ovaryan cysts

7/28/2019 Ovaryan Cysts

1/20

Y U N I T H A A N G G R A I N I E M O E D A K

0 8 - 1 0 5

Ovarian Cysts

(Case Report)


2/20

Abstract

Ovarian Cyst is a major problem in woman. The ovarian tumor areclassified as benign ( neoplastic and nonneoplastic), premalignant, ormalignant. The ovarian cysts can develop in females at any stage of life,from the neonatal period to postmenopause. The majority of theseneoplasm are benign in women of reproductive age with the age rangeof the patient from 11 to 70 years, but the risk of malignancy is 13% in apremenopausal woman and 45% in postmenopausal woman. Majorityof the patients presented with pain abdomen (70,5%). Thecharacteristics of the mass and the age of the patient are importantfactors guiding diagnosis and treatment. Ovarian cyst still become one

of the problem in Gynecology. This paper will report the ovarian cystsin a 50th years old women.

Keyword : ovarian cysts


3/20

Introduction

Ovarian tumor and cysts are the major problem inwomen. These cysts can develop in females at any

stage of life, from the neonatal period to postmenopouse. When ovarian cyst are large, persisten,or paintful, surgery may be required, sometimesresulting in removal of the ovary.


4/20

Insidence

In Americancorpus lutheum (45%)

Age Ranged 11 to 70 years :

highest in white woman (40-50%)

A result from india was diagnosed :

75% ovarianTumors

12,5%functional cysts

10,7%paraovarian

and paratubalcysts

6,25% werehemorhagic

infarct wherehystopatologycould not be

reported

< 40 years

1.4/100.000

> 60 years ~

45/100.000


5/20

Risk Factor

Nulliparity White Woman30-40% CigaretteSmoking


6/20

Classification

Ovarianneoplasia

Functionalovarian cysts

Polycysticovarian

syndrome

follicular cysts corpus luteumcysts

corpus luteumcysts


7/20

Diagnostic Approach

Most ovarian cysts do not cause any noticablesymptoms and are found incidentally upon physical

examination or ultrasound.

those having symptoms is abdominal or pelvic pain(>33%), bloating (>30%), vaginal bleeding (~ 20%)


8/20

Diagnostic Approach

CA-125 levels

Transvaginal and transabdominal ultrasonography :

determining the location, size, and physical featuresof the cyst finding suggestive of malignancy

The sonography and computed tomography (CT)enable to diagnose the mass provisionally


9/20

Therapy

Oral conctraceptive medication can be used to helpprevent futher functional cysts from forming


10/20

removal of an containing a tumor withindication of malignancy and the patient is > 35years of age

Ovariotomy

enucleation of the tumor from its capsule orovarian tissue

indicated for a tumor apparently benign in awoman >35th years of age

not be feasible in the case of a very large tumor

Myomectomy

restricted to some cases of polycystic ovarydiases

Resection is aportion of theovarian cortex

removed.

Surgical


11/20

The indications for surgical exploration ofpatients with ovarian tumor

An Ovarian cysts 5 cm persisting after 8weeks of observation and/or oralcontraceptive therapy

Any adnexal mass before menarcheAny adnexal mass after the menopause

A solid mass at any age

A cystic mass > 8 cm in diameter


12/20

Prognosis

70-80% offollicular cysts

resolve

spontaneously

multillocatedcysts, the risk of

malignancy

climbs to 36%

overall survivalrate is 86,2% at 5

years


13/20

Case Report

Patient Identity:

Name : Mrs. Topaniah

MR : 21.18.04.00

Age : 50 Years 6 months

Address : Jl. Rawa Kuning no.16 RT 003/016, PuloGadung.

Date of Entry : Februari, 5th 2013.

Main Complaint : dizziness

Additional Complaint : abdominal pain, nausea,vomiting


14/20

History of Present Illness :

The patient came to IGD UKI hospital with complaints ofdizziness about 3 days in head to neck, the dizziness feltintermmitent, like stabbed, and disturbing her activity,besidesthat she feels pain in her abdomen intermmitent and ascrushed, nausea, and vomiting. Patient not taking any

medication before, so she went to RSU UKI and then shehospitlized. After that, the patient is consulted fromdepartement of Interna to Obstetrycs and Gynecologistdepartement with ovarian cyst. The patient said about 2months ago, she went to polyclinic of gynecology in UKIhospital because she often felt pain in her abdomen since 1

month before she goes to polyclinic, and diagnosed by aphysician is ovarian cysts and do USG examination. Patienthas no complain ith vaginal bleeding. The patient underwentthe menopause since her subtotal hysterectomy in 6 years ago.


15/20

Previous Disease History

The patient was finding out she has DM after bloodtest in IGD RSU UKI and uncontrolled. Beside that,patient has uncontrolled hypertention since 7 yearsago. The patient has a history of subtotalhysterectomy6 years ago. None of her family has thesame complaint.


16/20

Parameter Theory Case Report

Age 11-70 50

Vaginal Bleeding ~ 20% Not Happened

Bloating >33% Not Happened

Nullipara parity women Double risk P1A0

Races White Woman Not a white woamn

Family history BRCA1, BRCA2 No family history

Early menarche 50% Not happened

Obese 30-75 % Happened

insulin resistance Persuambly Happened

Hysterectomy Risk factorHystory of

hysterectomy

Confirming the diagnosis USG/CT USG

Surgery Ooverectomy OOverectomy

DISCUSSION


17/20

Conclusion

Ovarian tumor and cysts are the major problem in women Can develop in females at any stage of life nd can be malignant in

postmeopausal age (45%) symptoms is abdominal or pelvic pain (>33%), bloating (>30%),

vaginal bleeding (~ 20%)

To diagnosis of ovarian cysts USG/CT Scan, CA-125 levels can be helpful for distinguishing between benign and

malignant The laparoscopic is used for benign ovarian cysts that are less than

10 cm in diameter Another surgery is ovariotomy with indication of malignancy and

over 35th


18/20

Bibliography

Najifiyan Mahim, Cheraghi Maria, Mahmodi Mandana. Clinical and Phatological Findings of ovarian cysts, torsion over, and theperiod of ten years (2001-2011). Download at http://jpsionline.com/admin/php/uploads/161_pdf.pdf. 6 March 2013.

C William Helm, MBBCh,MA, Michael E Rilvin. Ovarian Cysts, Update Aug 1,2012. Download athttp://emedicine.medscape.com/article/255865-overview. 6 March 2013.

Cheryl Horlen.Ovarian Cyst : A Review.2010.Download at http://www.medscape.com/viewarticle/726031_print

Schorge, Schaffer, Halvorson, Hoffman, Bradsaw, Cunningham. Williams Gynecology:Epithelial Ovarian Cancer. USA:TheMcGraw-Hill Companies. 2008: 1432-35.

Martin L Pernoll.Benson and Pernolls handbook of Obstetrics and Gynecology:The ovary & oviduct. Tenth edition. United Statesof America: McGraw-Hill 2001:651-23.

David McKay Hart, Jane Norman, Robin Callander, Ian Ramsden.Gynaecology Illustrated: Diseases of ovary and falopiantube.Fifth edition, London,2000: 250-13.

Ulker Kahraman, Ersoz Mustafa, Huseyinoglu Urfettin. Management of a Giant Ovarian Cyst by Keyless abdominal rope-liftingsurgery (KARS).Kafkas J Med Sci 2011; 1(1):25-29.
http://jpsionline.com/admin/php/uploads/161_pdf.pdf.%206%20March%202013http://emedicine.medscape.com/article/255865-overview.%206%20March%202013http://www.medscape.com/viewarticle/726031_printhttp://www.medscape.com/viewarticle/726031_printhttp://emedicine.medscape.com/article/255865-overview.%206%20March%202013http://emedicine.medscape.com/article/255865-overview.%206%20March%202013http://emedicine.medscape.com/article/255865-overview.%206%20March%202013http://jpsionline.com/admin/php/uploads/161_pdf.pdf.%206%20March%202013


19/20

Bibliography

Elmar PS, Manuel Penalver. UMSLE step 2 CK, Lecture Notes, Obstetrics and Gynecology: Gynecologyneoplasia and cancer. Edition 2005-2006. United States: Kaplan Medical :144-11.

Errol, John O Schorge. Obstetrics and Gynecology at a Glance: Benign Disorders of the upper genitaltract.USA: BlackwellScience. 2001: 26-10.

Quilan DK. The laparoscopic management of large ovarian cysts. J Obstet Gynecol India. Vol 60,No.2:March/April2010 : 152-156.

Mohamed Sabry, Abdou S, Eman R, Ayman A. Laparoscopic management of a large torted ovarian cyst in anadolescent virgin: a case report. International Journal of Women health.2012:4: 223-225.

Jayasree M, Bupathy A. A study of benign adnexal masses. Int. J Reprod Contracept Obstet Gynecol. 2012Dec;1(1):12-16.Download at http://www.ijrcog.org/volume1Issue1/IJRCOG000812.pdf

Eberhard Merz. Ultrasound in Obstetrics and Gynecology:Ovarian Masses. 2nd edition, fully revised.Germany:Thieme,2006:148-9.

Alan H DeCherney, Lauren N, T Murphy Goodwin, Neri Laufer. Current diagnosis and treatment in Obstetricsand Gynecology: Brnign Disorder of the ovaries & oviducts .Tenth edition. United States of America: McGraw-Hill,2007: Chapter 40.
http://www.ijrcog.org/volume1Issue1/IJRCOG000812.pdfhttp://www.ijrcog.org/volume1Issue1/IJRCOG000812.pdfhttp://www.ijrcog.org/volume1Issue1/IJRCOG000812.pdf


20/20

ovaryan cysts

Documents