Ovarian Cyst Alternative Medicine
Ovarian Cysts and Tumors Ovarian cysts and tumors may be detected as adnexal masses on one or both sides. Later, they may extend out of the pelvis. Cysts tend to be smooth and compressible, tumors more solid and often nodular. Uncomplicated cysts and tumors are not usually tender.
Anteriorly, from above down, it is related to the pancreas (separating it from the stomach), the third part of the duodenum and coils of small intestine. It is crossed by the left renal vein. A large tumour of pancreas or stomach, a mass of enlarged para-aortic nodes, or a large ovarian cyst may transmit the pulsations of the aorta and be mistaken for an aneurysm.
Patients usually present with visceral pain that localizes later to the left lower quadrant and that is associated with fever, nausea, vomiting, or constipation. A right lower quadrant presentation would not exclude this diagnosis because ascending colon or cecal diverticulitis can occur. If a colovesical fistula is present, the patient may present with pneumaturia or fecaluria (a virtually pathognomic finding). On examination, the patient may have localized left lower quadrant tenderness or more diffuse abdominal tenderness with peritoneal irritation signs, such as guarding or rebound tenderness. The differential diagnosis includes painful diverticular disease without diverticulitis, acute appendicitis, Crohn disease, colon carcinoma, ischemic colitis, irritable bowel syndrome, and gynecologic disorders such as ruptured ovarian cyst, endometriosis, ectopic pregnancy, and pelvic inflammatory disease.
Corpus luteum cysts develop from mature graafian follicles and are associated with normal endocrine function or prolonged secretion of progesterone. They usually are smaller than 3 cm in diameter. There can be intrafollicular bleeding because of thin-walled capillaries that invade the granulosa cells from the theca interna. When the hemorrhage is excessive, the cyst can enlarge, and there is an increased risk of rupture. Cysts tend to rupture more during pregnancy, probably due to the increased incidence and friability of corpus lutea in pregnancy. Anticoagulation therapy also predisposes to cyst rupture, and these women should receive medication to prevent ovulation. Patients with hemorrhagic corpus lutea usually present with sudden onset of severe lower abdominal pain. This presentation is especially common in women with a hemoperitoneum. Some women complain of unilateral cramping and lower abdominal pain for I to 2 weeks before overt rupture. Corpus luteum cysts rupture more...
A significant limitation to the use of the progestogen-only pill is erratic uterine bleeding which many women understandably dislike. There may be no bleeding for months or there may be frequent and irregular bleeding. Ectopic pregnancy may be more frequent due to a fertilised ovum being held up in a functionally depressed fallopian tube. Other adverse effects are generally less than the combined pill (blood coagulation is unaffected), data on breast cancer are conflicting but are largely reassuring. Ovarian cysts occur more frequently in progesterone-only pill users.
This benign vascular tumor affects adults aged 20 to 50 years. The majority of the tumors are sporadic, few are familial, and about 25 of them are the diagnostic hallmark of the dominantly inherited von Hippel Lindau syndrome. The mutant gene maps to chromosome 3p25-26. The tumor, single or multiple, typically occurs in the cerebellum, seldom in the cerebrum, brainstem, or spinal cord. Extracerebral manifestations are various combinations of retinal angiomatosis, pheochromocy-toma, congenital pancreatic and renal cysts, pancreatic islet cell tumor, renal carcinoma, and cystadenoma of epididymis. An erythropoietin hormone produced by the cells of capillary hemangioblastoma causes secondary polycythemia.
Although the occasional patient may undergo lapa-roscopic evaluation for a small solid adnexal mass or complex ovarian cyst, the patient with a large, solid adnexal mass or evidence of hemodynamic instability should undergo laparotomy through a vertical skin incision to ensure appropriate full surgical staging. Upon entering the peritoneal cavity, pelvic washings should be obtained, and hemoperitoneum, if present, evacuated. The site of hemorrhage is most commonly the mass itself, and such that surgical removal of the tumor may be all that is necessary to control the bleeding. A unilateral mass in a patient of any age should be removed by unilateral salpingo-oophorectomy and sent for immediate histologic evaluation. Every attempt should be made to avoid rupture, as this upstages an otherwise stage 1A or 1B carcinoma and may adversely affect survival 34, 35 . For this reason, the tumor should never be morcel-lated to effect laparoscopic removal. Occasionally, an ovarian cystectomy is...
Noncontraceptive benefits of combination oral contraceptives include decreased incidence of benign breast disease, relief from menstrual disorders (dysmenorrhea and menorrhagia), reduced risk of uterine leiomyomata, protection against ovarian cysts, reduction of acne, improvement of bone mineral density, and a reduced risk of colorectal cancer.
The diagnosis of acute salpingitis is made clinically by abdominal tenderness, cervical motion tenderness, and adnexal tenderness (Table 21-1). Confirmatory tests may include a positive gonorrhea or Chlamydia culture or an ultrasound suggesting a TOA. Other diseases that must be considered are acute appendicitis, especially if the patient has right-sided abdominal pain and ovarian torsion, which usually presents as colicky pain and is associated with an ovarian cyst on ultrasound. Renal disorders, such as pyelonephritis or nephrolithiasis, also must be considered. Right upper quadrant pain may be seen with salpingitis when perihepatic adhesions are present, the so-called Fitz-Hugh-Curtis syndrome. When the diagnosis is in doubt, the best method for confirmation is laparoscopy. The surgeon would look for purulent discharge exuding from the fimbria of the tubes.
LMP tumors represent a category of neoplasms that are distinct from benign cystadenomas and cystade-nocarcinomas. First described by Taylor in 1929, they have since been referred to as borderline tumors or atypically proliferating tumors 23, 24 . These tumors arise from the surface epithelium of the ovary and 80-95 are of serous or mucinous histology. LMP tumors of the ovary comprise approximately 15 of all epithelial ovarian tumors 25, 26 . The pathologic criteria for diagnosis of these tumors include the absence of stromal invasion in the ovary and any two of the following characteristics epithelial tufting, multilayering of epithelium, mitotic activity, and nuclear atypia. Trisomy 12 has been reported in LMP tumors 27 .
Mature benign cystic teratomas (dermoid cysts) constitute more than or sweat glands. However, they can also contain tissues of the three embryonic layers, including mesoderm and endoderm. They usually are multicystic and contain hair intermixed with foul-smelling, sticky, keratinaceous, and sebaceous debris. Although most are unilateral, they can appear bilaterally 10 to 15 of the time. Ultrasound features of dermoid cysts include a hypoe-choic area or echoic bandlike strand in a hypoechoic medium or the appearance of a cystic structure with a fat fluid level. Torsion is the most frequent complication, with severe acute abdominal pain as the typical initial symptom. This is more commonly seen during pregnancy and the puerperium. Torsion is also more common in children and younger patients. Rupture is an uncommon complication and presents as shock or hemorrhage. A chemical peritonitis can be caused by spill of the contents of the tumor into the peritoneal cavity. The treatment usually...
Infertility can result from ovulatory or uterine problems mechanical problems, including obstruction of the fallopian tubes male fertility factors or multiple factors in either sex or combined female and male factors. Ovulatory problems are the most common cause of female infertility. Polycystic ovarian syndrome (PCOS) affects up to 5 of reproductive-age women. It is the most common cause of ovulatory infertility. PCOS is a condition characterized by multiple ovarian cysts, often found in a row, resembling a string of pearls. Ovarian cysts are fluid-filled sacs arising from follicles swollen with fluid that are prevented from producing mature oocytes. Patients with PCOS also have hormonal imbalances, including decreased levels of LH, FSH, and progesterone and increased androgen production, including excess testosterone and DHEAS causing hirsutism or male facial patterns of hair growth. Insulin resistance is a common associated condition. PCOS is generally diagnosed when two of the...
Polycystic kidney disease The kidneys are bilaterally enlarged with multiple cysts of various sizes distorting the collecting system. Hepatic, pancreatic, splenic, and pulmonary cysts may also be identified. Hemorrhagic cysts are seen as high-density lesions. Calculi within cysts and cyst wall calcifications may also be noted.
Germ cell tumors can be either benign or malignant. Benign tumors include benign germ cell tumors and benign teratoma or dermoid cyst. The malignant germ cell tumors are much rarer than benign ones. The malignant germ cell tumors may be seminomanous or nonseminomanous. Patients with seminomanous malignant germ cell tumors must undergo ultrasound of the testicles even if physical examination is negative since there may be a nonpalpable focus of tumor still there with the mediastinal component being a metastasis rather than a primary tumor. Seminomanous tumors have low levels of beta HCG and alpha-fetopro-tein unlike its nonseminomanous germ cell counterpart.
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