Postmenopausal Ovarian Cyst

2021 ◽  
pp. 207-222
Author(s):  
Ioannis Kalogiannidis
Keyword(s):  
Ovarian Cancer ◽  
Early Diagnosis ◽  
Postmenopausal Women ◽  
Ovarian Cyst ◽  
Daily Practice ◽  
Optimal Management ◽  
Ovarian Pathology ◽  
Adnexal Pathology ◽  
Ovarian Masses

Ovarian masses (tumors) are very often in gynaecological daily practice. Almost 5%-10% of the women worldwide receive operative procedures for ovarian pathology. The risk related to ovarian cancer is increased from 3d to 8th decade of woman's life. However, in 80% of the ovarian pathology, the etiology will be of benign origin (cystic, solid, or mixed). The accurate follow-up of patients with adnexal pathology may contribute the early diagnosis of the disease and the improvement of prognosis in a case of malignancy. Optimal management of cysts in postmenopausal women remains challenging. The chapter aims to summarize current clinical evidence regarding diagnosis and treatment of such a pathology.

scholarly journals Hashimoto’s Thyroiditis Presenting as Bilateral Ovarian Masses in an Adolescent

2021 ◽  
Vol 2 (2) ◽  
pp. 81-85
Author(s):  
Paapa Dasari ◽  
Nitin M ◽  
Chitra Thiyagarajan
Keyword(s):  
Ovarian Cyst ◽  
Hashimoto’S Thyroiditis ◽  
Emergency Services ◽  
Past History ◽  
Cyst Formation ◽  
Hashimoto's Thyroiditis ◽  
Pain Abdomen ◽  
History Of ◽  
Ovarian Masses

Hypothyroidism can cause significant reproductive morbidity and its association with ovarian cyst formation is rare and when it occurs in children, it is referred to as Van Wyk and Grumbach syndrome. An 18-year-old girl was referred to our emergency services with suspicion of torsion ovarian cyst with USG findings as she had pain abdomen and vomiting of 3 days duration. She was provisionally prepared for laparoscopic surgery but on revaluation by USG bilateral thecaleutein cysts measuring 7x6.8x3.5 cms (right) and 10x6.8 x3.2 cms (left) were diagnosed. Her TSH level was 483 mI U/L . On probing she revealed past history of diagnosis of hypothyroidism and discontinuation of thyroxin therapy after taking for 6 months. Her anti TPO antibodies were >1300 IU/mL. USG thyroid revealed features suggestive of Hashimoto’s thyroiditis. She was counselled and started on thyroxin therapy with a dose of 4µg/kg and after 2 months of follow up the ovarian cysts have regressed and ovaries appeared normal on USG.

scholarly journals Diagnostic measures comparison for ovarian malignancy risk in Epithelial ovarian cancer patients: a meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arpita Suri ◽  
Vanamail Perumal ◽  
Prajwal Ammalli ◽  
Varsha Suryan ◽  
Sanjiv Kumar Bansal
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Accuracy ◽  
Epithelial Ovarian Cancer ◽  
Postmenopausal Women ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Diagnostic Measures ◽  
Ovarian Masses

AbstractEpithelial ovarian cancer has become the most frequent cause of deaths among gynecologic malignancies. Our study elucidates the diagnostic performance of Risk of Ovarian Malignancy Algorithm (ROMA), Human epididymis secretory protein 4 (HE4) and cancer antigen (CA125). To compare the diagnostic accuracy of ROMA, HE-4 and CA125 in the early diagnosis and screening of Epithelial Ovarian Cancer. Literature search in electronic databases such as Medicine: MEDLINE (through PUBMED interface), EMBASE, Google Scholar, Science Direct and Cochrane library from January 2011 to August 2020. Studies that evaluated the diagnostic measures of ROMA, HE4 and CA125 by using Chemilumincence immunoassay or electrochemiluminescence immunoassay (CLIA or ECLIA) as index tests. Using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). We included 32 studies in our meta-analysis. We calculated AUC by SROC, pooled estimated like sensitivity, specificity, likelihood ratio, diagnostic odds ratio (DOR), Tau square, Cochran Q through random effect analysis and meta-regression. Data was retrieved from 32 studies. The number of studies included for HE4, CA125 and ROMA tests was 25, 26 and 22 respectively. The patients with EOC were taken as cases, and women with benign ovarian mass were taken as control, which was 2233/5682, 2315/5875 and 2281/5068 respectively for the markers or algorithm. The pooled estimates of the markers or algorithm were sensitivity: ROMA (postmenopausal) (0.88, 95% CI 0.86–0.89) > ROMA (premenopausal) 0.80, 95% CI 0.78–0.83 > CA-125(0.84, 95% CI 0.82–0.85) > HE4 (0.73, 95% CI 0.71–0.75) specificity: HE4 (0.90, 95% CI 0.89–0.91) > ROMA (postmenopausal) (0.83, 95% CI 0.81–0.84) > ROMA (premenopausal) (0.80, 95% CI 0.79–0.82) > CA125 (0.73, 95%CI 0.72–0.74), Diagnostic odd’s ratio ROMA (postmenopausal) 44.04, 95% CI 31.27–62.03, ROMA (premenopausal)-18.93, 95% CI 13.04–27.48, CA-125-13.44, 95% CI 9.97–18.13, HE4-41.03, 95% CI 27.96–60.21 AUC(SE): ROMA (postmenopausal) 0.94(0.01), ROMA (premenopausal)-0.88(0.01), HE4 0.91(0.01), CA125-0.86(0.02) through bivariate random effects model considering the heterogeneity. Our study found ROMA as the best marker to differentiate EOC from benign ovarian masses with greater diagnostic accuracy as compared to HE4 and CA125 in postmenopausal women. In premenopausal women, HE4 is a promising predictor of Epithelial ovarian cancer; however, its utilisation requires further exploration. Our study elucidates the diagnostic performance of ROMA, HE4 and CA125 in EOC. ROMA is a promising diagnostic marker of Epithelial ovarian cancers in postmenopausal women, while HE4 is the best diagnostic predictor of EOC in the premenopausal group. Our study had only EOC patients as cases and those with benign ovarian masses as controls. Further, we considered the studies estimated using the markers by the same index test: CLIA or ECLIA. The good number of studies with strict inclusion criteria reduced bias because of the pooling of studies with different analytical methods, especially for HE4. We did not consider the studies published in foreign languages. Since a few studies were available for HE4 and CA125 in the premenopausal and postmenopausal group separately, data were inadequate for sub-group analysis. Further, we did not assess these markers' diagnostic efficiency stratified by the stage and type of tumour due to insufficient studies.

scholarly journals Do women with benign versus malignant ovarian masses demonstrate variable clinical presentation?

2020 ◽  
Vol 10 (1) ◽  
pp. 132
Author(s):  
Nilajkumar D. Bagde ◽  
Madhuri Bagde ◽  
Sarita Agrawal ◽  
Zamir A. Lone ◽  
Nighat Hussain
Keyword(s):  
Early Diagnosis ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
Ovarian Tumors ◽  
Lumbar Pain ◽  
Benign Tumors ◽  
Tertiary Care Centre ◽  
History Of ◽  
Ovarian Pathology ◽  
Ovarian Masses

Background: Early diagnosis of ovarian tumors is a challenge due to variable presentation. Early diagnosis of ovarian cancers aids in timely management and better clinical outcomes. Aim of study was to determine the different clinical presentations of ovarian tumors and compare those in benign tumors versus malignancies.Methods: Clinical data of all women operated for ovarian masses was extracted from case files at a tertiary care centre and evaluated and clinical features compared in women with benign versus malignant tumors.  Results: We found 50 cases of ovarian tumors with 26% malignancies. The mean age was 38.48+14.9 years. Malignancies were significantly common in menopausal than menstruating (χ2=13.57, p=0.001, fishers exact). Pain was the commonest symptom and combined lumbar and iliac pain was reported in 67% cases. The location of pain was not significantly different in women with malignancy compared to those with benign tumors (likelihood ratio χ2=7.93, p=0.24). The odds of reporting a mass in abdomen were significantly greater in women with cancers than benign tumors (OR= 4.9, 95%CI 1.07-24.06, p=0.01). More women with cancer had history of distension of abdomen compared to women with benign tumors (χ2=9.43, p=0.002).Conclusions: Lumbar pain is most frequent complaint in women with ovarian pathology. Symptoms of distension in abdomen or presence of lump in abdomen are a significant guide to alert the physician regarding possibility of malignancy must be evaluated without delay.

A randomized study of screening for ovarian cancer: a multicenter study in Japan

2008 ◽  
Vol 18 (3) ◽  
pp. 414-420 ◽  
Author(s):  
H. Kobayashi ◽  
Y. Yamada ◽  
T. Sado ◽  
M. Sakata ◽  
S. Yoshida ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Screening ◽  
Postmenopausal Women ◽  
Statistical Significance ◽  
Intervention Group ◽  
Developed Countries ◽  
Control Group ◽  
Ovarian Cancer Screening ◽  
Gynecological Examination

Ovarian cancer is common in women from developed countries. We designed a prospective randomized controlled trial of ovarian cancer screening to establish an improved strategy for the early detection of cancers. Asymptomatic postmenopausal women were randomly assigned between 1985 and 1999 to either an intervention group (n= 41,688) or a control group (n= 40,799) in a ratio of 1:1, with follow-up of mean 9.2 years, in Shizuoka district, Japan. The original intention was to offer women in the intervention group annual screens by gynecological examination (sequential pelvic ultrasound [US] and serum CA125 test). Women with abnormal US findings and/or raised CA125 values were referred for surgical investigation by a gynecological oncologist. In December 2002, the code was broken and the Shizuoka Cohort Study of Ovarian Cancer Screening and Shizuoka Cancer Registry were searched to determine both malignant and nonmalignant diagnoses. Twenty-seven cancers were detected in the 41,688-screened women. Eight more cancers were diagnosed outside the screening program. Detection rates of ovarian cancer were 0.31 per 1000 at the prevalent screen and 0.38–0.74 per 1000 at subsequent screens; they increased with successive screening rounds. Among the 40,779 control women, 32 women developed ovarian cancer. The proportion of stage I ovarian cancer was higher in the screened group (63%) than in the control group (38%), which did not reach statistical significance (P= 0.2285). This is to our knowledge the first prospective randomized report of the ovarian cancer screening. The rise in the detection of early-stage ovarian cancer in asymptomatic postmenopausal women is not significant, but future decisions on screening policy should be informed by further follow-up from this trial.

scholarly journals MicroRNAs as Biomarkers in Thyroid Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Marilena Celano ◽  
Francesca Rosignolo ◽  
Valentina Maggisano ◽  
Valeria Pecce ◽  
Michelangelo Iannone ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Early Diagnosis ◽  
Thyroid Tumor ◽  
Serum Biomarkers ◽  
Optimal Management ◽  
Thyroid Tumors ◽  
Prognostic Evaluation ◽  
Potential Applications ◽  
Novel Biomarkers

Optimal management of patients with thyroid cancer requires the use of sensitive and specific biomarkers. For early diagnosis and effective follow-up, the currently available cytological and serum biomarkers, thyroglobulin and calcitonin, present severe limitations. Research on microRNA expression in thyroid tumors is providing new insights for the development of novel biomarkers that can be used to diagnose thyroid cancer and optimize its management. In this review, we will examine some of the methods commonly used to detect and quantify microRNA in biospecimens from patients with thyroid tumor, as well as the potential applications of these techniques for developing microRNA-based biomarkers for the diagnosis and prognostic evaluation of thyroid cancers.

scholarly journals GYNAECOLOGICAL MALIGNANCIES

2013 ◽  
Vol 20 (05) ◽  
pp. 752-758
Author(s):  
Tasneem Ashraf ◽  
Samia Haroon
Keyword(s):  
Ovarian Cancer ◽  
Early Diagnosis ◽  
Genital Tract ◽  
Histopathological Examination ◽  
Public Awareness ◽  
Gynecological Cancer ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tract Cancer

Objectives: To determine the frequency of different Gynecological Malignancies and outcome following primary treatment.Study Design: Cross sectional Descriptive Study. Place and Duration of study: In a tertiary care hospital; Bolan Medical ComplexHospital Quetta Baluchistan from Feb 2006 to Nov 2009. Methodology: All the women presenting with genital tract cancer during thestudy period were included. Their age, parity, mode of presentation, anatomic area involved, and investigations performed were noted.Stage of disease (according to FIGO staging), surgical procedures performed, and operative finding were recorded. Specimens weresubjected to histopathological examination. Post operative chemo or radiotherapy was given according to stage and histopathologyreports. Patients were followed up by telephonic appointments for growth recurrence, disease free interval and mortality. Follow uprecords were also obtained from Oncology Department & CINAR (Cancer Institute of Nuclear Medicine and Radiotherapy) HospitalQuetta. Results: Amongst the 93 cases of gynecological cancer ovarian cancer was the commonest (45%), cervical and uterine cancerswere equal in frequency (17.2%), and Choriocarcinoma was seen in (9.3%) cases while vaginal cancer was rarest (1.83%). Epithelialovarian tumors were the commonest (71%) and 67% patients presented in stage III &IV. During the median follow up period of 25 months44% patients are alive without recurrence. 27% lost to follow up, 18% developed recurrence, 11% died with disease, 50% cancer deathswere due to ovarian cancer. Conclusions: Ovarian cancer is the commonest genital tract cancer and accounted for half of all genital tractcancer deaths. Early diagnosis and treatment can improve prognosis. Well established screening program and public awareness isimportant for early diagnosis and to decrease mortality.

scholarly journals Primary Clival Mucocele: ENT Perspective in Early Diagnosis and Management

2015 ◽  
Vol 8 (1) ◽  
pp. 27-29
Author(s):  
Alok Thakar ◽  
Preetam Chappity
Keyword(s):  
Early Diagnosis ◽  
Daily Practice ◽  
Diagnosis And Management ◽  
Unilateral Headache ◽  
Intracranial Complications ◽  
Rare Lesion

ABSTRACT Primary clival mucocele is a rare lesion encountered in our daily practice. The previous scant literature enumerate cases which presented with intracranial complications and were usually treated by neurosurgeons. We are presenting a case of a 24-year old female who presented to us with unilateral headache and recurrent episodes of sinusitis. The patient's radiology suggested a primary clival mucocele, which was drained endoscopically. The patient on follow-up is symptom free. This paper tries to implicate the importance of the otorhinolaryngologist in diagnosing this rare lesion and preventing its progression and thus, intracranial complications. How to cite this article Chappity P, Thakar A. Primary Clival Mucocele: ENT Perspective in Early Diagnosis and Management. Clin Rhinol An Int J 2015;8(1):27-29.

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

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