case shows that current diagnostic tools are not sufficient to distinguish between vital tumor and mature teratoma and can be misleading. Tumor biopsy and/or laparoscopic inspection are therefore indicated. 1. Introduction Malignant ovarian germ cell tumor is a rare disease, which mostly presents in adolescents and young women. With the current management of ovarian germ cell tumors including surgery and platinum based chemotherapy survival is excellent. Five-year survival rate is approaching 100% in early stage disease and at least 75% in advanced stage disease [1, 2]. Therefore, relapse is rare in this population and no standard treatment exists. In addition, during or after chemotherapy mature teratoma can develop, in particular for germ cell tumors with a teratoma compound. This is the so called growing teratoma syndrome or chemotherapeutic retroconversion [3–5]. This case shows that clinical and radiologic signs in combination with cytology can be misleading, suspecting relapsed disease. 2. Case Report A 22-year-old female presented with abdominal pain and distension of the abdomen, weight loss, constipation, and fatigue. Her medical history reported a common variable immune deficiency (CVID) with a deficiency of IgG2 subclasses, which was discovered after several pulmonary infections during childhood, resulting in bronchiectasis of the lungs. Since diagnosis she regularly receives immune globulins. An abdominal CT scan identified a mass in the pelvis, likely ovarian origin, and a large amount of ascites (Figure 1). Laboratory results showed an alpha fetoprotein (AFP) of 5300?μg/L (normal range 0.0–9.0), beta human chorionic gonadotropin
Variations in vascular endothelial growth factor levels during ovarian superovulation and reduction of ovarian hyperstimulation incidence in young women: A prospective study  [PDF]
Eliahu Levitas, M. Huleihal, E. Lunenfeld, R. Gakman, M. Friger, G. Potashnik
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.32055
Abstract:

Variations in Vascular Endothelial Growth Factor (VEGF) levels were prospectively evaluated in 18 young women undergoing in vitro fertilization treatments according to the “Long Protocol” and a typical pattern of VEGF levels was recorded. A significant increase in VEGF concentrations was observed only when the follicles reached a mean diameter of 15.3 mm in concurrence with mature oocyte retrieval. Since an increase in VEGF levels is related to follicular vascularity and oocyte developpment, our study supports the approach that oocyte retrieval may be performed when follicles > 15 mm in diameter appear. Anticipating egg retrieval in young patients with an optimal ovarian reserve may decrease the incidence of severe ovarian hyperstimulation, without compromising the treatment results.

A young man with a large lung mass  [cached]
Steven Praske,David Bradshaw,John Roberts,John Childs
Chest Disease Reports , 2012, DOI: 10.4081/cdr.2012.e4
Abstract: A 27-year-old man presented with a large solitary lung mass. Transbronchial lung biopsy and lobectomy specimens showed malignant melanoma. A thorough search for a primary melanoma lesion, including an ophthalmic exam and a dermatologic exam with special attention to the skin, mucous membranes, genitals, perineum, scalp, and nails showed no lesions suspicious for a melanoma. The diagnosis of primary malignant melanoma of the lung was considered. Whole-body positron emission tomography scan with computed tomography fusion imaging at the time of diagnosis showed no evidence of tumor outside the chest, and the diagnosis of primary malignant melanoma of the lung was confirmed. The prognosis of patients with this exceedingly rare neoplasm is poor, though surgical intervention may be warranted in some cases.
Evaluation of the peak bone mass by quantitative heel ultrasound in young women of the centre of Italy  [cached]
M. Ponteggia,L. Di Cato,F. Ponteggia,M. Pica
Reumatismo , 2011, DOI: 10.4081/reumatismo.2003.34
Abstract: Objective: To measure the reference young adult mean values in healthy women of the centre of Italy by Quantitative heel UltraSound (QUS). Methods: The study group was composed by 70 caucasian women: mean age was 25.4 years (Standard Deviation 4.7), mean weight was 58 Kg (SD 8.2), mean height was 166 cm (SD 5.8), mean BMI was 20.9 kg/m2 (SD 2.5). Every subject was evaluated firstly with an original questionnaire to discover risk factors (like for example steroids consumption, recent fractures of the lower limb), then was measured by quantitative heel ultrasonometry Hologic Sahara. Results: Mean extimated Bone Mineral Density (BMD) 0.588 g/cm2 (SD 0.124) mean Quantitative Ultrasound Index (QUI) 105.0 (SD 19.6), mean Speed of Sound (SOS) 1564.2 m/s (SD 31.4), mean Broadband Ultrasound Attenuation (BUA) 84.8 dB/MHz (SD 17.4). No significant correlation was found between QUS parameters and anthropometric data. A correlation was found between every QUS parameters. No significant differences were found about QUI and extimated BMD, between our results and Hologic normative data for European women. Conclusions: It is very important to develop specific reference values for any measurement device and site of skeleton especially in the age of reaching the peak bone mass because the T score is then measured referring to these data. Usually the normative data are supplied by manufacturer and are based on large multicentric study. In our opinion it could be helpful to verify if these data are compatible with the population examined in every region.
Anogenital distance is related to ovarian follicular number in young Spanish women: a cross-sectional study
Jaime Mendiola, Manuela Roca, Lidia Mínguez-Alarcón, Maria-Pilar Mira-Escolano, José J López-Espín, Emily S Barrett, Shanna H Swan, Alberto M Torres-Cantero
Environmental Health , 2012, DOI: 10.1186/1476-069x-11-90
Abstract: We used multiple linear and logistic regression analyses to model the relationships between adult female reproductive system characteristics (e.g. ovarian morphology, menstrual cycle) and two measures of AGD [anus-fourchette (AGDAF) and anus-clitoris (AGDAC)] in 100 college-age volunteers in Spain. Ovarian morphology was classified as having < 6 or ≥ 6 follicles per ovary.Both AGD measures were positively associated with ovarian follicle number, with AGDAF being more strongly associated. Women in the upper tertile of the AGDAF and AGDAC distributions were more likely to have ≥ 6 ovarian follicles [OR: 6.0 (95% CI 2.0, 17.6) and 3.0 (95% CI 1.1, 8.6), respectively] compared to women in the lowest tertile.Increased follicular recruitment has been related to excess androgen exposure in utero in toxicological studies. Our results suggest that the androgenic environment during early fetal life may influence reproductive system development, including AGD, in human females.Anogenital distance (AGD) is routinely used as a developmental endpoint in animal toxicology studies by the U.S. Environmental Protection Agency and is one of the most sensitive markers of in utero exposures to environmental endocrine-disrupting chemicals (EDC) [1,2]. A number of animal studies have shown that exogenous androgen or estrogen exposure (including EDC) during the prenatal period can alter the development of the female reproductive tract [3-15]. For example, bisphenol A (BPA), which may have both estrogenic and anti-androgenic properties, has been shown to disrupt and alter ovarian function [10-14]; and it has recently been demonstrated that BPA alters early oogenesis and follicle formation in the fetal ovary of nonhuman primates [14]. Moyer and Hixon [15] have recently shown that prenatal exposure to another well-known EDC, di(2-ethylhexyl) phthalate, increased the numbers of mature follicles in adult females in the highest exposure group and the subsequent decrease in overall reproductive l
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