Unplanned adnexectomy for ovarian cystadenoma with undiagnosed autoamputation of the contralateral ovary, lessons learned from medical mistakes (original) (raw)
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Diagnosis of an autoamputated ovary with dermoid cyst during a Cesarean section
Fertility and Sterility, 2009
Objective: To report an extremely rare case of an autoamputated ovary with a dermoid cyst diagnosed during a Cesarean section and review the literature. Design: Case report. Setting: Tertiary hospital. Patient(s): A 33-year-old pregnant woman submitted to Cesarean section and was incidentally diagnosed with absence of the right ovary, implanted in the cul-de-sac. Intervention(s): Cesarean section and extraction of a pedunculated tumor formation from the cul-de-sac, adhesiolysis. Main Outcome Measure(s): Histologic analysis of the extracted morphoma confirmed the diagnosis of a dermoid cyst with coexistence of residual ovarian tissue. Results: The patient had an uneventful postpartum period and was discharged home. Conclusion(s): Ovarian autoamputation is an extremely rare phenomenon that has uncertain etiology; it may develop after ovarian torsion or torsion of a dermoid cyst. It may be asymptomatic. Usual site of implantation is the greater omentum. (Fertil Steril Ò 2009;91:1294.e9-e12. Ó2009 by American Society for Reproductive Medicine.)
International Journal of Science and Research Archive
Background: Ovarian torsion is a common gynecological emergency prompt diagnosis and treatment results in favourable outcome. This may be unilateral or bilateral in rare cases. However, bilateral Adnexal torsion (AT) is a gynecological emergency which occurs in approximately 2.7-3.5% of women of all ages globally. Aim: To present this uncommon clinical condition and offer management modality. Presentation of case: AC was a 28 -year- old nulliparous woman, who presented to our institution with a history of sudden onset of severe lower abdominal pain and nausea. On physical examination, she was acutely ill-looking, in mild painful distress, and her vital signs were within normal limits. On abdominal examination, there was no distension but there was lower abdominal tenderness, with muscle guarding. A pelvic examination revealed bilateral adnexal tenderness. Ultrasound examination showed a right ovarian cyst of size about 9 × 7 cm poor visualization of the left ovary. An impression of ...
Laparoscopic Management of Ovarian Dermoid Cyst in a 31-year-old Woman: A Case Report
World Journal of Laparoscopic Surgery, 2021
Ovarian dermoid cysts, also known as mature teratomas, are one of the ovarian numbers that can develop into malignancy and are mostly found in women aged 20-40 years. Most cases of teratoma mature cystic were discovered accidentally through the imaging examination. We reported a 31-year-old woman with complaints of bleeding from the birth canal for 16 days and accompanied by sharp pain during menstruation. The general condition is good and other vital signs examined were within normal limits. Abdominal ultrasound examination showed a mass in the right adnexa with a size of 12 × 10 × 8 cm and there were longitudinal thin white lines. Laparoscopic right ovarian oophorectomy was performed. After removing the mass was opened and there was a lot of hair in it. There are no complications during surgery and after surgery. The results of the histopathological examination were by the dermoid cyst.
A Rare Case of Huge Unilocular Autoamputated Extra-ovarian Dermoid Cyst
International Journal of Medical Research and Review, 2015
Ovarian dermoid cysts are one of the commonest benign, pelvic tumours. However, presence of dermoid cysts at extraovarian locations is very rare. The extra-ovarian dermoid cysts can be of ovarian origin or may also originate from nonovarian sites like omentum, retroperitoneum, mediastinum, etc. We report one such rare case of extra-ovarian dermoid cyst observed in a 70-year-old postmenopausal woman at department of Gynaecology of our hospital. Her ultrasonographic observations showed a large well defined cystic lesion predominantly in the left adnexa extending into the midline with internal echoes within, which was later confirmed with MRI. Following this, she underwent a total abdominal hysterectomy with vertical midline incision. Intraoperatively, she was found to have a large tumour of 3.25kg (28cm x 26cm x 11cm) with adhesion to the omentum on its anterior upper and posterior aspects. The surface of the oval mass was smooth with few adherent lobules of fat in some areas. Its gross cut section showed a thick walled uniloculated cyst with yellow areas and thick creamy white fluid. Cyst wall had a bony hard area and two balls of hair were also noted in side. The pedicle of the tumour seen to arise from the left side broad ligament close to left ovary. Uterus was atretic with an intramural fibroid. The dermoid appears to be derived from its autoamputation from one of the pelvic organs; probably ovary. It is unique in its size and vastness occupying the major part of the lower half of the abdominal cavity.
Acta medica Iranica, 2014
Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to ovarian reserve damage due to laparoscopic cystectomy. In this study, we evaluate the ovarian damage following laparoscopic cystectomy for non-endometriosis cysts using ultrasound and pathology findings. This is a prospective cohort study conducted between 7 rd month of 2011 and 10th month of 2012 in Women hospital affiliated to Tehran university of medical sciences.45 non-endometriosis cysts (17 teratoma,7 mucinous, 10 simple serous and 11 simple cysts) underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histopathologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. AFC after cystectomy for teratoma and simple serous was significantly reduced P<0.05. By larger terat...
2020
Background: Ovarian dermoid is one of the commonly occurring ovarian neoplasms in young women but the occurrence of multiple dermoid cysts is comparatively rare. Case description: This is a case of 24-year-old woman who ignored her first diagnosis and management plan for a 3 × 3 cm dermoid cyst in one of the ovaries and later returned with severe symptoms of abdominal pain and vomiting and with a CT scan diagnosis of bilateral, large (7 × 7 cm) dermoid cysts. She was prepared for laparoscopic bilateral dermoid cyst excision, until the intraoperative scenario, revealing rightsided twisted bilobed dermoid cyst and left-sided twin dermoid cysts changed the original plan. Finally, the patient underwent right-sided ovariotomy with right-sided salpingectomy and left-sided twin dermoid cysts excision. Conclusion: Laparoscopy is the surgical mode of choice in dermoid presentations. Evaluation of contralateral ovary must be carried out while dealing with dermoid cyst of one ovary. Clinical significance: Torsion of a large dermoid cyst is not an indication for ovariotomy. However, ischemic dermoid cysts require an on-table judgement for cystectomy or ovariotomy. Laparoscopic management in skilled hands favors cystectomy. Examining contralateral ovary must be a routine while operating on a patient with dermoid cysts in ovary.
Self Amputated Ovarian Cyst: An Unexpected Laparoscopic Finding
Journal of Pediatrics & Neonatal Care, 2016
Today laparoscopy is necessary in the diagnostic and therapeutic management of abdominal masses also in neonatal period. We report the case of a 28 days old girl admitted in our department with a prenatal diagnosis of abdominal mass. The ultrasound and CT scan revealed a 4 cm cyst in the right superior abdominal region. Instead the MRI revealed the mass localized in the right iliac region. A diagnostic laparoscopy with an open transumbilical approach was performed, that revealed an intra-abdominal 5 cm cystic formation with a thin vascular bundle. A minimal laparotomy was performed and the cyst removed. The histological examination indicated a self amputated ovarian cyst. Laparoscopy is proved to be a significant contribution in the diagnosis of abdominal masses because it allows a correct diagnosis and to plan the best management.