1
|
Sheng Y, Yuan J, Wang J, Wang L, Li Y, Wang Y. Ovarian Mature Cystic Teratoma is an Independent Risk Factor for the Premature Rupture of Membranes in Pregnancy: A Single-Center Retrospective Study. Int J Womens Health 2022; 14:1477-1487. [PMID: 36277448 PMCID: PMC9586702 DOI: 10.2147/ijwh.s381297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022] Open
Abstract
Background Ovarian mature cystic teratomas (MCTs) are the most common tumors in pregnant women. The premature rupture of membranes (PROM) is a typical complication of pregnancy; however, the relationship between MCT and PROM is unknown. Therefore, we aimed to determine whether MCT is associated with the occurrence of PROM during pregnancy. Methods The data of patients with adnexal masses during pregnancy between January 2017 and August 2021 were retrospectively analyzed. Ovarian cystectomy was performed during cesarean delivery or after vaginal delivery. Univariate and multivariate logistic regression models were used for statistical analysis. Results A total of 234 patients with histopathological results were included. Among these patients, 21 occurred PROM during pregnancy, of which 11 were diagnosed with MCT. Compared with other subtypes, MCT (p=0.025) showed a stronger correlation with PROM and was an independent risk factor for PROM (odds ratio [OR], 2.811; 95% confidence interval [CI], 1.096-7.215; p=0.032). Furthermore, we found that MCT with a diameter >5 cm (p=0.0037) was more likely to promote the development of PROM than those that with a diameter <5 cm. Conclusion MCT was an independent risk factor for PROM during pregnancy. Positive actions and preventative clinical treatments should be fully taken into consideration by clinicians for pregnant women with MCTs, especially those ≥5 cm in diameter, to reduce the clinical complications related to MCT-associated PROM.
Collapse
Affiliation(s)
- Yaru Sheng
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jiangjing Yuan
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jing Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Liya Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yuhong Li
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yudong Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China,Shanghai Municipal Key Clinical Specialty, Female Tumor Reproductive Specialty, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Embryo Original Disease, Shanghai, People’s Republic of China,Correspondence: Yudong Wang; Yuhong Li, Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, People’s Republic of China, Tel +86-21-64070434-18602; +86-21-64070434-25517, Email ;
| |
Collapse
|
2
|
Alafandi BZ, Marstawi H, Saleh HH, Chakhide M, Mohamad AH, Alayyoubi A, Raslan H, Danial AK, Al-Haj A. A late-diagnosed dermoid cyst complicated with a fistula in the left scapular region: a case report. J Surg Case Rep 2022; 2022:rjac268. [PMID: 35769311 PMCID: PMC9230704 DOI: 10.1093/jscr/rjac268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Dermoid cysts are a rare case of developmental abnormality that results in benign tumors, which are classified into three categories based on their cause and appearance. Dermoid cysts tend to present within the first year after birth and are most commonly diagnosed by the age of 5. A 15-year-old girl presented with a complaint of localized, paroxysmal pain and malodorous fluid oozing from the left shoulder for the last 2 weeks. A fistulogram showed an extension of the fistula behind the clavicle and above the scapula with a cystic formation measuring ~2 cm on the upper part of the fistula tract, which called for appropriate surgical intervention. Our case is the first reported dermoid cyst in the left shoulder area associated with a fistula at birth, which is a rare complication since the complications of dermoid cysts differ depending on their location and size.
Collapse
Affiliation(s)
| | - Hiba Marstawi
- Faculty of Medicine , University of Aleppo, Aleppo , Syrian Arab Republic
| | - Hiba Haj Saleh
- Faculty of Medicine , University of Aleppo, Aleppo , Syrian Arab Republic
| | - Maria Chakhide
- Faculty of Medicine , University of Aleppo, Aleppo , Syrian Arab Republic
| | - Aya Haji Mohamad
- Faculty of Medicine , University of Aleppo, Aleppo , Syrian Arab Republic
| | - Aya Alayyoubi
- Faculty of Medicine , University of Aleppo, Aleppo , Syrian Arab Republic
| | - Hasan Raslan
- Faculty of Medicine , University of Aleppo, Aleppo , Syrian Arab Republic
| | | | - Ahmad Al-Haj
- Department of Surgery, Aleppo University Hospital , Aleppo , Syria
| |
Collapse
|
3
|
Ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration. Clin Imaging 2019; 56:47-51. [PMID: 30878712 DOI: 10.1016/j.clinimag.2019.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/13/2019] [Accepted: 03/07/2019] [Indexed: 11/23/2022]
Abstract
Dermoid cysts, or mature cystic teratomas, are complicated by malignant degeneration in only 1-2% of cases. Rarely, dermoid cysts result in complications of small bowel obstruction or entero-ovarian fistula formation. In the current report we present the case of a 59-year-old female with a known dermoid cyst who presented with leukocytosis and was discovered to have a small bowel obstruction at the level of an ileo-ovarian fistula. The patient was taken to the operating room and was treated with total abdominal hysterectomy, bilateral salpingo-oopherectomy, and short segment small bowel resection. Review of the surgical pathology revealed areas of malignant degeneration within the dermoid cyst to squamous cell carcinoma. To our knowledge, this is only the second reported case of an ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration.
Collapse
|
4
|
Kizaki Y, Nagai T, Ohara K, Gomi Y, Akahori T, Ono Y, Matsunaga S, Takai Y, Saito M, Baba K, Seki H. Ovarian mature cystic teratoma with fistula formation into the rectum: a case report. SPRINGERPLUS 2016; 5:1700. [PMID: 27757372 PMCID: PMC5047864 DOI: 10.1186/s40064-016-3426-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 09/28/2016] [Indexed: 11/25/2022]
Abstract
Background While ovarian mature cystic teratomas are benign ovarian germ-cell tumors and the most common type of all ovarian tumors, the formation of fistulas into surrounding organs such as the bladder and the intestinal tract is extremely rare. This report documents a case of ovarian mature cystic teratoma with a rectal fistula, thought to be caused by local inflammation. Case description A pelvic mass was diagnosed as an ovarian mature cystic teratoma of approximately 10 cm in diameter on transvaginal ultrasound and magnetic resonance examinations. Endoscopic examination of the lower gastrointestinal tract to investigate diarrhea revealed an ulcerative lesion with hair in the rectal wall adjacent to the ovarian cyst, and formation of a fistula from the ovarian teratoma into the rectum was suspected. Laparotomy revealed extensive inflammatory adhesions between a left ovarian tumor and the rectum. Left salpingo-oophorectomy and upper anterior resection of the rectum were performed. The final pathological diagnosis was ovarian mature cystic teratoma with no malignant findings, together with severe rectal inflammation and fistula formation with no structural disorders such as diverticulitis of the colon or malignant signs. Discussion The formation of fistulas and invasion into the neighboring organs are extremely rare complications for ovarian mature cystic teratomas. The invasion of malignant cells into neighboring organs due to malignant transformation of the tumor is reported as the cause of fistula formation into the neighboring organs. A review of 17 cases including the present case revealed that fistula formation due to malignant transformation comprised only 4 cases (23.5 %), with inflammation as the actual cause in the majority of cases (13 cases, 76.5 %). Conclusion Although malignancy is the first consideration when fistula formation is observed between ovarian tumors and surrounding organs, in mature cystic teratoma, local inflammation is more likely than malignant transformation.
Collapse
Affiliation(s)
- Yuichiro Kizaki
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Tomonori Nagai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Ken Ohara
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Yosuke Gomi
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Taichi Akahori
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Yoshihisa Ono
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Shigetaka Matsunaga
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Masahiro Saito
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Kazunori Baba
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| | - Hiroyuki Seki
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama Japan
| |
Collapse
|
5
|
Atalay MA, Orhan A, Oz Atalay F, Saydam I, Cetinkaya Demir B. Cutaneous Fistulization of an Ovarian Mature Cystic Teratoma: An Unusual Occurrence. Gynecol Obstet Invest 2015; 80:64-6. [PMID: 26043679 DOI: 10.1159/000431225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 05/06/2015] [Indexed: 11/19/2022]
Abstract
A bilobulated mature cystic teratoma (MCT) at the left ovary measuring 6 cm in diameter fistulized to the left lower quadrant of the anterior abdominal wall, contralateral to McBurney's point. This is the first reported case of a MCT fistulized to the skin. Symptoms, if present, usually depend on the size of the teratoma. However, most patients with a MCT are asymptomatic. Complications such as rupture of the cyst capsule are quite rare. Moreover, complication of fistulization is highly infrequent.
Collapse
Affiliation(s)
- Mehmet Aral Atalay
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, Bursa, Turkey
| | | | | | | | | |
Collapse
|
6
|
Min KW, Lee SJ, Jung HY, Han HS, Lee SY, Seong MK, Sung IK, Kim WY. Squamous cell carcinoma arising in a mature cystic teratoma exposed through a colo-ovarian fistula. J OBSTET GYNAECOL 2015; 35:763-4. [PMID: 25692501 DOI: 10.3109/01443615.2015.1007339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- K-W Min
- a Department of Pathology , Hallym University Sacred Heart Hospital, Hallym University College of Medicine , Anyang, Gyeonggi-do , Republic of Korea
| | - S-J Lee
- b Department of Obstetrics and Gynecology , KonKuk University School of Medicine , Seoul , Republic of Korea
| | - H Y Jung
- c Department of Pathology , KonKuk University School of Medicine , Seoul , Republic of Korea
| | - H S Han
- c Department of Pathology , KonKuk University School of Medicine , Seoul , Republic of Korea
| | - S-Y Lee
- c Department of Pathology , KonKuk University School of Medicine , Seoul , Republic of Korea
| | - M-K Seong
- d Department of Colorectal Surgery , KonKuk University School of Medicine , Seoul , Republic of Korea
| | - I-K Sung
- e Department of Internal Medicine , KonKuk University School of Medicine , Seoul , Republic of Korea
| | - W Y Kim
- c Department of Pathology , KonKuk University School of Medicine , Seoul , Republic of Korea
| |
Collapse
|