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 ; Ovarian Cysts*

No abstract available.
Female ; Hydronephrosis* ; 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*

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

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

BACKGROUND/AIMS: Although increased serum anti-Müllerian hormone (AMH) level has been suggested to be a surrogate marker of polycystic ovarian morphology (PCOM), its association with polycystic ovary syndrome (PCOS) is controversial, and its diagnostic value has not been determined. We aimed to observe the relationship between the AMH level and PCOS phenotypes and to determine the optimal cutoff value of AMH for the diagnosis of PCOS in young Korean women. METHODS: We recruited 207 women with PCOS (120 with PCOM and 87 without PCOM) and 220 regular cycling women with normoandrogenemia (100 with PCOM and 120 without PCOM). Subjects underwent testing at a single outpatient visit. Serum AMH level was measured. RESULTS: Women with PCOS had higher serum AMH levels than did regular cycling women with normoandrogenemia (p < 0.05). Women with PCOM had higher serum AMH levels than women without PCOM, regardless of PCOS status (p < 0.05). The optimal AMH cutoff value for the diagnosis of PCOS was 10.0 ng/mL (71% sensitivity, 93% specificity). Serum AMH was an independent determinant of total testosterone after adjustment for age, body mass index, and the number of menses/year (β = 0.31, p < 0.01). An association between AMH and hyperandrogenism was only observed in women with PCOS, and it was independent of the presence of PCOM. CONCLUSION: The serum AMH level can be useful for the diagnosis of PCOS at any age less than 40 years, and the optimal cutoff value for the diagnosis of PCOS identified in this study of young Korean women was 10.0 ng/mL.
Anti-Mullerian Hormone ; Biomarkers ; Body Mass Index ; Diagnosis ; Female ; Humans ; Hyperandrogenism ; Outpatients ; Ovarian Cysts ; Phenotype ; Polycystic Ovary Syndrome* ; Testosterone