Ovarian Cysts Before the Menopause
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Bartholin's Cyst, Also Called a Bartholin's Duct Cyst, Is a Small Growth Just Inside the Opening of a Woman’S Vagina
Saint Mary’s Hospital Bartholin’s cyst Information For Patients 2 Welcome to the Gynaecology Services at Saint Mary’s Hospital This leaflet aims to give you some general information about Bartholin’s cysts and help to answer any questions you may have. It is intended only as a guide and there will be an opportunity for you to talk to your nurse and doctor about your care and treatment. What is a Bartholin;s cyst? A Bartholin's cyst, also called a Bartholin's duct cyst, is a small growth just inside the opening of a woman’s vagina. Cysts are small fluid-filled sacs that are usually harmless. Normal anatomy Bartholin gland cyst Bartholin’s glands The Bartholin’s glands are a pair of pea-sized glands that are found just behind and either side of the labia minora (the inner pair of lips surrounding the entrance to the vagina). The glands are not usually noticeable because they are rarely larger than 1cm (0.4 inches) across. 3 The Bartholin’s glands secrete fluid that acts as a lubricant during sexual intercourse. The fluid travels down tiny ducts (tubes) that are about 2cm (0.8 inches) long into the vagina. If the ducts become blocked, they will fill with fluid and expand. This then becomes a cyst. How common is a Bartholin’s cyst? According to estimates, around 2% (1 in 50) of women will experience a Bartholin’s cyst at some point. The condition usually affects sexually active women between the ages of 20 and 30. The Bartholin’s glands do not start functioning until puberty, so Bartholin’s cysts do not usually affect children. -
About Ovarian Cancer Overview and Types
cancer.org | 1.800.227.2345 About Ovarian Cancer Overview and Types If you have been diagnosed with ovarian cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to start. ● What Is Ovarian Cancer? Research and Statistics See the latest estimates for new cases of ovarian cancer and deaths in the US and what research is currently being done. ● Key Statistics for Ovarian Cancer ● What's New in Ovarian Cancer Research? What Is Ovarian Cancer? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and can spread. To learn more about how cancers start and spread, see What Is Cancer?1 Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of the fallopian tubes. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 What are the ovaries? Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is on each side of the uterus. The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of tumor: ● Epithelial tumors start from the cells that cover the outer surface of the ovary. -
Prohibitin-Induced Obesity Leads to Anovulation and Polycystic Ovary in Mice Sudharsana Rao Ande1,*, Khanh Hoa Nguyen1,*, Yang Xin Zi Xu1 and Suresh Mishra1,2,‡
© 2017. Published by The Company of Biologists Ltd | Biology Open (2017) 6, 825-831 doi:10.1242/bio.023416 RESEARCH ARTICLE Prohibitin-induced obesity leads to anovulation and polycystic ovary in mice Sudharsana Rao Ande1,*, Khanh Hoa Nguyen1,*, Yang Xin Zi Xu1 and Suresh Mishra1,2,‡ ABSTRACT and Dunphy, 2014). Along with the increase in the prevalence of Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder overweight and obesity in women, there has been an increase in and the most common cause of female infertility. However, its etiology anovulatory infertility (Giviziez et al., 2016). Androulakis et al. and underlying mechanisms remain unclear. Here we report that a (2014) reported that visceral adiposity index is related to the severity transgenic obese mouse (Mito-Ob) developed by overexpressing of anovulation and other clinical features in women with polycystic prohibitin in adipocytes develops polycystic ovaries. Initially, the ovaries. An increase in subcutaneous abdominal fat has also been female Mito-Ob mice were equally fertile to their wild-type littermates. associated with anovulation in women with obesity (Kuchenbecker The Mito-Ob mice began to gain weight after puberty, became et al., 2010). It is believed that anovulatory infertility accounts for significantly obese between 3-6 months of age, and ∼25% of them 25-50% of causes of female infertility (Weiss and Clapauch, 2014). had become infertile by 9 months of age. Despite obesity, female One of the main causes of anovulatory infertility is polycystic Mito-Ob mice maintained glucose homeostasis and insulin sensitivity ovaries (Ben-Shlomo et al., 2008; Messinis et al., 2015). -
Diagnostic Approach to Congenital Cystic Masses of the Neck from a Clinical and Pathological Perspective
Review Diagnostic Approach to Congenital Cystic Masses of the Neck from a Clinical and Pathological Perspective Amanda Fanous 1,†, Guillaume Morcrette 2,†, Monique Fabre 3, Vincent Couloigner 1,4 and Louise Galmiche-Rolland 5,* 1 Pediatric Otolaryngology-Head and Neck Surgery, AP-HP, Hôpital Universitaire Necker Enfants Malades, 75015 Paris, France; [email protected] (A.F.); [email protected] (V.C.) 2 Department of Pediatric Pathology, AP-HP, Hôpital Robert Debré, 75019 Paris, France; [email protected] 3 Department of Pathology, AP-HP, Hôpital Universitaire Necker Enfants Malades, Université Paris Descartes, 75015 Paris, France; [email protected] 4 Faculté de Médecine, Université de Paris, 75015 Paris, France 5 Department of Pathology, University Hospital of Nantes, 44000 Nantes, France * Correspondence: [email protected] † These authors contributed equally to this work. Abstract: Background: neck cysts are frequently encountered in pediatric medicine and can present a diagnostic dilemma for clinicians and pathologists. Several clinical items enable to subclassify neck cyst as age at presentation, anatomical location, including compartments and fascia of the neck, and radiological presentation. Summary: this review will briefly describe the clinical, imaging, pathologi- cal and management features of (I) congenital and developmental pathologies, including thyroglossal duct cyst, branchial cleft cysts, dermoid cyst, thymic cyst, and ectopic thymus; (II) vascular malforma- Citation: Fanous, A.; Morcrette, G.; Fabre, M.; Couloigner, V.; tions, including lymphangioma. Key Messages: pathologists should be familiar with the diagnostic Galmiche-Rolland, L. Diagnostic features and clinicopathologic entities of these neck lesions in order to correctly diagnose them and Approach to Congenital Cystic to provide proper clinical management. -
Prohibitin-Induced Obesity Leads to Anovulation and Polycystic Ovary in Mice
Prohibitin-induced obesity leads to anovulation and polycystic ovary in mice Sudharsana Rao Ande†1, Khanh Hoa Nguyen†1, Yang Xin Zi Xu1, Suresh Mishra*1,2 Department of Internal Medicine1, Department of Physiology & Pathophysiology2, University of Manitoba, Winnipeg, Canada Key words: Transgenic models, periovarian adipose tissue, cystic ovary, female infertility. † Contributed equally to this manuscript. * Correspondence Suresh Mishra, Ph.D. Department of Internal Medicine University of Manitoba Rm 843, John Buhler Research Centre 715 McDermot Avenue Winnipeg, MB R3E 3P4 Canada Ph. 204 977 5629 Fax: 204 789 3988 E-mail: [email protected] © 2017. Published by The Company of Biologists Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution and reproduction Biology Open • Advance article in any medium provided that the original work is properly attributed. ABSTRACT Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder and the most common cause of female infertility. However, the etiology of the disease and the mechanisms by which this disorder progress remain unclear. Here we report that a transgenic obese mouse (Mito-Ob) developed by overexpressing prohibitin in adipocytes develops polycystic ovaries. Initially, the female Mito-Ob mice were equally fertile to their wild-type littermates. Mito-Ob mice begin to gain weight after puberty, become significantly obese between 3-6 months of age, and roughly 25% of them become infertile by 9 months of age. Despite obesity, female Mito-Ob mice maintained glucose homeostasis and insulin sensitivity similar to their wild- type littermates. -
Practical Applications of Molecular Testing in the Cytologic Diagnosis of Pancreatic Cysts
Review Practical Applications of Molecular Testing in the Cytologic Diagnosis of Pancreatic Cysts Mingjuan Lisa Zhang * and Martha B. Pitman * Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA * Correspondence: [email protected] (M.L.Z.); [email protected] (M.B.P.) Abstract: Mucinous pancreatic cysts are precursor lesions of ductal adenocarcinoma. Discoveries of the molecular alterations detectable in pancreatic cyst fluid (PCF) that help to define a mucinous cyst and its risk for malignancy have led to more routine molecular testing in the preoperative evaluation of these cysts. The differential diagnosis of pancreatic cysts is broad and ranges from non-neoplastic to premalignant to malignant cysts. Not all pancreatic cysts—including mucinous cysts—require surgical intervention, and it is the preoperative evaluation with imaging and PCF analysis that determines patient management. PCF analysis includes biochemical and molecular analysis, both of which are ancillary studies that add significant value to the final cytological diagnosis. While testing PCF for carcinoembryonic antigen (CEA) is a very specific test for a mucinous etiology, many mucinous cysts do not have an elevated CEA. In these cases, detection of a KRAS and/or GNAS mutation is highly specific for a mucinous etiology, with GNAS mutations supporting an intraductal papillary mucinous neoplasm. Late mutations in the progression to malignancy such as those found in TP53, p16/CDKN2A, and/or SMAD4 support a high-risk lesion. This review highlights PCF triage and analysis of pancreatic cysts for optimal cytological diagnosis. Keywords: pancreatic cytology; pancreatic cyst fluid; cyst fluid triage; molecular testing; mucinous cyst; intraductal papillary mucinous neoplasm; mucinous cystic neoplasm Citation: Zhang, M.L.; Pitman, M.B. -
Grading Pelvic Prolapse and Pelvic Floor Relaxation Using Dynamic Magnetic Resonance Imaging
ADULT UROLOGY GRADING PELVIC PROLAPSE AND PELVIC FLOOR RELAXATION USING DYNAMIC MAGNETIC RESONANCE IMAGING CRAIG V. COMITER, SANDIP P. VASAVADA, ZORAN L. BARBARIC, ANGELO E. GOUSSE, AND SHLOMO RAZ ABSTRACT Objectives. With significant vaginal prolapse, it is often difficult to differentiate among cystocele, enterocele, and high rectocele by physical examination alone. Our group has previously demonstrated the utility of magnetic resonance imaging (MRI) for evaluating pelvic prolapse. We describe a simple objective grading system for quantifying pelvic floor relaxation and prolapse. Methods. One hundred sixty-four consecutive women presenting with pelvic pain (n ϭ 39) or organ prolapse (n ϭ 125) underwent dynamic MRI. The “H-line” (levator hiatus) measures the distance from the pubis to the posterior anal canal. The “M-line” (muscular pelvic floor relaxation) measures the descent of the levator plate from the pubococcygeal line. The “O” classification (organ prolapse) characterizes the degree of visceral prolapse beyond the H-line. Results. The image acquisition time was 2.5 minutes per study. Each study cost $540. In the pain group, the H-line averaged 5.2 Ϯ 1.1 cm versus 7.5 Ϯ 1.5 cm in the prolapse group (P Ͻ0.001). The M-line averaged 1.9 Ϯ 1.2 cm in the pain group versus 4.1 Ϯ 1.5 cm in the prolapse group (P Ͻ0.001). Incidental pelvic pathologic features were commonly noted, including uterine fibroids, ovarian cysts, hydroureter, urethral diverticula, and foreign body. Conclusions. The HMO classification provides a straightforward and reproducible method for staging and quantifying pelvic floor relaxation and visceral prolapse. -
Non-Cancerous Breast Conditions Fibrosis and Simple Cysts in The
cancer.org | 1.800.227.2345 Non-cancerous Breast Conditions ● Fibrosis and Simple Cysts ● Ductal or Lobular Hyperplasia ● Lobular Carcinoma in Situ (LCIS) ● Adenosis ● Fibroadenomas ● Phyllodes Tumors ● Intraductal Papillomas ● Granular Cell Tumors ● Fat Necrosis and Oil Cysts ● Mastitis ● Duct Ectasia ● Other Non-cancerous Breast Conditions Fibrosis and Simple Cysts in the Breast Many breast lumps turn out to be caused by fibrosis and/or cysts, which are non- cancerous (benign) changes in breast tissue that many women get at some time in their lives. These changes are sometimes called fibrocystic changes, and used to be called fibrocystic disease. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Fibrosis and cysts are most common in women of child-bearing age, but they can affect women of any age. They may be found in different parts of the breast and in both breasts at the same time. Fibrosis Fibrosis refers to a large amount of fibrous tissue, the same tissue that ligaments and scar tissue are made of. Areas of fibrosis feel rubbery, firm, or hard to the touch. Cysts Cysts are fluid-filled, round or oval sacs within the breasts. They are often felt as a round, movable lump, which might also be tender to the touch. They are most often found in women in their 40s, but they can occur in women of any age. Monthly hormone changes often cause cysts to get bigger and become painful and sometimes more noticeable just before the menstrual period. Cysts begin when fluid starts to build up inside the breast glands. Microcysts (tiny, microscopic cysts) are too small to feel and are found only when tissue is looked at under a microscope. -
Oligo-Anovulation Is Not a Rarer Feature in Women with Documented Endometriosis
Oligo-anovulation is not a rarer feature in women with documented endometriosis Pietro Santulli, M.D., Ph.D.,a,b Chloe Tran, M.D.,a Vanessa Gayet, M.D.,a Mathilde Bourdon, M.D.,a,b Chloe Maignien, M.D.,a Louis Marcellin, M.D.,a,b Khaled Pocate-Cheriet, M.D.,b Charles Chapron, M.D.,a,b and Dominique de Ziegler, M.D.a a Department of Gynaecology Obstetrics II and Reproductive Medicine, Assistance Publique-Hopitaux^ de Paris (AP-HP), Hopital^ Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Universite Paris Descartes, Sorbonne Paris Cite; and b Department of Development, Reproduction and Cancer, Institut Cochin, INSERM U1016, Universite Paris Descartes, Sorbonne Paris Cite, Paris, France Objective: To study the prevalence of oligo-anovulation in women suffering from endometriosis compared to that of women without endometriosis. Design: A single-center, cross-sectional study. Setting: University hospital-based research center. Patient (s): We included 354 women with histologically proven endometriosis and 474 women in whom endometriosis was surgically ruled out between 2004 and 2016. Intervention: None. Main Outcome Measure(s): Frequency of oligo-anovulation in women with endometriosis as compared to that prevailing in the disease-free reference group. Results: There was no difference in the rate of oligo-anovulation between women with endometriosis (15.0%) and the reference group (11.2%). Regarding the endometriosis phenotype, oligo-anovulation was reported in 12 (18.2%) superficial peritoneal endometriosis, 12 (10.6%) ovarian endometrioma, and 29 (16.6%) deep infiltrating endometriosis. Conclusion(s): Endometriosis should not be discounted in women presenting with oligo-anovulation. -
A Novel SRY Missense Mutation Affecting Nuclear Import in a 46,XY Female Patient with Bilateral Gonadoblastoma
European Journal of Human Genetics (2009) 17, 1642 – 1649 & 2009 Macmillan Publishers Limited All rights reserved 1018-4813/09 $32.00 www.nature.com/ejhg ARTICLE A novel SRY missense mutation affecting nuclear import in a 46,XY female patient with bilateral gonadoblastoma Remko Hersmus1, Bertie HCGM de Leeuw1, Hans Stoop1, Pascal Bernard2, Helena C van Doorn3, Hennie T Bru¨ggenwirth4, Stenvert LS Drop5, J Wolter Oosterhuis1, Vincent R Harley2 and Leendert HJ Looijenga*1 1Department of Pathology, Erasmus MC-University Medical Center Rotterdam, Josephine Nefkens Institute, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; 2Human Molecular Genetics Laboratory, Prince Henry’s Institute of Medical Research, Clayton, Victoria, Australia; 3Department of Gynaecologic Oncology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; 4Department of Clinical Genetics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands and 5Department of Pediatric Endocrinology, Erasmus MC-University Medical Center Rotterdam, Sophia, Rotterdam, The Netherlands Patients with disorders of sex development (DSD), especially those with gonadal dysgenesis and hypovirilization, are at risk of developing the so-called type II germ cell tumors (GCTs). Both carcinoma in situ and gonadoblastoma (GB) can be the precursor lesion, resulting in a seminomatous or non- seminomatous invasive cancer. SRY mutations residing in the HMG domain are found in 10–15% of 46,XY gonadal dysgenesis cases. This domain contains two nuclear localization signals (NLSs). In this study, we report a unique case of a phenotypical normal woman, diagnosed as a patient with 46,XY gonadal dysgenesis, with an NLS missense mutation, on the basis of the histological diagnosis of a unilateral GB. -
Minimally Invasive Approach in Treating Large Ovarian Endometrioma
Bagchi B, et al., J Reprod Med Gynecol Obstet 2019, 4: 024 DOI: 10.24966/RMGO-2574/100024 HSOA Journal of Reproductive Medicine, Gynaecology & Obstetrics Case Series Minimally Invasive Approach Introduction Endometriosis is an enigmatic disease, diagnosed by a combined in Treating Large Ovarian approach - clinical findings, pelvic ultrasonography and laparoscopy, being the gold standard. It usually presents with moderate to severe Endometrioma pain, infertility, or both, in 35-50% patients. Although no specific mechanism has been documented but distorted pelvic anatomy, ovu- Bishista Bagchi1, Sugata Bhattacharya2, Gon Chowdhury latory abnormalities, impaired hormonal and cell-mediated functions Rajib1 and Siddhartha Chatterjee1,3* in the endometrium, are considered as the reasons of infertility [1]. Though the confirmation of diagnosis is by laparoscopy but it has 1Department of Reproductive Medicine, Calcutta Fertility Mission, Kolkata, India been well accepted that the main suspicion of its presence comes from its symptoms and clinical findings along with non-invasive pro- 2Department of Radiology, Manisha X-Ray Clinic, Kolkata, India cedures like ultrasonography. The main problem of endometriosis in 3Department of Biochemistry and Endocrinology, Institute of Post Graduate clinical practice is presence or recurrence of endometrioma which Medical Education & Research, Kolkata, India either presents with pain or with associated infertility and a large mass. Recurrence poses a huge problem so far further treatment is concerned. Abstract Case Reports Objective: Management of large ovarian endometriomas has been a potential challenge; be it laparoscopy, open approach or drainage Patient 1 of the cystic fluid. The present procedure has been carried out to A 27-year-old woman presented at Calcutta Fertility Mission, Kol- benefit young yet to conceive patients to restore ovarian function kata, with complaints of abdominal distension and infertility. -
Ultrasound of Female Pelvic Organ
울산의대 서울아산병원 영상의학과 김미현 Introduction Benign disease of uterus Malignant disease of uterus Non-tumorous condition of ovary Tumorous condition of ovary Transvaginal – 소변(-) Transabdominal – 소변(+) Tranrectal or transperineal - virgin Sonohysterography Thick or irregular endometrium on transvaginal US Endometrium Basal layer – echogenic Functional layer – hypoechoic Endometrial stripe Endometrium 가임기 증식기 4-12 mm 분비기 8-15 mm 폐경기 5 mm 미만 Myometrium Innermost layer junctional zone Ovary Oval shape Central medulla – hyperecho Peripheral cortex (follicle) - hypoecho Benign disease of uterus Ectopic endometrial glands and stroma in the myometrium m/c cause of vaginal bleeding Due to unopposed estrogen Overgrowth of EM glands and stroma US Focally increased EM thickening DDx (HSG-US helpful) Hyperplasia Submucosal myoma < EM cancer m/c pelvic tumor Submucosal, intramural, subserosal US Well-defined hypoechoic solid mass Variable echogenicity due to degeneration Interface vessels btw tumor and uterus bridging vascular sign(+) Subserosal myoma > ovary tumor M U Cause Dilatation and currettage Gestational trophoblastic disease Complication of malignancy Previous surgery Uterine myoma Endometriosis Antagonist of the estrogen receptor in breast tissue Agonist in the endometrium EM hyperplasia Antagonist of the estrogen receptor in breast tissue Agonist in the endometrium EM hyperplasia Malignant disease of uterus Cervical cancer Endometrial cancer Gestational trophoblastic disease US- poor sensitivity for diagnosis • 45F, premenopause • EM