Search Results (147)

Introduction: Fetal ovarian cysts are known to be a common form of fetal abdominal masses in female fetuses, often resulting from hormonal stimulation in utero. Although many resolve spontaneously without sequelae, others can develop into more complex pathologies, such as intracystic hemorrhage or torsion, which can compromise ovarian integrity and long-term reproductive outcomes. Early detection and appropriate follow-up evaluation are therefore crucial for optimal perinatal management. Materials and Methods: We conducted a retrospective study of 12 cases of fetal ovarian cysts diagnosed by routine prenatal ultrasound examinations over a two-year period at our institution. Inclusion criteria were the presence of a cystic adnexal lesion detected in utero, detailed prenatal ultrasound documentation, and a comprehensive postnatal examination. Sonographic features such as cyst size, internal echogenicity, and signs of vascular compromise were recorded. The mother’s clinical variables, including gestational age at diagnosis and relevant medical conditions, were noted. Postnatal follow-up evaluation consisted of ultrasound examinations and, if indicated, pediatric surgical consultation. Results: Of the 12 cases, 9 were characterized by a simple cystic morphology. All spontaneously regressed postnatally and did not require surgical intervention. Three were defined as complex cysts showing septations or echogenic deposits; one of these cysts required immediate surgical exploration for suspected torsion. No cases with a malignant background were identified. All infants showed a favorable course with normal growth and development until follow-up evaluation. Conclusions: This series emphasizes that most fetal ovarian cysts are benign and often resolve without intervention, highlighting the benefit of systematic prenatal imaging. Nevertheless, complex or large cysts require close prenatal and neonatal monitoring to diagnose complications such as torsion. Full article

Background and Clinical Significance: A paratubal cyst, which makes up about 10% of all adnexal masses, is a specific type of adnexal cyst that develops from the mesothelium in the broad ligament located between the fallopian tube and the ovary. Interestingly, the majority of paratubal cyst cases are initially misidentified as ovarian cysts, with suspicion arising in only 1 out of every 15 patients before undergoing surgery. Case Presentation: We report a case of a giant paratubal cyst mimicking an ovarian cyst in a 21-year-old woman supported by some representative images along with a literature review. The cyst’s therapeutic management was surgical removal of the adnexa and the final postoperative histopathological diagnosis was that of a benign paratubal cyst. Conclusions: This case highlights the need to include a paratubal cyst in the differential diagnosis of pelvic masses, especially in women of reproductive age. To the best of our knowledge, this represents the largest paratubal cyst reported in the literature to date, based on overall dimensions and the highest recorded volume of aspirated fluid, successfully managed via laparoscopy. A further notable aspect of this case is the coexistence of the giant paratubal cyst with an ovarian mucinous cystadenoma. Full article

Background/Objectives: Ovarian follicular cysts (OFCs) in dairy cows represent a significant cause of infertility and share striking similarities with polycystic ovary syndrome (PCOS) in women. This study aimed to elucidate the molecular mechanisms underlying OFCs and their relevance to PCOS by profiling differentially expressed (DE) microRNAs (miRNAs) and constructing integrative RNA interaction networks. Methods: Expression analysis of 84 bovine miRNAs was conducted in antral follicular fluid from normal and cystic follicles using miScript PCR arrays. Bioinformatic tools including miRBase, miRNet, and STRING were employed to predict miRNA targets, construct protein–protein interaction networks, and perform gene ontology and KEGG pathway enrichment. Network analyses integrated miRNAs with coding (mRNAs) and non-coding RNAs (circRNAs, lncRNAs, snRNAs). Results: Seventeen miRNAs were significantly dysregulated in OFCs, including bta-miR-18a, bta-miR-30e-5p, and bta-miR-15b-5p, which were associated with follicular arrest, insulin resistance, and impaired steroidogenesis. Upregulated miRNAs such as bta-miR-132 and bta-miR-145 correlated with inflammation, oxidative stress, and intrafollicular androgen excess. Key regulatory lncRNAs such as Nuclear Enriched Abundant Transcript 1 (NEAT1), Potassium Voltage-Gated Channel Subfamily Q Member 1 Opposite Strand/Antisense Transcript 1 (KCNQ1OT1), Taurine-Upregulated 1 (TUG1), and X Inactive Specific Transcript (XIST), as well as circRNA/pseudogene hubs, were identified, targeting pathways involved in metabolism, inflammation, steroidogenesis, cell cycle, and apoptosis. Conclusions: The observed transcriptomic changes mirror core features of human PCOS, supporting the use of bovine OFCs as a comparative model. These findings provide novel insights into the regulatory RNA networks driving ovarian dysfunction and suggest potential biomarkers and therapeutic targets for reproductive disorders. This network-based approach enhances our understanding of the complex transcriptomic landscape associated with follicular pathologies in both cattle and women. Full article

Cutaneous manifestations can serve as early and sometimes the first clinical indicators in various hereditary cancer predisposition syndromes. This review provides a comprehensive overview of the dermatological signs associated with these syndromes, aiming to facilitate their recognition in clinical practice. Hereditary Breast and Ovarian Cancer syndrome is notably linked to an increased risk of melanoma. BAP1 tumor predisposition syndrome is characterized by BAP1-inactivated melanocytic tumors. Muir–Torre syndrome, a variant of Lynch syndrome, presents with distinctive cutaneous neoplasms such as sebaceous carcinomas, sebaceous adenomas, and keratoacanthomas. PTEN hamartoma tumor syndrome commonly features hamartomatous growths, trichilemmomas, acral keratoses, oral papillomas, and genital lentiginosis. Gorlin syndrome is marked by basal cell carcinomas and palmoplantar pits, while Peutz–Jeghers syndrome is identified by mucocutaneous pigmentation. In familial adenomatous polyposis, the cutaneous findings include epidermoid cysts, fibromas, desmoid tumors, and lipomas. Additionally, we examined monogenic disorders associated with cancer risk and skin involvement, such as xeroderma pigmentosum, neurofibromatosis type 1, familial atypical multiple-mole melanoma syndrome, and Fanconi anemia. The early recognition of these dermatologic features is essential for a timely diagnosis and the implementation of appropriate surveillance strategies in individuals with hereditary cancer syndromes. Full article

Background/Objectives: As a well-known source of energy from feed, the significance of fatty acids in regulating the reproductive potential of livestock has received attention in recent years, especially follicular development. Moreover, successful ovulation is a process that is crucial for reproduction and fertility in domestic animals. Therefore, it is important to reveal the signatures of fatty acids in follicular fluid during mammalian ovulation, and this provides a possible method to prevent the occurrence of ovarian cysts in domestic animals. Methods: Pre-ovulatory follicles (n = 6) and peri-ovulatory follicles (n = 6) during normal ovulation, as well as cystic follicles (n = 6) in ovulation-deficient ovarian cyst were isolated and characterized, while follicular fluid was collected for targeted fatty acid metabolomics detection and analysis. Results: We have illustrated the anatomical and biochemical characterization of pre-ovulatory, peri-ovulatory, and cystic follicles. Subsequently, we identified changes in 51 fatty acids profiles in the follicular fluid. The highest proportion of fatty acids in the follicular fluid at three different ovulation stages is polyunsaturated fatty acids, among which the abnormality of the linoleic acid metabolism pathway was involved in ovulation defects in cystic follicles. Remarkably, we found that linoleic acid was significantly increased while arachidonic acid was significantly decreased in cystic follicles. Conclusions: Polyunsaturated fatty acids play a significant role in the follicular ovulation stage of sows. Among them, linoleic acid and arachidonic acid are closely related to the ovulation defects of cystic follicles, which suggests that identifying changes in important metabolic signatures may give us a better understanding of the pathogenesis of ovarian cyst. Full article

Ovarian cancer (OC) has an extremely unfavourable prognosis. This is due to its asymptomatic course and lack of screening tests. Therefore, new methods are needed to diagnose OC. The aim of this study was to evaluate the concentrations and diagnostic utility of selected matrilysins and stromelysins in the diagnosis of OC in comparison with the classical markers CA125 and HE4. The study group included 100 patients with serous OC, 70 with serous cysts (BL), and 50 healthy women (HW). Selected MMPs were determined by ELISA, routine markers by CMIA. Ovarian cancer patients have elevated concentrations of MMP-7, MMP-26, MMP-10 as well as CA125 and HE4 in the total group and subgroups (stage I + II, and III + IV). The highest values of diagnostic parameters—SP, SE, NPV, PPV, and ACC, as compared to CA125 and HE4, were observed for MMP-7. Performing ROC analyses showed that the highest AUC values were observed for MMP-7, CA125, and HE4, in the whole group of patients and divided into stages I and II according to FIGO. Performing ROC analyses for groups III and IV according to FIGO was associated with an increase in AUC for the MMPs studied. Of the MMPs tested, MMP-7, MMP-26, and MMP-10 have the highest potential in diagnostics of serous ovarian cancer patients. Full article

Background: This study investigates the impact of ovarian endometriosis on pregnancy outcomes. Methods: A retrospective analysis was conducted at Etlik Zübeyde Hanım Women’s Diseases Training and Research Hospital between January 2019 and December 2024, including 1127 pregnant women—170 with ovarian endometriosis and 957 healthy controls. Pregnancies achieved via assisted reproductive techniques were excluded. Statistical analyses were performed using appropriate tests, and a p-value < 0.05 was considered significant. Results: Women with ovarian endometriosis had higher rates of miscarriage (21.8% vs. 7.5%), preterm birth (15.0% vs. 8.8%), and placenta previa (4.7% vs. 0.6%), with adjusted odds ratios (OR) of 3.41, 1.84, and 7.82, respectively. No significant differences were observed in terms of gestational diabetes, hypertensive disorders, fetal growth restriction (FGR), intrahepatic cholestasis of pregnancy (ICP), placental abruption, or preterm premature rupture of membranes (PPROM). Cyst size and bilaterality were not associated with complications. Conclusions: Spontaneously conceiving women with ovarian endometriosis are at increased risk for miscarriage, placenta previa, and preterm birth. Prospective randomized studies are warranted to validate these findings. Full article

Background/Objectives: Endometriosis can present as ovarian endometriosis in 15–25% of the cases. While chronic pelvic pain and dysmenorrhea dominate its clinical presentation, acute complications, such as spontaneous OMA rupture, are rare (<3%), often mimicking acute abdominal pain and necessitating emergency surgery. Diagnostic delays persist due to the condition’s rarity and overlapping symptoms with ovarian torsion or appendicitis. This study investigates the clinical features of ruptured OMAs to enhance preoperative suspicion and optimize management. Methods: From February 2011 to August 2023, 14 patients with spontaneous rupture of histologically confirmed endometriomas underwent emergency laparoscopy for acute abdominal pain in the University Hospital of Bern, Switzerland. The clinical data of these patients were analyzed to find common patterns of spontaneous endometrioma ruptures. We also conducted a literature search in PubMed, Scopus, ScienceDirect, Cochrane, and Embase databases from inception to December 2023 in order to identify other possible confounding factors. The search was based on the keywords “ruptured endometrioma”. All English full-text prospective and retrospective observational and interventional studies with at least five patients that described the clinical features and findings of women diagnosed with ruptured endometrioma and treated surgically were included. Results: The median age at operation was 37.4 (23–49) years old, and all cases presented with acute abdominal pain, with/without peritonitis. Only 3/14 patients presented with fever, while the most common laboratory finding was an elevated CRP level of 45.6 mg/L (3–100 mg/L), while leukocytosis was less pronounced, with a median of 12.2 G/L (6.04–21.4 G/L). Notably, 64.3% (9 out of 14) of the patients reported experiencing dysmenorrhea, while for the remaining 5 individuals, the presence or absence of dysmenorrhea could not be obtained. Interestingly, only one patient had undergone hormonal treatment, with a combined oral contraceptive (COC) of Ethinylestradiol (0.02 mg) and Desogestrel (0.15 mg), while the other patients either lacked awareness of their endometriosis or expressed reluctance towards hormonal downregulation therapy. The median endometrioma size was 7 cm (3.5–18 cm), and 78.57% of the cases (11 out of 14 patients) had only ovarian endometriosis, while only 3 patients had involvement of compartment A, B, or C according to the # ENZIAN classification. Conclusions: Though rare, spontaneous OMA rupture should be considered in acute abdomen cases, especially with cysts > 5 cm. Hormonal therapy may reduce rupture risk, but more research is needed to confirm this and refine diagnostic strategies. Full article

Background: Adult granulosa cell tumours (AGCT) of the ovary account for 2–5% of ovarian tumours, with 30% occurring in women of childbearing age. Despite a good prognosis, up to 25% recur. There is a paucity of high-quality evidence to guide management. Objective: To describe management of AGCT across multiple gynaecological cancer centres. Methods: Retrospective analysis of electronic patient records from six gynaecological cancer centres in Southwest England between 2000 and 2021 (n = 119). Results: We included 107 patients with a median follow-up of 60 months (0–261 months). Most (97/107; 90.7%) were diagnosed with stage I disease (31.8% stage Ic). Primary management was staging surgery in 33/107 (30.8%), hysterectomy and bilateral salpingo-oophorectomy (BSO) (28/107; 26.2%), or conservation of an ovary (17/107; 15.9%). Three had a subsequent pregnancy. A quarter (27/107; 25.2%) were diagnosed with recurrent disease. Fifteen patients (15/107; 14%) had multiple recurrences. Recurrence was more likely if cyst rupture was reported at surgery (38.7%) compared with no rupture (14.3%; p < 0.001). The recurrence rate was higher with ovarian conservation (6/17; 35.3%) compared with BSO (21/90; 23.3%; p < 0.01), and all recurrences involved the residual ovary. Of the 11 deaths, 6 (54.5%) were attributed to progressive disease. Conclusions: Although survival with early-stage disease is good, ovarian cystectomy or unilateral ovarian conservation was associated with increased risk of recurrence. There is no conclusive evidence to support a contralateral oophorectomy in pre-menopausal women, but completion surgery should at least be considered, either immediately or after childbearing/assisted reproductive treatment. Full article

Background/Objectives: We aimed to determine the reliability of simple ultrasound (US) markers and CA-125 measurements in diagnosing peri- and postmenopausal ovarian masses. Methods: The study was conducted in a retrospective setting. The preoperative imaging properties of peri- (PEM) and postmenopausal (POM) ovarian cysts were examined. Based on ultrasound findings, lesions were categorized as either (1) simple cysts, defined as unilocular, anechoic structures without solid components, or (2) complex cysts, characterized by any deviation from this morphology. Imaging characteristics, mass size, and demographic data were matched with histology and CA125 levels. Results: In total, 379 cystic structures (PEM: N = 195, average age: 45.6 years; range: 40–54 years, POM: N = 184, average age 61.2 years; range: 41–88 years) were analyzed. In the PEM group, there were 75 simple (Ø < 5 cm N = 32, Ø ≥ 5 cm N = 43) and 122 complex cysts (Ø < 5 cm N = 29, Ø ≥ 5 cm, N = 93), while in the POM group, 49 simple (Ø < 5 cm N = 9, Ø ≥ 5 cm N = 40) and 135 complex cysts (Ø < 5 cm N = 15, Ø ≥ 5 cm N = 120) were found. In the PEM group, malignancy was detected in complex cysts larger than 5 cm (N = 16, 17.58%). In the POM group, malignancy was present in 40 cases, and 3 of them proved to be smaller than 5 cm. The majority of cysts were functional (54.36%) in the PEM group. In the POM group, serous cysts were the most frequent (38.04%), followed by malignant (21.74%) and mucinous cysts (13.04%). CA125 was elevated in 66 of 217 cases (30.41%); only 23 were malignant (NPV: 0.95, PPV: 0.35). Conclusions: Functional cysts are frequently found among perimenopausal ovarian cysts, with malignancy occurring exclusively in complex cysts exceeding 5 cm in diameter. However, complex cysts of any size carry a significant risk of malignancy in menopause, thus, surgery is recommended. Simple cysts can be followed by serial scans in both groups. CA-125 does not give added value to the detection of malignancy in perimenopausal patients. However, in postmenopausal complex morphology cysts larger than 5 cm, it may give added value to the suspicion of malignancy. Full article

The majority of abdominal masses in female children derive from the ovaries. Ovarian masses in pediatric populations can vary from simple functional cysts to malignant neoplasms. Their incidence, clinical presentation, and histological distribution vary across age groups. In the assessment of ovarian masses in children, the primary aim is to determine the probability of malignancy, as the treatment approaches for benign and malignant lesions are significantly distinct. The primary imaging tool for evaluating ovarian cysts and masses is ultrasound, which can assess the size, location, and characteristics of masses. Magnetic resonance imaging (MRI) or computed tomography (CT) may be used for further evaluation if ultrasound findings are inconclusive or if malignancy is suspected, especially in older adolescents. Serum markers may be considered in older adolescents to help assess the risk of malignancy, though it is less useful in younger populations due to normal developmental variations. Many functional ovarian cysts, especially those detected in fetuses or infants, often resolve spontaneously without intervention. Surgical intervention is indicated in cases of large cysts that cause symptoms, or if there are concerns for malignancy. Common procedures include primarily ovarian sparing laparoscopy or laparotomy. Complications like torsion, rupture, or hemorrhage may require urgent surgical intervention. Treatment should be performed in specialized centers to avoid unnecessary oophorectomies and ensure the best possible outcome for the patient. This comprehensive review aims to provide an overview of the evaluation, diagnosis, and treatment of ovarian masses in the pediatric population. Emphasis is placed on the particularities of the lesions and their management in relation to age subgroups. Full article

In dairy cattle, ovarian cysts (COFs) represent a major cause of infertility. They can be divided morphologically into follicular and luteal cysts based on their wall thickness, which can be examined by ultrasound, and progesterone secretion, which can be analyzed in serum or milk. The aim of our study was to evaluate cyst recovery using a modified ovsynch protocol with no need to differentiate COFs. Additionally, the beta-hydroxybutyric acid level (BHB), progesterone values, and trace elements in the serum were measured when therapy started. Fourteen days after treatment, COF recovery was confirmed in 88% of the cases. The median calving-to-conception interval, number of artificial inseminations until pregnancy, and median number of days from treatment to pregnancy were not different between the modified ovsynch protocol group and all other COF treatments. The logistic regression for COF included the parameters group, the cyst type, breed, the number of artificial inseminations (AIs), calving to conception cut at 200 d p.p., the cyst size, and therapy. The backward (and also forward) variable selection of the logistic regression yielded only the cyst size as a significant negative impact factor for recovery. In conclusion, the modified ovsynch protocol is a useful, practical option for COF treatment with the advantage of not needing to differentiate between the two cyst types. Full article

Background: Ovarian follicular cysts often resolve spontaneously, with giant forms being a rarity. Cases of giant ovarian follicular cysts in biological sisters without clear familial predisposition are even exceptional. Cases Presentation: Two biological sisters presented to our hospital with large pelvic masses in the setting of a clinical and biological hyperandrogenism. After surgical removal, pathology confirmed the diagnosis of ovarian follicular cysts. Recurrence was detected shortly after surgery, with both sisters displaying similar clinical courses. Chromosomal screening showed no abnormalities. Hormonal analysis revealed elevated anti-Müllerian hormone (AMH), prolactin (PRL), and testosterone, alongside low FSH and LH levels. Family exome sequencing also showed no significant findings. After treatment with bromocriptine and short-acting contraceptive pills, the recurrent ovarian cysts resolved spontaneously, and hormonal levels returned to normal ranges. Conclusions: In women of childbearing age, it is important to conduct thorough endocrine evaluations and genetic screenings following the occurrence of large ovarian follicular cysts. Once endocrine levels are balanced, follicular cysts may decrease in size substantially, which helps to avoid unnecessary ovarian surgery. Full article

Background and Clinical Significance: Paratubal Leydig cell nodules are rare incidental findings that present diagnostic challenges. Case Presentation: A 45-year-old female with a history of hypertension and diabetes mellitus presented with fever and chills following an episode of severe dysmenorrhea and menorrhagia. The patient reported heavy menstrual bleeding, persisting for 2–3 years. Physical examination revealed erythema of the perineum and whitish vaginal discharge, with no cervical lesions. Imaging revealed a 15 cm right ovarian cyst. Laboratory investigations showed elevated C-reactive protein (6.37 mg/L) and CA125 (88.82 U/mL) levels, whereas other tumor markers were within normal limits. A pelvic ultrasound revealed a retroverted uterus and a large ovarian mass suggestive of malignancy. The patient underwent a right salpingo-oophorectomy, during which a 15 cm ovarian tumor adherent to the right pelvic sidewall was excised. Histopathological examination revealed an endometriotic cyst with endometrial glandular epithelium positive for estrogen receptor and focal mucinous metaplasia. CD10-positive endometrial stromal cells and paratubal cysts were also observed. Additionally, a small Leydig cell tumor originated from the ovarian hilum was identified and confirmed by positive staining for inhibin, calretinin, and androgen receptors, as well as negative estrogen receptor staining. The postoperative recovery was uneventful, and at the five-week follow-up, the patient’s hormonal levels were normal, and there were no complications. Conclusions: This case highlights the importance of thorough histopathological evaluation in managing ovarian masses and the potential coexistence of benign and rare pathological entities, such as Leydig cell tumors. Full article

Background/Objectives: The prognosis of endometriosis-related ovarian clear cell carcinoma (OCCC) versus non-endometriosis-associated OCCC remains unclear. We examined the impact of endometriosis on OCCC diagnosis and progression and assessed whether prior surgical intervention for endometriotic ovarian cysts affects prognosis. Methods: In this retrospective study (2006–2024), OCCC patients were classified as non-endometriosis-associated or endometriosis-related. A subgroup analysis compared endometriosis-related OCCC patients with and without a history of endometriotic ovarian cyst surgery. Results: The average CA-125 level was 104.20 (29.90, 347.70) in the non-endometriosis-associated OCCC group and 80.70 (32.40, 247.90) in the endometriosis-related OCCC group (p = 0.32). Early-stage diagnosis occurred in 62.77% and 75.21% of these groups, respectively (p = 0.046). The average age at diagnosis was 53.95 ± 9.71 years for the non-endometriosis-associated group and 45.68 ± 7.98 years for the endometriosis-related group (p < 0.001). Mortality or poor prognosis was observed in 24.11% and 17.80% of these groups, respectively (p = 0.226). In endometriosis-related OCCC, comparisons were made between patients with and without a history of endometriotic ovarian cyst surgery. The average age at diagnosis was 45.84 ± 8.24 years for those without a surgical history and 44.71 ± 6.35 years for those with a surgical history (p = 0.59). Early-stage diagnosis was observed in 77.23% and 62.50%, respectively (p = 0.339). Mortality or poor prognosis occurred in 14.85% of those without a surgical history and 35.29% of those with a surgical history (p = 0.008). The hazard ratio for women with a surgical history was 3.48 (1.29–8.69) (p = 0.008). The incidence rate was 3.17 per 1000 person-years (PYRs) for individuals without surgery and 13.36 per 1000 PYRs for those with a history of surgical intervention (p = 0.008). Conclusions: Endometriosis did not impact the prognosis of women with OCCC. However, women with endometriosis-related OCCC were diagnosed at earlier stages and at younger ages. A history of endometriotic ovarian cyst surgery did not influence OCCC detection but was linked to poorer survival outcomes. Full article