We report a partial fetus-like structure (homunculus) in benign ovarian mature cystic teratoma removed from a 23-yr-old female. The cyst displayed various tissues derived from the three germ layers. The homunculus had a distinguished fetal cranial structure with one upper extremity. A partially developed osteocartilagenous skeleton was identified in the cranial structure of the homunculus. Intracranial structures such as cerebral cortex, retinal pigment, and leptomeninges were extruded from the partially disrupted calvarium.
Adult ; Female ; Human ; Ovarian Cysts/*pathology ; Ovarian Neoplasms/*pathology ; Pregnancy ; Teratoma/*diagnosis/*pathology

With the development of fetal ultrasonography, detection of fetal ovarian cysts has been increased. Although ovarian cyst formation during the perinatal period is a self limiting process, there is still considerable controversy regarding the best treatment of the fetal ovarian cyst. The purpose of this study is to evaluate the natural history of fetal ovarian cysts and to analyze the result of treatment. From 1995 to 2004, 31 consecutive fetuses with ovarian cysts were followed by ultrasonography during the perinatal period. The fetal ovarian cyst was diagnosed by prenatal ultrasonography between 25weeks and 38 weeks and the mean size of the cysts was 5cm (ranged from 2 to 8cm). At birth, 3 cysts disappeared. In 2 cases, the diagnoses were changed to multicystic kidney disease and intestinal duplication. During following up of 26 cysts, 15 cysts have resolved completely. Seven cysts required oophorectomy because of cyst torsion (n=3), differentiation of tumorous condition (n=2), increased size of cyst (n=1), and large size (8cm) of cyst at birth (n=1). Fetal ovarian cyst should primarily be observed, and only in the limited cases, surgical treatment would be required for the risk of complications such as torsion and differentiation from benign to malignant pathology.
Diagnosis ; Female ; Fetus ; Multicystic Dysplastic Kidney ; Natural History ; Ovarian Cysts* ; Ovariectomy ; Parturition ; Pathology ; Ultrasonography ; Ultrasonography, Prenatal

OBJECTIVES: To evaluate preoperative anti-Mullerian hormone (AMH) levels in women with endometrioma or other benign ovarian cysts and differences of AMH changes according to various characteristics. METHODS: Ninety-seven patients aged 20 to 39 years who underwent surgery for benign ovarian cyst were enrolled retrospectively. Of these, 65 patients were diagnosed as endometriomas, and 32 had other benign cysts. Serum AMH, mean, maximum, and total diameter of ovarian cysts were measured. The AMH levels were compared according to pathology (endometrioma vs. other benign cyst), size of ovarian cyst, age-matched AMH quartile percentile and characteristics of endometrioma. RESULTS: Preoperative serum AMH level was significantly lower in endometrioma group than other benign cyst group (4.12 +/- 2.42 ng/mL vs. 6.02 +/- 2.29 ng/mL, P < 0.001). Serum AMH level was significantly lower in endometrioma group, especially in patients aged 30 to 39 years. Dividing to age-matched AMH quartile percentile, there were significantly fewer patients with AMH level > or = 75 percentile in endometrioma group (24.6% vs. 50.0%, P = 0.035). Among 4 subgroups of endometrioma, patients with AMH level > or = 75 percentile were significantly decreased in multiple bilateral endometrioma group. Mean and total diameter of cysts were negatively correlated with preoperative serum AMH level in other benign cyst group. CONCLUSION: We suggest that preoperative AMH level measurement might be considered in women with endometrioma, especially in 30 to 39 years old, multiple bilateral type, or big-sized other benign ovarian cyst to assess the diminished ovarian reserve.
Anti-Mullerian Hormone* ; Endometriosis* ; Female ; Humans ; Ovarian Cysts* ; Pathology ; Retrospective Studies

Accessory ovary is a rare gynecologic condition, and tumors arising in accessory ovaries are extremely rare. Accessory ovary may result from separation of migrating ovaries during embryogenesis and injuries such as inflammation and operation on normal ovary. Congenital malformations, most frequently malformations of the genitourinary organ, are seen in connection with the accessory ovary. We experienced the first case of two dermoid cysts developing in an accessory ovary located in the left infundibulopelvic ligament and another in the eutopic ovary at the same side concurrently. Here, we present this extremely rare case with a review of the literature.
Adult ; Dermoid Cyst/*diagnosis/pathology ; Female ; Human ; Ovarian Cysts/*diagnosis/pathology ; Ovarian Diseases/congenital/*diagnosis ; Ovary/abnormalities/*pathology ; Tomography, X-Ray Computed

INTRODUCTIONThe purpose of this case series was to determine the sonographic features of neonatal ovarian torsion.

MATERIALS AND METHODSSeven surgically proven cases of neonatal ovarian cysts were included in this retrospective study. The patients were divided into 2 groups, torsion and non-torsion. These 7 patients were evaluated for the clinical presentation, sonographic features, surgical and pathological findings. The findings on follow-up sonography after surgery were also noted.

RESULTSThe sonographic appearance was variable. Of the 4 cases with torsion, 2 lesions had internal echoes with 'fi sh-net appearance'. The other 2 lesions were predominantly cystic on the sonography with internal echoes and echogenic nodule. A calcific focus was present in 1 of these echogenic nodules. One of the cysts had fluid-fluid level. In the non-torsion group, only 1 lesion had mixed echogenic appearance. The other 2 lesions were cystic with low level internal echoes in 1 of the cysts. The surgical procedure performed in the torsion group was salpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1 patient, cystectomy was attempted without success. In the non-torsion group, only cystectomy was performed with preservation of normal ovaries, which was confirmed on follow-up sonography.

CONCLUSIONThe sonographic features of cysts with 'fish-net appearance', fluid-debris level and cysts with echogenic nodule favour torsion. The former sign has so far not been described as a sonographic predictor for neonatal ovarian torsion.

Female ; Humans ; Infant, Newborn ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovary ; diagnostic imaging ; pathology ; Postoperative Period ; Retrospective Studies ; Torsion Abnormality ; diagnostic imaging ; pathology ; surgery ; Ultrasonography, Doppler ; instrumentation

The objective of this retrospective field study was to associate the type and smell of discharge, the size of the uterus, the ovarian and treatment status, and the time to diagnosis of animals with chronic clinical endometritis (CCE) with the incidence of ovarian cysts and with a marked loss in body condition in German Holstein Friesian cows. Two hundred and sixty-four cows diagnosed with CCE from day 14 to day 42 postpartum participated in this study. In addition, 100 days milk production and the parity of the animals were included in the analysis. With the use of logistic regression, a purulent vaginal discharge (>or = 50% pus), the decision not to treat the animals for CCE and a high 100 days milk production proved to be significant factors for the incidence of ovarian cysts. Additionally, the type of discharge showed interactions with the parity and the smell of the discharge, as more animals with fetid and purulent discharge and more animals in the first lactation with a purulent discharge developed ovarian cysts. A high milk production and the parity showed associations with an excessive body condition score loss. Additionally, more animals with a diagnosis of an oversized uterus in comparison to cows with an early involution experienced a considerable reduction in their nutritional condition.
Animals ; Cattle ; Cattle Diseases/*pathology ; Chronic Disease ; Endometritis/complications/pathology/*veterinary ; Female ; Lactation ; Models, Biological ; Ovarian Cysts/complications/pathology/*veterinary ; Parity ; Pregnancy ; Retrospective Studies ; Risk Factors

OBJECTIVETo evaluate the surgery in simple ovarian cysts.

METHODSFrom Jan. 1994 to Dec. 1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was < 5 cm in 76 cases, and was > or = 5 cm in 145 cases ultrasonically. One hundred and eighty-four patients underwent laparoscopy, and thirty-seven underwent laparotomy.

RESULTSHistological findings showed no malignancy in this series. Simple cysts, paraovarian cysts and corpus luteum were found histologically in 90.8% of cases with cysts < 5 cm, and 60% of those with cysts > 7 cm respectively, their difference was significant (chi2=37.13, P<0.001). The simple cysts, paraovarian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of premenopausal women.

CONCLUSIONPatients with cysts > 7 cm are indicated for surgical procedures, while a period of followup is acceptable for patients with cysts < 7 cm, and surgery is advisable if the cyst is persistent during followup. Postmenopausal women with cysts should have operations.

Endometriosis ; diagnostic imaging ; surgery ; Evaluation Studies as Topic ; Female ; Humans ; Laparoscopy ; Laparotomy ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovarian Diseases ; diagnostic imaging ; surgery ; Ovarian Neoplasms ; diagnostic imaging ; surgery ; Teratoma ; diagnostic imaging ; surgery ; Ultrasonography

INTRODUCTIONThe risk of malignancy index (RMI) is a scoring system used to triage benign from malignant ovarian masses. We compared the specificity and sensitivity of the four indices (RMI 1, RMI 2, RMI 3 and RMI 4) to discriminate a benign ovarian mass from a malignant one in a Southeast Asian population.

METHODSThis was a five-year retrospective study of women who were admitted for surgery due to ovarian masses. RMI scores were calculated based on standardised preoperative cancer antigen (CA)-125 levels, ultrasonography findings, menopausal status and tumour size based on ultrasonography. Postoperative histopathologic diagnosis was regarded as the definite outcome. Data were analysed using the Statistical Package for the Social Sciences, and Mann-Whitney U test was used to compare the individual RMI scores between the benign and malignant cases.

RESULTSOut of the 480 patients reviewed, 228 women aged 10-65 years were included in the study. Of these, 17 (7.5%) had malignant disease and 211 (92.5%) had benign pathology. There was no statistical difference in the RMI 1, 2, 3 and 4 scores between the benign and malignant cases. Individual variables that were analysed showed significant differences in median CA-125 level and tumour size (p = 0.044 and p < 0.0005, respectively) between the benign and malignant cases.

CONCLUSIONOur study shows that RMI is not a valuable triage tool for our Southeast Asian population. Further prospective validation, with regard to standardising results in different patient populations and centres, is required.

Adolescent ; Adult ; Aged ; Area Under Curve ; CA-125 Antigen ; metabolism ; Child ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Models, Statistical ; Ovarian Cysts ; diagnosis ; pathology ; Ovarian Neoplasms ; diagnosis ; pathology ; ROC Curve ; Retrospective Studies ; Risk ; Sensitivity and Specificity ; Singapore ; Young Adult

Adnexa Uteri ; surgery ; Colectomy ; methods ; Colonic Diseases ; etiology ; pathology ; surgery ; Colostomy ; Endometriosis ; complications ; pathology ; surgery ; Female ; Fistula ; etiology ; pathology ; surgery ; Follow-Up Studies ; Humans ; Intestinal Fistula ; etiology ; pathology ; surgery ; Middle Aged ; Ovarian Cysts ; complications ; pathology ; surgery ; Ovarian Diseases ; etiology ; pathology ; surgery ; Ovariectomy

A mesothelial cyst of the round ligament is a rare cause of an inguinal mass. Clinically, it is frequently misdiagnosed as one of commoner diseases such as an inguinal hernia, femoral hernia, lipoma, and lymphadenopathy upon physical examination. Some previous reports elaborated the sonographic features of a mesothelial cyst of the round ligament. However, to our knowledge, few reports have described the CT features of a mesothelial cyst. We illustrated here the sonographic and multidetector CT features of a case of a mesothelial cyst of the round ligament that presented as an inguinal palpable mass and mimicked a metastasis in a patient with a Sertoli-Leydig cell tumor of the ovary.
Abdominal Neoplasms/*diagnosis/secondary ; Aged ; Contrast Media/diagnostic use ; Cysts/*radiography/*ultrasonography ; Diagnosis, Differential ; Epithelium/radiography/ultrasonography ; Female ; Humans ; Ovarian Neoplasms/*pathology ; Radiographic Image Enhancement/methods ; Round Ligament/*radiography/*ultrasonography ; Sertoli-Leydig Cell Tumor/*pathology ; Tomography, X-Ray Computed/methods