non-neoplastic ovarian tumors
Friday 24 February 2012
NON-NEOPLASTIC OVARIAN TUMORS
ovarian endometriosis (endometrioma of the ovary)
- Endometriosis, or endometrioma, of the ovary may cause an adnexal mass in reproductive age females.
- Pigmented foci on an otherwise normal ovary or a large solitary hemor-rhagic cyst are the gross ﬁndings.
- Histologic ﬁndings include columnar-to-plump cuboidal epithelium with condensed sub-epithelial stroma, hemosiderin-laden macrophages, ﬁ brosis, and inﬂammation.
- Rare cases may also contain smooth muscle. Patients with uterine anomalies may develop severe endometriosis.
Acute torsion of the adnexal structures
- Acute torsion of the adnexal structures is an uncommon event but is a surgical emergency.
- The severity of the symptoms varies widely and includes fever, nausea or vomiting, and abdominal pain.
- The correct diagnosis is rarely made preoperatively.
- The preoperative radiograph commonly shows a pelvic mass with a cystic or solid texture, often with thin internal septae, and may simu-late an ovarian mass.
- Because the sigmoid colon cushions and secures the left adnexa, the right adnexa is more often affected than the left.
- The Fallopian tube and ovary have usually undergone hemorrhagic necrosis by the time of the surgery, often with secondary calciﬁcation.
- As a result, the cause of the torsion is not clear in most cases.
- massive ovarian edema is an unusual clinical entity most often occurring in adolescence.
- It is characterized by marked enlargement of one or both ovaries due to marked accumulation of edema ﬂ uid in the ovarian stroma.
- Massive ovarian edema may result from partial or intermittent torsion of the mesovarium, interfering with venous and lymphatic drainage, but not with arterial blood ﬂow.