Giant Ovarian Cysts Treated by Single-Port Laparoscopic Surgery: A Case Series

BackgroundOvarian cysts are very common diseases of the female reproductive system. Giant ovarian cysts refer to the tumors with diameters greater than 10 cm. In recent years, due to the development of clinical diagnosis, imaging modalities, and the improvement of patients’ cognition of the diseases, the occurrence of giant ovarian cysts has become rare. The purpose of this study was to show a new operation method of single-port laparoscopy to treat giant ovarian cysts.MethodsWe report a case series of five patients with giant ovarian cysts who underwent single-port laparoscopic surgery in the gynecology department of the Shengjing Hospital of China Medical University between June 2020 and March 2021. The inclusion criteria were ovarian cysts at least 20 cm in diameter, and cases when the tumor might be malignant were excluded.ResultsThe patients’ mean age was 26.2years. The most common clinical presentation was progressive abdominal distension. Median size of the cysts at imaging was 39.2 cm (range 21–63 cm). All patients underwent single-port laparoscopic surgery, and none of them converted to laparotomy. On final pathological reports, two cysts were serous cystadenomas, and three were mucinous cystadenomas. All patients recovered well and were discharged on time.ConclusionGiant ovarian cysts can be treated by single-port laparoscopic surgery. In addition to the well-known advantages of laparoscopic surgery (e.g., small pelvic interference, fast postoperative recovery), it can also play the role of perfect cosmetic results, which has more advantages for young women.

HYDATIC CYST OF THE LIVER OR HEPATIC MUCINOUS CYSTADENOMA

Mucinous cystadenomas of the liver are rare cystic neoplasms, often mistaken for simple cysts or hydatid cysts of the liver. They are generally benign tumors, often discovered incidentally on imaging or during independent surgeries. Despite their tendency to grow slowly, mucinous cystadenomas of the liver can reach symptomatic dimensions. And given their potential for malignant transformation into mucinous cystadenocarcinomas, a misdiagnosis can have serious secondary consequences. We report the case of a 55-year-old woman with chronic right hypochondrium pain in whom a mucinous cystadenoma of the liver was accidentally discovered during surgery for hepatic hydatid cyst at the general surgery department at the ARRAZI Hospital - UHC Mohammed VI in Marrakech, Morocco.

Large primary retroperitoneal mucinous cystadenoma managed laparoscopically: Case report and literature review

Background: Retroperitoneal cystic lesions (RCLs) are uncommon clinical findings that arise within the retroperitoneal compartments and account for various etiologies. They can be benign or malignant in nature and may present with different manifestations. Case report: A 55-year-old woman presented with nonspecific right sided abdominal pain. Ultrasound detected a large cyst in the right retroperitoneal region, computed tomography revealed a large well-defined cystic lesion measuring 13 X 9 X 6 cm in the right posterior peritoneum extending from the subhepatic area to the right pelvis. Laparoscopic complete resection performed with uneventful perioperative course. Histopathologic findings were suggestive of mucinous cystadenoma. Conclusion: Primary Retroperitoneal Mucinous Cystadenoma (PRMC) is an extremely rare pathology that can pose some challenge for clinicians. Awareness of this entity can help us in establishing the diagnosis and provide an optimal management. Although laparotomy is considered the standard approach of huge mucinous cystadenomas; laparoscopic surgery can be a safe and adequate therapeutic option. Keywords: retroperitoneal cystic lesions (RCL); primary retroperitoneal mucinous cystadenomas (PRMCs); cystadenoma; mucinous; laparoscopy.

Emerging hazard for women of new era: ovarian malignancy.

Objective: The present study aims to assess the incidence of ovarian malignancies and its rise from 2010 to 2020 at subnational levels in tertiary care hospital in Faisalabad. Study Design: Retrospective Analysis. Setting: Madina Teaching Hospital, Faisalabad. Period: January 2010 and January 2020. Material & Methods: After the precise processing of data extracted from the Pakistan Cancer Registry and hospital records, annual standardized incidence and increasing trends were calculated during the period of the study. Results: A total of 103 patients of ovarian tumors were included in the study. During this period 550 oophorectomies were received out of 4752 (11.5%) gynecological admissions. 103 cases(18.73%) selected after formulating an inclusion criteria. The data showed 75 benign (74.25%) cases, 7 borderline tumors (6.93%) and 21 malignant tumors (20.79%). Age of patients ranged from 14-69 years. Out of all the benign tumors, serous cystadenomas were most common (45.33%) followed by mucinous cystadenomas (24%), dermoid cyst (30.66%). Commonest malignant tumor was serous cystadenocarcinoma (42.85%) followed by mucinous cystadenocarcinoma (33.33%) granulosa cell tumors (14.28%) krukenberg tumor (4.76%) and dysgerminoma (4.76%). Clinical signs and symptoms were mostly abdominal pain and distention. Conclusion: Ovarian malignancies are increasing in frequency at an early age with relatively longer duration of symptoms. This emphasizes the need of early detection and management because of desirability of maintaining patient’s menstrual and reproductive capabilities.

Ovarian cysts in Pregnancy: Obstetric Outcome and Management

Objective: To study the pregnancy outcome and management of ovarian cysts during pregnancy. Methods : A prospective observational study was conducted in Prathima Institute of Medical Sciences, Karimnagar from June 2018 to June 2020. A total of 32 cases with ovarian cysts 5cm with benign features as suggested by ultrasound were included in the study. The pregnancy outcome and management were studied. Results : Out of 32 pregnant women with ovarian cysts, 25(78.12%) were asymptomatic and were managed conservatively. Of the 25, spontaneous resolution was seen in 18(56.25%) patients while 7(21.87%) patients in whom ovarian cyst persisted or was incidentally detected during cesarean section were managed by cystectomy at the same time. Surgery was needed in the antenatal period in 7(21.87%) patients due to complications such as increase in size of the cyst seen in 4(12.5%) and torsion seen in 3(9.37%). All the 32 patients had good perinatal outcome. There were no miscarriages. All patients continued to term except one, who presented at 36 weeks with torsion, andunderwent emergency cesarean section with oophorectomy. Histopathological examination of the excised cysts showed 5 as simple cyst, 5 as serous cystadenomas, 3 as mucinous cystadenomas and 1 as dermoid. Conclusion: Management of the ovarian cysts during pregnancy is conservative. Most of them undergo spontaneous resolution. Surgical management is reserved for only symptomatic patients. Pregnancy outcome as such is not affected by ovarian cysts during pregnancy.

Giant Ovarian Cysts Treated by Single-Port Laparoscopic Surgery: A Case Series

Background: Ovarian cysts are very common diseases of female reproductive system. Giant ovarian cysts refer to the tumors with diameters greater than 10 cm. In recent years, due to the development of clinical diagnosis, imaging modalities and the improvement of patients' cognition of the diseases, the occurrence of giant ovarian cysts become rare. The purpose of this study was to show a new operation method of single-port laparoscopy to treat giant ovarian cysts. Methods: We report a case series of 5 patients with giant ovarian cysts who underwent single-port laparoscopic surgery in gynecology department, Shengjing Hospital of China Medical University between June 2020 and March 2021. The inclusion criteria were ovarian cysts at least 20 cm in diameters, and cases which the tumor might be malignant were excluded. Results: The patients' mean age was 26.2years. The most common clinical presentation was progressive abdominal distension. Median size of the cysts at imaging was 39.2 cm (range 21–63 cm). All patients underwent single-port laparoscopic surgery, and none of them converted to laparotomy. On final pathological reports, two cysts were serous cystadenomas, and three were mucinous cystadenomas. All patients recovered well and discharged on time. Conclusion: Giant ovarian cysts can be treated by single-port laparoscopic surgery. In addition to the well-known advantages of laparoscopic surgery (e.g., small pelvic interference, fast postoperative recovery), it can also play the role of perfect cosmetic results, which has more advantages for young women.

Study of Histomorphological Spectrum of Mucinous Tumours of Ovary in a Tertiary Care Center in Thrissur, Kerala, India

BACKGROUND Mucinous ovarian tumours have various histomorphological patterns. Histopathological examination plays an important role in classifying ovarian tumours for prognosis and better treatment. Mucinous ovarian tumours are classified into benign cystadenomas, borderline mucinous tumours and malignant mucinous cystadenocarcinomas. This study was done to evaluate the distribution of ovarian tumours with respect to various parameters like age, laterality, size, loculation, stratification of cells, nuclear atypia, to study the gross morphological patterns of the various histopathological tumour types and evaluate the association between various parameters of ovarian tumours and risk of malignancy. METHODS A cross sectional study was conducted in the Department of Pathology, in a tertiary health care centre over a period of 5 years. The study includes cases of mucinous cystadenomas, borderline mucinous tumours and cystadenocarcinomas. Formalin fixed and paraffin embedded sections were reviewed. Data was collected & entered in Microsoft Office Excel 2007 sheet. RESULTS Among 32 cases of mucinous tumours studied 15 are mucinous cystadenomas, 10 are borderline tumours and 7 are cystadenocarcinomas. The mean age is 45 years. 1 case of mucinous cystadenocarcinoma showed bilateralism. 68.8 % of the tumours were more than 15 cms in size. 72 % of the tumours were multiloculated and 28 % were uniloculated. 78.1 % of the tumours have stratification of less than 4 cell-thickness. 46.9 % of tumours had no nuclear atypia, 31.2 % had mild atypia and 21.9 had severe nuclear atypia. CONCLUSIONS Benign cystadenomas were more common than malignant and borderline tumours. The mean age of presentation was 45 years. KEYWORDS Benign Cystadenomas, Mucinous Borderline Tumours, Mucinous Cystadenocarcinomas

The treatment approach of a 12 kg giant ovarian mucinous cystadenoma in a 13-year-old: a case report

Epithelial ovarian tumours are rare in the adolescent age group, accounting for less than 15% of overall ovarian malignancy. Of this, one-fourth of them are mucinous in nature. Mucinous cystadenomas, being precursors of borderline and invasive ovarian tumours, can reach to size as large as 15-30 cm in diameter without having malignant potential. Also, intraoperative management of such large abdominal mass can be challenging. We present a case of a giant unilateral 12 kg mucinous cystadenoma in a 13-year-old young girl, that grew over a period of 1 year. She underwent left salpingo-oophorectomy after decompression of the mass without any complications.