Abstract
Dermoid cyst (Mature cystic teratoma), the most common type of primordial germ cell ovarian tumors is usually benign and asymptomatic. It can be malignant for only 5 per cent. Giant ones can be symptomatic. Torsion is the most common complication. Ovarian (adnexal) torsion is defined that is twisting of ovarian(adnexal) mass around itself and compression of its vascular pedicle. Unless it’s diagnosed and treated quickly, ovarian torsion can give a way to haemorrhagic infarct and necrosis of that ovary. Torsion occurs and progesses in a few hours. The most important entities are early diagnosis and early treatment. Clinical signs are similar in pregnant and non-pregnant cases. Approximately 20 per cent can give symptoms during pregnancy. It can occur in any trimester, but especially in first trimester. The patient complains about severe lower abdominal and pelvic pain, nausea and vomiting. Ultrasound and Doppler scan are first choices to make a diagnosis. For an exact assessment and treatment, it is warranted to detorsion of that adnex-ovary, visualize and observe its vitality during the operation. Here we are presenting a case that is pregnant in ten weeks’ gestation with bilateral dermoid cyst and unilateral ovarian torsion.
References
- Tewari K, Cappuccini F, Disaia PJ, et al. Malignant germ cell tumors of the ovary. Obstet Gynecol 2000;95:128.
- Comparison of adnexal torsion between pregnant and nonpregnant women. Hasson J, Tsafrir Z, Azem F, Bar-On S, Almog B, Mashiach R, Seidman D, Lessing JB, Grisaru D Am J Obstet Gynecol. 2010;202:536.e1.
- Schmeler KM, Mayo-Smith WW, Peipert JF, et al. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol. 2005;105:1098.
- Koonings PP, Campbell K, Mishell DR Jr, Grimes DA. Relative frequency of primary ovarian neoplasms: a 10-year review. Obstet Gynecol. 1989;74:921–6.
- Risk analysis of torsion and malignancy for adnexal masses during pregnancy. AU Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, Arici A SO Fertil Steril. 2009;91:1895.
- Adnexal masses during pregnancy: accuracy of sonographic diagnosis and outcome. AU Bromley B, Benacerraf B SO J Ultrasound Med. 1997;16:447.
- Adnexal masses in pregnancy: surgery compared with observation. AU Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME SO Obstet Gynecol. 2005;105:1098.
- Conservative management of ovarian cystic teratoma during pregnancy and labor. Caspi B, Levi R, Appelman Z, Rabinerson D, Goldman G, Hagay Z. Am J Obstet Gynecol 2000;182:503–5.
- Teratoma cystic. [monograph on the Internet] New York, eMedicine. Hamilton CA, Kost E, Ellison MC. Last updates Jun 30, 2006. Cited April 1 2008.
Abstract
Dermoid kist (olgun kistik teratom), primordiyal germ hücre yumurtalık tümörlerinin en yaygını olup genellikle iyi huylu ve asemptomatiktir. Sadece %5'i kötü huylu olabilir. Büyük olanlar semptomatik olabilir. Torsiyon en yaygın komplikasyondur. Ovaryum (adneksal) torsiyonu, ovaryumun kendi etrafında dönmesi ve vaskuler sapçık basıncı ile tanımlanabilir. Tanı konulmaz ve hızlı şekilde tedavi edilmezse, ovaryum torsiyonu, kan kaybetme enfaktüse ve ovaryumun nekrozuna sebep olabilir. Torsiyon sadece birkaç saat içinde meydana gelir ve gelişim gösterir. En önemli özelliği erken tanı ve erken tedavidir. Klinik belirtiler hamilelikte ve hamilelik dışı vakalarda benzerdir. Yaklaşık %20'si hamilelik sırasında semptomlar verebilir. Herhangi bir trimesterde meydana gelebilir, fakat genelde özellikle ilk trimesterde rastlanır. Hastalar, şiddetli alt dominal ve pelvis ağrısı, bulantı ve kusmadan şikayet ederler. Ultrason ve Doppler taraması tanı koymak için tercih edilebilir. Kesin tanı ve tedavi için, adneks-ovaryumun torsiyonunun düzeltilmesi, görüntülenmesi ve ameliyat sırasında canlılığının gözlenmesi gereklidir. Burada biz, bilateral dermoid kist ve unilateral ovaryum torsiyonunun gözlendiği 10 haftalık bir gebelik vakası sunuyoruz.
References
- Tewari K, Cappuccini F, Disaia PJ, et al. Malignant germ cell tumors of the ovary. Obstet Gynecol 2000;95:128.
- Comparison of adnexal torsion between pregnant and nonpregnant women. Hasson J, Tsafrir Z, Azem F, Bar-On S, Almog B, Mashiach R, Seidman D, Lessing JB, Grisaru D Am J Obstet Gynecol. 2010;202:536.e1.
- Schmeler KM, Mayo-Smith WW, Peipert JF, et al. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol. 2005;105:1098.
- Koonings PP, Campbell K, Mishell DR Jr, Grimes DA. Relative frequency of primary ovarian neoplasms: a 10-year review. Obstet Gynecol. 1989;74:921–6.
- Risk analysis of torsion and malignancy for adnexal masses during pregnancy. AU Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, Arici A SO Fertil Steril. 2009;91:1895.
- Adnexal masses during pregnancy: accuracy of sonographic diagnosis and outcome. AU Bromley B, Benacerraf B SO J Ultrasound Med. 1997;16:447.
- Adnexal masses in pregnancy: surgery compared with observation. AU Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME SO Obstet Gynecol. 2005;105:1098.
- Conservative management of ovarian cystic teratoma during pregnancy and labor. Caspi B, Levi R, Appelman Z, Rabinerson D, Goldman G, Hagay Z. Am J Obstet Gynecol 2000;182:503–5.
- Teratoma cystic. [monograph on the Internet] New York, eMedicine. Hamilton CA, Kost E, Ellison MC. Last updates Jun 30, 2006. Cited April 1 2008.
Details
| Primary Language | English |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | October 5, 2015 |
| Published in Issue | Year 2015 Volume: 40 Issue: 4 |
