Ovarian cyst lecture

2021-03-21 12:00 AM

Pelvic pain, amenorrhea or late menstrual period can easily be confused with ectopic pregnancy, cystic twisting, cyst rupture causing bleeding to laparoscopy or opening of the abdomen to stop bleeding.

Preamble

Ovarian cysts are fluid-filled inner-shell tumors found in all ages. Ovarian cysts cause local irritant menstrual disorders, impaired reproductive function, sometimes causing weakness, or can cause death from complications of intestinal obstruction or urinary retention.

Functional ovarian tumors such as granulosa cell tumors, or shell tumors cause early puberty due to the secretion of enough Oestrogens to develop breasts, pubic hairs appear, and genitals develop despite lack of ovulation. Therefore, in girls with early puberty, if the ovaries are palpable, abnormal ovarian tumors need to be carefully examined.

Muscle function

These are small fluid-filled cysts that can be found at any age but are common during puberty and premenopause. Usually small cysts, clinically difficult to detect, but if the tumor is between 5-6 cm in size, palpable, common at menopause, so the patient needs to be carefully monitored. The cyst usually disappears after a few cycles, if the cyst persists for more than 60 days with normal menstruation, it should be considered as an entity tumor.

Ovarian cyst

The capsule size is usually 3-8 cm or more, as De Graff does not break on the specified date.

Symptoms: Unclear, sometimes manifesting blood or cystic torsion or causing long, or short menstrual cycle. When enlarged cysts cause pain, pain during intercourse.

Differential diagnosis with Tubular injection, endometriosis, luteal cysts, other tumors.

Treatment: Usually the cyst disappears spontaneously in about 60 days, requiring no treatment.

Use birth control pills to create artificial menstrual cycles.

If the cyst persists for more than 60 days with a regular menstrual cycle then it is likely that it is not a functional follicle. Should laparoscopy, aspiration follicle under the guidance of ultrasound is also a matter of controversy because if the tumor is an entity, the tumor cells can fall into the abdominal cavity and spread the tumor.

Lymphoid cysts

There are two types of corpus luteum cysts: granulocytes and shell cell cysts.

Granular cell corpus luteum cysts

As a functional follicle, meeting after the oocyte release, the granulosa cells become corpus luteum.

Symptom:

Pelvic pain, amenorrhea or late menstrual period can easily be confused with ectopic pregnancy, cystic twisting, cyst rupture causing bleeding to laparoscopy or opening of the abdomen to stop bleeding.

Lymphoid cysts

This type of follicle is not large. This type of follicle is common in polycystic ovaries, pregnancy, chorio or hypersensitivity to ovulation stimulation.

Treatment: The cyst usually disappears after treatment such as curettage, chorio therapy.

Polycystic ovaries (Stein-Leventhal syndrome)

Meet on both sides of the ovary, causing amenorrhea, infertility, amenorrhea, 50% with facial growth and obesity. Polycystic ovaries are more common in those with disorders involving the hypothalamus.

Expressed by the ovarian shell is keratinized, the surface is ivory-white, so it is called a scallop shape, many small follicles are under the thick shell.

Diagnosis: Based on history, physical examination, elevated LH test, body temperature monitoring without oocyte.

Diagnosis is confirmed by ultrasound and laparoscopy.

Treatment: Chlomifen 50-100 mg for 5-7 days incorporates Pregnyl 5000 units to cause oocyte release, sometimes with angular amputation of the ovaries.

Entity ovarian cyst

Ovarian epithelial cyst

Account for 60-80% of all types of cysts, including: water cysts, mucous cysts, endometriosis, bright cell tumors, Brenner tumors, ovarian cysts.

Water cysts

Thin shell, long stalk, clear fluid, large, sometimes filling the abdomen, is a benign tumor, may have papillae on the inside or outside of the capsule. If there is a easily malignant papilla.

Symptoms: Meet at any age, but is most likely to be discovered in the 20-30s.

Subframe examination found the tumor.

Treatment: Removal of the cyst.

Mucous cyst

Approximately 10-20% of all types of epithelial tumors, 85% are benign.

The structure of the cystic shell consists of 2 layers: fibrous organization and cylindrical epithelium. Cyst consists of many inner lobes containing yellow fluid, the largest size of ovarian tumors.

Endometrial optimism

Treatment: Surgery to remove the cyst.

Usually detectable through laparoscopy or in surgery 10-25% due to the endometrial glands growing out of the uterus, commonly seen in the ovaries.

The structure of the capsule shell is thin, clear, containing chocolate-coloured fluid, the tumor is usually sticky, easily broken when removed.

Diagnosis: Manifestations of pain in hypotension, abdominal pain during menstruation, pain during intercourse. Subframe examination for tumor detection.

Light-cell tumors (Mesonephroid tumors) resemble endometriosis

Diagnosis can only be confirmed by pathology.

Brenner tumor

80% is benign.

Subframe examination: detects tumors, the density of tumors with soft, hard, yellow or white addition.

Dermoid cyst

Accounting for 25% of ovarian tumors. Commonly seen is teratom, tumor containing organization arising from germ cells. In the follicle contains organizations such as teeth, hair, and peas. Dermal cysts are usually benign but can also become malignant. Or discovered in the age group 20-30 years old. About 20% develop on both sides of the ovary.

Symptoms: Usually no symptoms. Discovered by cesarean section or X-ray to find teeth in the tumor.

Treatment: Surgery is the optimal approach. If the cyst is small, the cyst should be removed, leaving the part of the ovary to heal.

Progression and complications

Common complications are:

Cystic helix

Commonly found in tumours with small size, long stalk, not stick, the cystic spiral can occur during pregnancy, or during labor.

Symptoms: sudden, severe pain, sweating, dizziness, vomiting.

Management: Emergency surgery.

Cyst breakage

Occurs after the cyst is twisted.

Cystic infection

Occurs when cystic twisting. Infection causes the follicle to enlarge, stick to the surrounding organs. Clinical manifestations resemble endometritis.

Squeeze the subframe

Tumor compressing the rectum, bladder. Enlarged cyst, progressing for many years, occupies the abdomen, compresses the lower aorta causing edema, collateral circulation, and ascites.

Bleeding in the follicles

From John Nang.

Pregnancy with an ovarian cyst

Diagnosed by routine pregnancy check-ups or by ultrasound.

Any type of cyst can be encountered, but the most common is a luteum or epidermal cyst, and a malignant cyst is rare. If the prognosis is afraid of cystic spiral surgery as soon as possible. If surgery is done early in the first 3 months of pregnancy, it is easy to have a miscarriage, so the operation should be done after 16 weeks because the placenta has already secreted enough progesterone to nourish the fetus. They have also decreased in size or no longer grown, so there is no need for surgery.

If the tumor develops after 16 weeks, then surgery should be done immediately, unless it is only detectable in late pregnancy.