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non-neoplastic ovarian tumors

Friday 24 February 2012

NON-NEOPLASTIC OVARIAN TUMORS

Types

- 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

  • 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.

See also

- ovarian lesions