Leiomyosarcomas of the ovarian vein are very rare. Four cases have been reported in the English language clinical literature. We present a case of leiomyosarcomas where the use of multi-detector CT had a substantial role in the establishment of the preoperative diagnosis. The radiological images as well as intraoperative features are illustrated. We also discuss the radiological findings of the ovarian vein leiomyosarcoma in comparison with those of other venous or retroperitoneal leiomyosarcomas. We expect that the use of multi-detector CT will be the choice for the diagnostic work-up of vascular leiomyosarcomas.
Adult ; Female ; Humans ; Leiomyosarcoma/*radiography/surgery ; Ovary/*blood supply ; Tomography, X-Ray Computed ; Vascular Neoplasms/*radiography/surgery ; Veins

BACKGROUNDAppendectomy is the traditional surgical procedure for correcting torsion of the adnexa. Although it prevents pulmonary embolism, ovarian necrosis, and secondary infection, it can have critical adverse effects on the ovarian function.

METHODSWe performed surgery for adnexal torsion in 12 patients, using high ligation of the ovarian vein, followed by removal of the ovarian tumor.

RESULTSBlood flow in the residual ovary gradually returned to normal within 1 - 3 months, and a dominant follicle could be seen in the residual ovary within 2 - 6 months post-surgery in all the 12 cases. Menstruation recovered in these three cases within 2 - 3 months. Postoperative intrauterine pregnancies occurred in two cases, with a corpus luteum graviditatis in the residual ovary in one case, while the other patient underwent labor after 13 months and a normal ovary on the affected side was seen at cesarean section.

CONCLUSIONSThis new surgical technique involving high ligation of the ovarian vein for adnexal torsion allowed successful preservation of the residual ovary and ovarian blood distribution, and can thus be used for the treatment of primary diseases of the ovary. The surgical procedure is simple, safe, and effective, and warrants extensive application in clinical practice.

Adolescent ; Adult ; Female ; Humans ; Ligation ; Ovarian Neoplasms ; physiopathology ; surgery ; Ovary ; blood supply ; physiopathology ; Torsion Abnormality ; surgery ; Ultrasonography, Doppler, Color

OBJECTIVETo evaluate the efficacy and safety of transcatheter arterial embolization (TAE) of the ovarian arteries (OA) additionally supplying the tumor of pelvic cavity.

METHODSTAE of OA was performed in 63 patients with a pelvic tumor additionally supplied by the OA. The mean age of those patients was 43.6 years (range, 16 - 66 years). In this series, there were 28 cervical carcinomas, 22 uterus fibroids, 6 ovarian cancers, 3 choriocarcinomas, 2 uterine sarcomas, 1 fibrosarcoma, and 1 rectal carcinoma infiltrating the uterus and adnexa. Emergency TAE was performed in 8 patients due to colporrhagia. The embolization materials consisted of polyvinyl alcohol particles (PVA) in 24 patients, gelatin sponge particles in 10 cases, PVA + gelatin sponge particles in 26; and PVA + gelatin sponge particles + microcoils in 3 cases.

RESULTSThe OA embolization was successfully performed in all the 63 cases, including bilateral in 19 cases and unilateral in 44 cases (left 27, right 17). No complications related to the procedure were observed. Bleeding from the vagina in 8 patients ceased immediately after supplemental OA embolization, and no re-bleeding occurred in any of them during their hospital stay.

CONCLUSIONPelvic tumors may be supplied additionally by the ovarian arteries. Therefore, routine internal iliac artery/uterine artery chemoembolization or embolization may not effectively cure the tumors. Ovarian artery angiography should be routinely performed before interventional treatment. A supplementary selective ovarian artery chemoembolization or embolization is safe and effective in the management of pelvic tumors with additional blood supply from the ovarian arteries.

Adolescent ; Adult ; Aged ; Choriocarcinoma ; blood supply ; therapy ; Female ; Gelatin Sponge, Absorbable ; therapeutic use ; Humans ; Middle Aged ; Ovarian Neoplasms ; blood supply ; therapy ; Ovary ; blood supply ; Polyvinyl Alcohol ; therapeutic use ; Uterine Artery Embolization ; methods ; Uterine Cervical Neoplasms ; blood supply ; therapy ; Uterine Neoplasms ; blood supply ; therapy ; Young Adult

OBJECTIVETo observe the clinical therapeutic effect of Nuzhen Yunyu Decoction (NYD, a Chinese recipe for nourishing blood and reinforcing Shen) and its influence on the hemodynamic parameters in ovarian and uterine arteries.

METHODSSixty-eight patients were randomly divided into two groups at the ratio of 2:1, 45 in the TCM group treated with Chinese medicine and 23 in the control group treated with clomiphene citrate. Menstrual cycle were taken as the indexes for clinical observation; basal body temperature, cervical mucus, vaginal exfoliative cells, serum hormones and B ultrasonic examination were taken as the indexes for ovulation and pregnancy assessment. The hemodynamic parameters of uterus and ovary were determined by using color Doppler ultrasonography, and the growth of follicles and ovulation, thickness of uterine endometrium were also monitored continuously.

RESULTSResults of 3 cycles treatment and 1 year follow-up study showed that the ovulation promoting rate, pregnancy rate and abortion rate in the two groups were similar, but the treated group showed better effects than that of control group, in such aspects as regulating menstruation, promoting growth and development of follicle, strengthening endometrium, improving blood supply and circulation of uterine and ovary (P < 0.05, P < 0.01).

CONCLUSIONNYD has the effects of ovulation promotion and holistic regulation of reproductive system.

Adult ; Anovulation ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemodynamics ; Humans ; Infertility, Female ; drug therapy ; etiology ; Ovary ; blood supply ; Ovulation Induction ; Phytotherapy ; Uterus ; blood supply ; Yin Deficiency ; drug therapy

A 46-year-old Vietnamese woman received embolization therapy in order to control postpartum hemorrhage. Angiography revealed an aberrant ovarian artery arising from the right common iliac artery. Superselective catheterization and subsequent embolization of the aberrant ovarian artery and bilateral uterine arteries were performed. Precise knowledge of the anatomic variations of the ovarian artery is important for successful embolization.
Angiography ; Embolization, Therapeutic/*methods ; Female ; Humans ; Iliac Artery/*radiography ; Middle Aged ; Ovary/*blood supply/*radiography ; Postpartum Hemorrhage/*radiography/*therapy ; Pregnancy ; Vascular Malformations/*radiography/*therapy

OBJECTIVETo evaluate the ability of multidetector computed tomography (MDCT) in differentiating ovarian tumors from non-ovarian masses.

METHODSForty-two cases with pelvic masses were examined with 16-row MDCT. All source image of each case was put into workstation for multi-planar reconstruction (MPR) and curved planar reconstruction(CPR). Axial image combined with 2D image was used for determining the relationship of the mass to ovarian vascular pedicle and identifying the normal ovary, which was compared with postoperative pathologic result and the finding during operation. All the data was compared using Fisher's exact test.

RESULTSThere were 28 ovarian tumors and 14 non-ovarian tumors in this series. If the ovarian vascular pedicle sign was used for determining whether the tumor was from the ovary or not, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 89.3%, 85.7%, 92.6%, 80.0% and 88.1%, respectively, with a significant difference in differentiating the tumor from the ovary or non-ovarian organs (P <0.05). If the identification of full normal ovary was used to determine non-ovarian origin of the tumor, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 50.0%, 100.0%, 100.0%, 80.0% and 83.3%, respectively, also with a significant difference in differentiating the tumors from the ovary or non-ovarian organs (P <0.05).

CONCLUSIONMDCT can clearly show the relationship of the tumor to the normal ovary and its vascular pedicle, which is very helpful in differentiating the ovarian tumors from a non-ovarian masses.

Adult ; Aged ; Cystadenocarcinoma, Mucinous ; diagnostic imaging ; Cystadenocarcinoma, Serous ; diagnostic imaging ; Cystadenoma, Mucinous ; diagnostic imaging ; Cystadenoma, Serous ; diagnostic imaging ; Diagnosis, Differential ; Female ; Gastrointestinal Stromal Tumors ; diagnostic imaging ; Humans ; Leiomyoma ; diagnostic imaging ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; Ovary ; blood supply ; diagnostic imaging ; Retroperitoneal Neoplasms ; diagnostic imaging ; Teratoma ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Uterine Neoplasms ; diagnostic imaging ; Young Adult