Anti-Mullerian hormone (AMH), also called Mullerian-inhibiting substance, is a member of the transforming growth factor (TGF)-beta superfamily. It is well known that AMH is expressed by Sertoli cells in fetal testis, and that it induces Mullerian duct degeneration during male fetal development. However, in females AMH is produced by granulosa cells of the ovarian follicles. Recently, numerous studies have demonstrated that AMH could be a useful marker of ovarian function. Serum AMH levels decrease progressively with age, become undetectable after menopause, and show high cycle-to-cycle reproducibility. It has been shown that AMH level is correlated with various outcomes of controlled ovarian hyperstimulation (COH). Many studies showed that AMH can discriminate very effectively poor responders, cycle cancellation, and ovarian hyperstimulation syndrome after COH. AMH also has a functional role in folliculogenesis and could be a qualitative marker of ovarian follicular states. In addition, AMH has been associated with various clinical statuses such as polycystic ovarian syndrome, endometriosis, obesity, granulosa cell tumor, and premature ovarian failure. AMH is an effective and promising biomarker of various conditions in female reproduction. In this article, current research results on role of AMH as a marker of ovarian function and dysfunction are discussed.
Anti-Mullerian Hormone ; Endometriosis ; Female ; Fetal Development ; Granulosa Cell Tumor ; Granulosa Cells ; Humans ; Male ; Menopause ; Obesity ; Ovarian Follicle ; Ovarian Hyperstimulation Syndrome ; Polycystic Ovary Syndrome ; Primary Ovarian Insufficiency ; Reproduction ; Sertoli Cells ; Testis ; Transforming Growth Factors

BACKGROUND: Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant disease. Usually malignant cells secreted various types of cytokine, and the cytokine levels have been shown to be potential for diagnosis of malignant disease. To differentiate the ovarian cancer from other benign diseases, the levels of cytokine in peritoneal fluid have been revealed more effect than those in blood. METHODS: The levels of interferon-gamma, tumor necrosis factor-alpha, interleukin-1 beta, interleukin-5, interleukin-6 and interleukin-10 in peritoneal fluid from 31 cases of ovarian cyst, 14 cases of ovarian cancer, and 20 cases of endometriosis were determined by enzyme-linked immunosorbent assay(Endogen Inc., USA). RESULTS: The mean level of interleukin-1 beta, interleukin-6, and interleukin-10 in the patients of in ovarian cancer were 10.49+/-17.44 pg/mL, 705.79+/-236.06 pg/mL and 231.56+/-145.43 pg/mL, respectively, which were significantly higher than in ovarian cyst(2.00+/-2.04 pg/mL, 103.42+/-154.49 pg/mL and 27.90+/-23.20 pg/mL, respectively)(P<0.05). The mean concentration of interferon-gamma, tumor necrosis factor-alpha, and interleukin-5 in patients of ovarian cancer were not significantly different from the benign group. CONCLUSIONS: The cytokine levels of peritoneal fluid in ovarian cancer were significantly higher than ovarian cyst and endometriosis. So, the measurement of cytokine level in neoplastic effusion could be useful to differentiate malignant from ovarian cyst.
Ascitic Fluid* ; Cytokines ; Diagnosis ; Diagnosis, Differential* ; Endometriosis ; Female ; Humans ; Immune System ; Interferon-gamma ; Interleukin-1 ; Interleukin-10 ; Interleukin-1beta ; Interleukin-5 ; Interleukin-6 ; Ovarian Cysts ; Ovarian Diseases* ; Ovarian Neoplasms* ; Tumor Necrosis Factor-alpha

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

Adult ; Female ; Humans ; Ovarian Diseases ; diagnosis ; Ovarian Neoplasms ; diagnosis ; Pregnancy

Meigs' syndrome is defined by the presence of ascites and hydrothorax in association with an ovarian fibroma, which spontaneously resolve soon after the removal of the tumor. Pseudo-Meigs' syndrome refers to the same clinical features associated with other ovarian tumors; thecoma, granulosa cell tumor, Brenner tumor, struma ovarii, etc. Elevated serum CA 125 levels have a strong correlation with ovarian malignancy, but several benign ovarian tumors have been found to cause a rise in CA 125 levels. We present a case of Pseudo-Meigs' syndrome with an elevated CA 125 resulting from thecoma with a brief review of the literatures.
Ascites ; Brenner Tumor ; Female ; Fibroma ; Granulosa Cell Tumor ; Hydrothorax ; Meigs Syndrome ; Struma Ovarii ; Thecoma

Megaureter is a relatively rare disease, and first described by Caulk in 1923. Authors report a case of huge primary megaureter misdiagnosed as an ovarian cyst preoperatively in a 20 year-old female patient with brief review of literatures.
Female ; Humans ; Ovarian Cysts* ; Rare Diseases ; Young Adult

With the advent of B-mode transvaginal sonography, new opportunities are presented to better define ovarian lesions. Since its development in 1966, the transvaginal ultrasound continues to be an essential component in the diagnostic work-up of adnexal masses. This study reviewed the histopathological diagnoses of 387 patients who underwent surgery for removal of a benign ovarian cyst at our institution and compared it with the results of the patient's pre-operative ultrasound examinations done at the ultrasound section. After statistical analysis, this study showed that the B-mode transvaginal ultrasound is accurate in diagnosing the majority of benign ovarian cysts. Although it is more sensitive and specific for some types of benign ovarian cysts over others, it continues to be an important tool in the initial work-up of an ovarian cyst.

Human ; Female ; Ovarian Cysts ; Adnexal Diseases ; Ultrasonography ; Physical Examination

A sex cord tumor with annnular tubules is a relatively rare ovarian neoplasm. The cytologic findings from a fine needle aspiration biopsy of neck metastasis of a sex cord tumor with annnular tubules are described. The origin of the neck metastasis was the right ovary, and the tumor was diagnosed six years ago. The cytologic findings were characterized by tumor cells arranged in solid or follicular patterns. The tumor cells formed rosette-like or complex tubular structures with central rounded or coalesced hyaline materials. It was difficult to distinguish this tumor cytologically from granulosa cell tumor, thyroid follicular neoplasm, Sertoli-Leydig cell tumor, and Brenner tumor, but complex tubular structures were helpful in discriminating between these tumors.
Biopsy ; Biopsy, Fine-Needle* ; Brenner Tumor ; Female ; Granulosa Cell Tumor ; Hyalin ; Neck* ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary ; Sertoli-Leydig Cell Tumor ; Thyroid Gland

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*

Actinomycosis is a rare disease in human and has variable clinical features, which make the diagnosis difficult. Actinomycosis may be confused with malignancy and other inflammatory diseases because of its infiltrative nature and its tendency to invade normal anatomic barriers. We have experienced a case of abdominal actinomycosis combined with ovarian mucinous cystadenocarcinoma and report this case with brief review of literatures.
Actinomycosis* ; Cystadenocarcinoma, Mucinous ; Diagnosis ; Humans ; Ovarian Neoplasms* ; Rare Diseases