Ovarian cyst

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Ovarian cyst

Pathology

Male and female reproductive system disorders

Precocious puberty

Delayed puberty

Klinefelter syndrome

Turner syndrome

Androgen insensitivity syndrome

5-alpha-reductase deficiency

Kallmann syndrome

Male reproductive system disorders

Hypospadias and epispadias

Bladder exstrophy

Priapism

Penile cancer

Prostatitis

Benign prostatic hyperplasia

Prostate cancer

Cryptorchidism

Inguinal hernia

Varicocele

Epididymitis

Orchitis

Testicular torsion

Testicular cancer

Erectile dysfunction

Male hypoactive sexual desire disorder

Female reproductive system disorders

Amenorrhea

Ovarian cyst

Premature ovarian failure

Polycystic ovary syndrome

Ovarian torsion

Krukenberg tumor

Sex cord-gonadal stromal tumor

Surface epithelial-stromal tumor

Germ cell ovarian tumor

Uterine fibroid

Endometriosis

Endometritis

Endometrial hyperplasia

Endometrial cancer

Choriocarcinoma

Cervical cancer

Pelvic inflammatory disease

Urethritis

Female sexual interest and arousal disorder

Orgasmic dysfunction

Genito-pelvic pain and penetration disorder

Mastitis

Fibrocystic breast changes

Intraductal papilloma

Phyllodes tumor

Paget disease of the breast

Breast cancer

Hyperemesis gravidarum

Gestational hypertension

Preeclampsia & eclampsia

Gestational diabetes

Cervical incompetence

Placenta previa

Placenta accreta

Placental abruption

Oligohydramnios

Polyhydramnios

Potter sequence

Intrauterine growth restriction

Preterm labor

Postpartum hemorrhage

Chorioamnionitis

Congenital toxoplasmosis

Congenital cytomegalovirus (NORD)

Congenital syphilis

Neonatal conjunctivitis

Neonatal herpes simplex

Congenital rubella syndrome

Neonatal sepsis

Neonatal meningitis

Miscarriage

Gestational trophoblastic disease

Ectopic pregnancy

Fetal hydantoin syndrome

Fetal alcohol syndrome

Reproductive system pathology review

Disorders of sex chromosomes: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Uterine disorders: Pathology review

Ovarian cysts and tumors: Pathology review

Cervical cancer: Pathology review

Vaginal and vulvar disorders: Pathology review

Benign breast conditions: Pathology review

Breast cancer: Pathology review

Complications during pregnancy: Pathology review

Congenital TORCH infections: Pathology review

Disorders of sexual development and sex hormones: Pathology review

Amenorrhea: Pathology Review

Testicular and scrotal conditions: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

HIV and AIDS: Pathology review

Penile conditions: Pathology review

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Ovarian cyst

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Ovarian cyst

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A 35-year-old woman comes to the emergency department due to abdominal pain that started suddenly several hours ago. Two hours ago, the patient felt a sudden, sharp pain in the lower abdomen during a routine workout at the gym. Since then, she has felt nauseated and vomited twice. Medical history is unremarkable. She denies any trauma or history of similar symptoms, vaginal bleeding, unprotected sexual intercourse, or history of sexually transmitted diseases. Temperature is 37°C (98.6°F), pulse is 98/min, respirations are 16/min and blood pressure is 127/74 mmHg. On physical examination, there is no guarding, but severe, right adnexal tenderness is noted. Urine pregnancy test is negative. Doppler ultrasound confirms the diagnosis of ovarian torsion and a thin-walled, unilocular cystic mass filled with anechoic fluid is visualized. The patient subsequently undergoes ovarian cystectomy and detorsion. The results of the histopathological examination are shown below:  


Reproduced from: Wikimedia Commons

Which of the following is the most likely diagnosis?

External References

First Aid

2022

2021

2020

2019

2018

2017

2016

Dysmenorrhea

endometriomas p. 670

Dyspareunia p. 590

endometriomas p. 670

Endometriomas p. 670

Endometriosis p. 665

endometriomas and p. 670

Ovarian cysts p. 670

Transcript

Content Reviewers

Contributors

Marisa Pedron

“Cyst” comes from kustis, which means “pouch”, so ovarian cysts are fluid-filled sacs on or in the ovaries. They are very common in females of reproductive age, but can affect females of any age.

The ovaries are a pair of white-ish organs about the size of walnuts. They’re held in place, slightly above and on either side of the uterus and fallopian tubes by ligaments.

Specifically, there’s the broad ligament, the ovarian ligament, and the suspensory ligament. And the suspensory ligament is particularly important because the ovarian artery, ovarian vein, and ovarian nerve plexus pass through it to reach the ovary.

If you slice the ovary open and look at it (don’t try this at home) there’s an inner layer called the medulla, which contains most of the blood vessels and nerves and an outer layer called the cortex, which has ovarian follicles scattered throughout it.

Each follicle is initially made up of an immature sex cell, or primary oocyte, which is the female sex cell, and layers of theca and granulosa cells surrounding the oocyte.

Now, there’s actually loads going on with the ovaries throughout the menstrual cycle, which is controlled by the hypothalamus and the pituitary up in the brain.

The hypothalamus secretes gonadotropin-releasing hormone, or GnRH, which makes the nearby anterior pituitary gland release follicle-stimulating hormone, or FSH, and luteinizing hormone, or LH.

In the first two weeks of an average 28-day cycle, the ovaries go through the follicular phase, meaning that out of the many follicles scattered throughout the ovaries, a couple of them enter a race to become the dominant follicle, that will be released at ovulation, while the rest regress and die off.

Summary

An ovarian cyst is any fluid-filled sac that develops in the ovary. Common ovarian cyst types are corpus luteum cysts, theca-lutein cysts, dermoid cysts, endometrioid cysts, etc. Most ovarian cysts do not cause any symptoms unless they either break open or cause the ovary to twist and become ischemic (ovarian torsion). This can result in lower abdominal and back pain, vomiting and feeling faint, bloating, and loss of the affected ovary.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Diagnosis and management of ovarian cyst accidents" Best Practice & Research Clinical Obstetrics & Gynaecology (2009)
  6. "Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation" Women's Health (2018)
Elsevier

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