eMedicine Specialties > Obstetrics and Gynecology > General Gynecology

Ovarian Cysts: Multimedia

Author: C William Helm, MB, BCh, MA, FRCS(Edin), FRCSE, Associate Professor, Division of Gynecologic Oncology, James Graham Brown Cancer Center, University of Louisville
Contributor Information and Disclosures

Updated: Mar 19, 2008

Multimedia

An ovarian cyst that has undergone torsion (twist...Media file 1: An ovarian cyst that has undergone torsion (twisting of the vascular pedicle). The patient presented with a short history of severe lower abdominal pain. The twisted pedicle can be seen attached to the cyst, which has turned dusky due to ischemia. No viable epithelial lining was available for histologic diagnosis.
An ovarian cyst that has undergone torsion (twist...

An ovarian cyst that has undergone torsion (twisting of the vascular pedicle). The patient presented with a short history of severe lower abdominal pain. The twisted pedicle can be seen attached to the cyst, which has turned dusky due to ischemia. No viable epithelial lining was available for histologic diagnosis.

Endovaginal sonogram shows a striking echogenic m...Media file 2: Endovaginal sonogram shows a striking echogenic mass lateral to the uterus, with posterior acoustic shadowing giving a "tip-of-the-iceberg" appearance. This is pathognomonic for dermoid cyst. Occasionally, this appearance may be mistaken for gas-filled bowel. Courtesy of Patrick O'Kane, MD.
Endovaginal sonogram shows a striking echogenic m...

Endovaginal sonogram shows a striking echogenic mass lateral to the uterus, with posterior acoustic shadowing giving a "tip-of-the-iceberg" appearance. This is pathognomonic for dermoid cyst. Occasionally, this appearance may be mistaken for gas-filled bowel. Courtesy of Patrick O'Kane, MD.

A dermoid cyst (mature cystic teratoma) after op...Media file 3: A dermoid cyst (mature cystic teratoma) after opening the abdomen. Note the yellowish color of the contents seen through the wall.
A dermoid cyst (mature cystic teratoma) after op...

A dermoid cyst (mature cystic teratoma) after opening the abdomen. Note the yellowish color of the contents seen through the wall.

A dermoid cyst has been opened in the operating r...Media file 4: A dermoid cyst has been opened in the operating room to reveal copious sebaceous fluid. This cyst also contained hair.
A dermoid cyst has been opened in the operating r...

A dermoid cyst has been opened in the operating room to reveal copious sebaceous fluid. This cyst also contained hair.

A dermoid cyst has been opened and contains teeth.Media file 5: A dermoid cyst has been opened and contains teeth.
A dermoid cyst has been opened and contains teeth.

A dermoid cyst has been opened and contains teeth.

Theca-lutein cysts replacing an ovary in a patien...Media file 6: Theca-lutein cysts replacing an ovary in a patient with a molar pregnancy. Despite their size these cysts are benign and usually resolve after treatment of the underlying disease.
Theca-lutein cysts replacing an ovary in a patien...

Theca-lutein cysts replacing an ovary in a patient with a molar pregnancy. Despite their size these cysts are benign and usually resolve after treatment of the underlying disease.

A 24-cm diameter multilocular right ovarian cyst ...Media file 7: A 24-cm diameter multilocular right ovarian cyst is seen with adjacent Fallopian tube and uterus. The infundibulo-pelvic ligament carrying the ovarian artery and vein has been divided.
A 24-cm diameter multilocular right ovarian cyst ...

A 24-cm diameter multilocular right ovarian cyst is seen with adjacent Fallopian tube and uterus. The infundibulo-pelvic ligament carrying the ovarian artery and vein has been divided.

Transabdominal sonogram of the cyst in Picture 7 ...Media file 8: Transabdominal sonogram of the cyst in Picture 7 demonstrating a large, complex, cystic mass with septations. Color Doppler image shows vascularity within the septations. Red and blue colors show blood flow towards and away from the transducer. The resistive index was low. Histology reported a mucinous cystadenocarcinoma of low malignant potential. Courtesy Patrick O'Kane, MD.
Transabdominal sonogram of the cyst in Picture 7 ...

Transabdominal sonogram of the cyst in Picture 7 demonstrating a large, complex, cystic mass with septations. Color Doppler image shows vascularity within the septations. Red and blue colors show blood flow towards and away from the transducer. The resistive index was low. Histology reported a mucinous cystadenocarcinoma of low malignant potential. Courtesy Patrick O'Kane, MD.

The cyst in Images 7-8 has been removed and cut o...Media file 9: The cyst in Images 7-8 has been removed and cut open. It has a smooth surface and a multicystic internal structure.
The cyst in Images 7-8 has been removed and cut o...

The cyst in Images 7-8 has been removed and cut open. It has a smooth surface and a multicystic internal structure.

Cross-section of a clear cell carcinoma of the ov...Media file 10: Cross-section of a clear cell carcinoma of the ovary. Note the cystic spaces intermingled with solid areas.
Cross-section of a clear cell carcinoma of the ov...

Cross-section of a clear cell carcinoma of the ovary. Note the cystic spaces intermingled with solid areas.

More on Ovarian Cysts

Overview: Ovarian Cysts
Differential Diagnoses & Workup: Ovarian Cysts
Treatment & Medication: Ovarian Cysts
Follow-up: Ovarian Cysts
Multimedia: Ovarian Cysts
References

References

  1. Chan L, Lin WM, Uerpairojkit B, Hartman D, Reece EA, Helm W. Evaluation of adnexal masses using three-dimensional ultrasonographic technology: preliminary report. J Ultrasound Med. May 1997;16(5):349-54. [Medline].

  2. Kupesic S, Plavsic BM. Early ovarian cancer: 3-D power Doppler. Abdom Imaging. Sep-Oct 2006;31(5):613-9. [Medline].

  3. Caruso PA, Marsh MR, Minkowitz S, Karten G. An intense clinicopathologic study of 305 teratomas of the ovary. Cancer. Feb 1971;27(2):343-8. [Medline].

  4. Clement PB. Anatomy and histology of the ovary. In: Kurman RJ, ed. Blaustein's Pathology of the Female Genital Tract. 4th ed. New York, NY: Springer-Verlag; 1989:438-70.

  5. Dewhurst J, Pryce-Davis J, Helm W. Diagnosis and management of granulosa/theca cell tumours in childhood. Paediatric and Adoloscent Gynaecology. 1985;3(2):131-56.

  6. Evans AT 3rd, Gaffey TA, Malkasian GD Jr, Annegers JF. Clinicopathologic review of 118 granulosa and 82 theca cell tumors. Obstet Gynecol. Feb 1980;55(2):231-8. [Medline].

  7. Farah L, Azziz R. Polycystic Ovary Syndrome. The Female Patient. 1999;24:79-86.

  8. Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin. Jan-Feb 2000;50(1):7-33. [Medline].

  9. Higgins RV, Matkins JF, Marroum MC. Comparison of fine-needle aspiration cytologic findings of ovarian cysts with ovarian histologic findings. Am J Obstet Gynecol. Mar 1999;180(3 Pt 1):550-3. [Medline].

  10. International Federation of Gynecology and Obstetrics. Annual Report on the Results of Treatment in Gynaecological Cancer. J Epidemiol Biostat. 1998;3:1-68.

  11. Jacobs I, Bast RC Jr. The CA 125 tumour-associated antigen: a review of the literature. Hum Reprod. Jan 1989;4(1):1-12. [Medline].

  12. Loyer EM, Whitman GJ, Fenstermacher MJ. Imaging of ovarian carcinoma. Int J Gynecol Cancer. Sep 1999;9(5):351-361. [Medline].

  13. Lu D, Davila RM, Pinto KR, Lu DW. ThinPrep evaluation of fluid samples aspirated from cystic ovarian masses. Diagn Cytopathol. May 2004;30(5):320-4. [Medline].

  14. Maiman M. Laparoscopic removal of the adnexal mass: the case for caution. Clin Obstet Gynecol. Jun 1995;38(2):370-9. [Medline].

  15. Miller BA, Kolonel LN, Bernstein L, et al. Racial/Ethnic Patterns of Cancer in the United States 1988-1992. Bethesda, Md: National Cancer Institute; 1996.

  16. Moran O, Menczer J, Ben-Baruch G, et al. Cytologic examination of ovarian cyst fluid for the distinction between benign and malignant tumors. Obstet Gynecol. Sep 1993;82(3):444-6. [Medline].

  17. Osmers R. Sonographic evaluation of ovarian masses and its therapeutical implications [editorial]. Ultrasound Obstet Gynecol. Oct 1996;8(4):217-22. [Medline].

  18. Peterson WF, Prevost EC, Edmunds FT, et al. Benign cystic teratomas of the ovary; a clinico-statistical study of 1,007 cases with a review of the literature. Am J Obstet Gynecol. Aug 1955;70(2):368-82. [Medline].

  19. Ries LAG, Kosary CL, Hankey BF, et al. Cancer Statistics Review: 1973-1996. Bethesda, Md: National Cancer Institute; 1999.

  20. Roman LD. Small cystic pelvic masses in older women: is surgical removal necessary?. Gynecol Oncol. Apr 1998;69(1):1-2. [Medline].

  21. Schmeler KM, Mayo-Smith WW, Peipert JF, et al. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol. May 2005;105(5 Pt 1):1098-103. [Medline].

  22. Schnorr JA Jr, Miller H, Davis JR, et al. Hyperreactio luteinalis associated with pregnancy: a case report and review of the literature. Am J Perinatol. Feb 1996;13(2):95-7. [Medline].

  23. Simpkins F, Zahurak M, Armstrong D, et al. Ovarian malignancy in breast cancer patients with an adnexal mass. Obstet Gynecol. Mar 2005;105(3):507-13. [Medline].

  24. Steinkampf MP, Hammond KR, Blackwell RE. Hormonal treatment of functional ovarian cysts: a randomized, prospective study. Fertil Steril. Nov 1990;54(5):775-7. [Medline].

  25. Sykes PH, Quinn MA, Rome RM. Ovarian tumors of low malignant potential: a retrospective study of 234 patients. Int J Gynecol Cancer. 1997;7:218-26.

  26. Weiss NS, Homonchuk T, Young JL Jr. Incidence of the histologic types of ovarian cancer: the U.S. Third National Cancer Survey, 1969-1971. Gynecol Oncol. Jun 1977;5(2):161-7. [Medline].

  27. Whittemore AS, Harris R, Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Collaborative Ovarian Cancer Group. Am J Epidemiol. Nov 15 1992;136(10):1184-203. [Medline].

Further Reading

Keywords

ovary, benign cyst, graafian follicles, functional cysts, theca-lutein cysts, hyperreactio luteinalis, ovarian hyperstimulation syndrome, serous cystadenoma, mucinous cystadenoma, neoplastic cyst, malignant cyst, granulosa cell tumor, sex cord stromal tumor, germ cell tumor, primordial cell tumor, teratoma, endometrioma, pseudomyxoma peritonei, ovarian tumors, cystadenocarcinoma

gestational trophoblastic neoplasia, hydatidiform mole, choriocarcinoma, polycystic ovary syndrome, polycystic ovarian syndrome, PCOS, ovarian hyperstimulation syndrome, epithelial ovarian cystadenocarcinomas, ovulation induction with gonadotropins, ovulation induction with clomiphene citrate, ovulation induction with letrozole

Contributor Information and Disclosures

Author

C William Helm, MB, BCh, MA, FRCS(Edin), FRCSE, Associate Professor, Division of Gynecologic Oncology, James Graham Brown Cancer Center, University of Louisville
C William Helm, MB, BCh, MA, FRCS(Edin), FRCSE is a member of the following medical societies: American College of Obstetricians and Gynecologists, European Society of Gynaecologic Oncology, and International Gynecologic Cancer Society
Disclosure: ThermaSolutions, Inc Grant/research funds Support for the HYPERO database - a collaborative clinical research study analysing outcomes for HIPEC in ovarian cancer; Sanofi-Aventis, Inc Grant/research funds Support for and investigator initiated research study of HIPEC for consolidation in ovarian cancer

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

A David Barnes, MD, PhD, MPH, FACOG, Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, California), Pioneer Valley Hospital (Salt Lake City, Utah), Warren General Hospital (Warren, Pennsylvania), and Mountain West Hospital (Tooele, Utah)
A David Barnes, MD, PhD, MPH, FACOG is a member of the following medical societies: American College of Forensic Examiners, American College of Obstetricians and Gynecologists, American Medical Association, Association of Military Surgeons of the US, and Utah Medical Association
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

Michel E Rivlin, MD, Professor, Coordinator of Quality Assurance/Quality Improvement, Department of Obstetrics and Gynecology, University of Mississippi School of Medicine
Michel E Rivlin, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, Mississippi State Medical Association, and Royal College of Surgeons of Edinburgh
Disclosure: Nothing to disclose.

 
 
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