Immature cystic teratoma (IMCT) is a rare ovarian malignancy, usually presenting as a huge unilateral pelvoabdominal mass in the pediatric age. Even rarer is the occurrence of a concomitant contralateral mature cystic teratoma. Management issues include use of fertility sparing versus complete surgical staging, and the use of chemotherapy. Fortunately, IMCT carries a good prognosis, especially when diagnosed early. Chemotherapy is used only in higher stage disease and recurrence.
Ovarian Cysts

OBJECTIVES: To compare the effects of metformin and orlistat in terms of reduction in weight or BMI, and improvement of ovulation rates, endocrinologic and lipid profiles, and occurrence of adverse events among overweight or obese women diagnosed with PCOS.

SEARCH METHODS: We searched Medline, OVID, HERDIN, EMBASE, Cochrane Library and ClinicalTrials.gov for head to head clinical trials of metformin versus orlistat for the treatment of overweight and obese women with PCOS. We also contacted the pharmaceutical companies and did hand-searching to look for related studies.

SELECTION CRITERIA: Only randomized controlled trials comparing metformin and orlistat as treatment for overweight and obese PCOS women were included. Other inclusion criteria included: trial period of at least 3 months duration, participants, of any ethnicity, 18-40 years old, who are overweight or obese, and studies with or without non-pharmacologic interventions as part of the treatment regimen.

DATA COLLECTION AND ANALYSIS: Titles and abstracts identified through the search strategies were screened by two reviewers. Two authors extracted data on publication characteristics, inclusion and exclusion criteria, intervention and co-intervention, primary and secondary outcomes, and details of study design. Two authors assessed the quality and risk bias of each RCT based on random sequence generation, allocation concealment, blinding of participants, caregivers, and assessors, attrition bias, incomplete outcome data, selective reporting, and publication bias.

MAIN RESULTS: We included 5 RCTs (n=221). Overall, treatment effects of orlistat and metformin showed no significant difference in the following outcomes: ovulation rates (RR 0.78; 95% CI 0.41, 1.49), reduction of BMI (MD -0.47; 95%CI:-1.53,0.59), serum testosterone levels (MD -2.15;95% CI -9.64, 5.33), free androgen index MD 3.26; 95% CI -7.91, 14.43), homeostatic model assessment-insulin resistance (3.70; 95% CI -6.74, 14.15), fasting insulin (MD 7.86; 95% CI -3.09, 18.81), HDL-C (MD -1.19 ; 95% CI -4.78, 7.16) and triglycerides (MD -1.95; 95% CI -8.81, 4.90). Orlistat was significantly better than metformin in reducing total cholesterol (MD -6.60; 95% CI -10.79, -2.41), and LDL (MD -5.04; 95% CI -9.64, 5.33), free androgen index (MD 3.26; 95% CI -7.91, 14.43), homeostaic model assessment-insulin resistance (3.70; 95% CI -6.74, 14.15), fasting insulin (MD 7.86; 95% CI -3.09, 18.81), HDL-C (MD -1.19 ; 95% CI -4.78, 7.16) and triglycerides (MD -1.95; 95% CI -8.81, 4.90). Orlistat was significantly better than metformin in reducing total cholesterol (MD -6.60; 95% CI -10.79, -2.41), and LDL (MD -5.04); 95% CI  -9.99, -0.09), and had less adverse events (RR 0.37, 95% CI 0.14, 0.96).

AUTHORS' CONCLUSIONS: Metformin and Orlistat have similar effects on weight loss, ovulation rates, and endocrinologic profiles of obese women with PCOS. Orlistat is more effective than metformin in decreasing total cholesterol and LDL -C levels, and has less adverse events than metformin. Therefore, we may recommend orlistat to overweight or obese women with PCOS who also have dyslipidemia. However, caution is given to our interpretations since small sample size, low quality of RCTs, and wide confidence intervals of pooled estimates significantly influence interpretation and recommendations. RCTs with adequately powered study populations are recommended to confirm findings of this review.

The purpose of this study is to examine the histopathological findings of ruptured ovarian cysts and to compare them with clinical symptoms. In general, this condition has been misdiagnosed with appendicitis (54.6%) or with ruptured ectopic pregnancy (18.2%). During 5 years from January 1, 1994 to December 31, 1998, 182 samples of ovarian cystomas were referred to ViÖt §øc Hospital for histopathological study. Among these, 36 cysts were ruptured. 69.4% of the ruptures occurred in patients aged from 15 to 35 years. More than half (58.3%) were found in the right ovary. The most common histological types were ruptures of the cystic corpus luteum (61.1%) and secondary ruptures of the Grafian follicles (16.7%). The commonest complication was intraperitoneal hemorrhage - an indication for emergency laparotomy in clinical. The amount of blood found in peritoneum was largely insignificant, with 50 - 500 ml in 95% of patients.
Ovarian Cysts ; Ovarian Neoplasms ; diagnosis

No abstract available.
Female ; Hydronephrosis* ; Ovarian Cysts*

No abstract available.
Female ; Ovarian Cysts* ; Ultrasonography*

No abstract available.
Female ; Ovarian Cysts*

The torsion of the pedicle is the complication of any ovarian cyst. This complication is more common with tumors of small or moderate size than the large ones. These tumors are usually benign and not adhesive. The incidence of torsion varies from 3.5 to 16%. Ultrasound could help us diagnose rapidly and accurately the size and characteristics of the ovarian cysts.
Ovarian Cysts ; Torsion

No abstract available.
Female ; Ovarian Cysts*

Ovarian cysts are rare in children. Their common presentation is acute abdomen, which can be a life-threatening event that needs emergent investigation and intervention. Herein, we report a gynaecological case of a twisted ovarian cyst in an 11-year-old girl who presented to the emergency department with sudden-onset generalised abdominal pain. Multiple strong analgesics were prescribed, and pain-controlled analgesia was then started. Abdominal ultrasound revealed a left adnexal mass, and abdominal computed tomography showed a non-enhancing soft tissue tumour with multiple cystic components in the pouch of Douglas. The patient underwent emergency laparotomy, which revealed a gangrenous left ovarian mass measuring 9×5 cm that was twisted five times. Histopathology showed extensive haemorrhagic infarction with no remnant of viable tissue, consistent with a twisted ovary. It was challenging to determine the origin of the pain in this patient, as thorough examination could not be performed because she was in severe pain. Abdominal ultrasound helps guide diagnosis, as a gynaecological cause is rare in premenarchal children. A vigilant assessment is important to avoid delays in diagnosis and emergency intervention.
Ovarian Cysts ; Abdomen ; Child

No abstract available.
Female ; Humans ; Ovarian Cysts* ; Ovary*