Ovarian Cysts (Case Report)

YUNITHA ANGGRAINI E MOEDAK 08-105

Abstract
Ovarian Cyst is a major problem in woman. The ovarian tumor are classified as benign ( neoplastic and nonneoplastic), premalignant, or malignant. The ovarian cysts can develop in females at any stage of life, from the neonatal period to postmenopause. The majority of these neoplasm are benign in women of reproductive age with the age range of the patient from 11 to 70 years, but the risk of malignancy is 13% in a premenopausal woman and 45% in postmenopausal woman. Majority of the patients presented with pain abdomen (70,5%). The characteristics of the mass and the age of the patient are important factors guiding diagnosis and treatment. Ovarian cyst still become one of the problem in Gynecology. This paper will report the ovarian cysts in a 50th years old women.

Keyword : ovarian cysts

Introduction

Ovarian tumor and cysts are the major problem in women. These cysts can develop in females at any stage of life, from the neonatal period to post menopouse. When ovarian cyst are large, persisten, or paintful, surgery may be required, sometimes resulting in removal of the ovary.

Insidence
In American corpus lutheum (45%)

Age Ranged 11 to 70 years :

< 40 years 1.4/100.000 > 60 years ~ 45/100.000

highest in white woman (40-50%)

A result from india was diagnosed :
75% ovarian Tumors 12,5% functional cysts
10,7% paraovarian and paratubal cysts 6,25% were hemorhagic infarct where hystopatology could not be reported

Risk Factor
Nulliparity
White Woman 30-40% Cigarette Smoking

Classification
Polycystic ovarian syndrome

Ovarian neoplasia
Functional ovarian cysts

follicular cysts

corpus luteum cysts

corpus luteum cysts

Diagnostic Approach

Most ovarian cysts do not cause any noticable

symptoms and are found incidentally upon physical examination or ultrasound.

those having symptoms is abdominal or pelvic pain

(>33%), bloating (>30%), vaginal bleeding (~ 20%)

Diagnostic Approach
CA-125 levels Transvaginal and transabdominal ultrasonography :

determining the location, size, and physical features of the cyst finding suggestive of malignancy
The sonography and computed tomography (CT)

enable to diagnose the mass provisionally

Therapy
Oral conctraceptive medication can be used to help

prevent futher functional cysts from forming

Surgical
Ovariotomy
removal of an containing a tumor with indication of malignancy and the patient is > 35 years of age enucleation of the tumor from its capsule or ovarian tissue indicated for a tumor apparently benign in a woman >35th years of age not be feasible in the case of a very large tumor

Myomectomy
Resection is a portion of the ovarian cortex removed.

restricted to some cases of polycystic ovary diases

The indications for surgical exploration of patients with ovarian tumor

An Ovarian cysts 5 cm persisting after 8

weeks of observation and/or oral contraceptive therapy Any adnexal mass before menarche Any adnexal mass after the menopause A solid mass at any age A cystic mass > 8 cm in diameter

70-80% of follicular cysts resolve spontaneously

Prognosis overall survival rate is 86,2% at 5 years multillocated cysts, the risk of malignancy climbs to 36%

Case Report
Patient Identity: Name MR Age Address

Gadung. Date of Entry

: Mrs. Topaniah : 21.18.04.00 : 50 Years 6 months : Jl. Rawa Kuning no.16 RT 003/016, Pulo
: Februari, 5th 2013.

Main Complaint Additional Complaint

vomiting

: dizziness : abdominal pain, nausea,

History of Present Illness :

The patient came to IGD UKI hospital with complaints of dizziness about 3 days in head to neck, the dizziness felt intermmitent, like stabbed, and disturbing her activity,besides that she feels pain in her abdomen intermmitent and as crushed, nausea, and vomiting. Patient not taking any medication before, so she went to RSU UKI and then she hospitlized. After that, the patient is consulted from departement of Interna to Obstetrycs and Gynecologist departement with ovarian cyst. The patient said about 2 months ago, she went to polyclinic of gynecology in UKI hospital because she often felt pain in her abdomen since 1 month before she goes to polyclinic, and diagnosed by a physician is ovarian cysts and do USG examination. Patient has no complain ith vaginal bleeding. The patient underwent the menopause since her subtotal hysterectomy in 6 years ago.

Previous Disease History

The patient was finding out she has DM after blood test in IGD RSU UKI and uncontrolled. Beside that, patient has uncontrolled hypertention since 7 years ago. The patient has a history of subtotal hysterectomy 6 years ago. None of her family has the same complaint.

DISCUSSION
Parameter Age Theory 11-70 Case Report 50

Vaginal Bleeding
Bloating Nullipara parity women Races Family history Early menarche Obese insulin resistance Hysterectomy Confirming the diagnosis Surgery

~ 20%
>33% Double risk White Woman BRCA1, BRCA2 50% 30-75 % Persuambly Risk factor USG/CT Ooverectomy

Not Happened
Not Happened P1A0 Not a white woamn No family history Not happened Happened Happened Hystory of hysterectomy USG OOverectomy

Conclusion
Ovarian tumor and cysts are the major problem in women Can develop in females at any stage of life nd can be malignant in

postmeopausal age (45%) symptoms is abdominal or pelvic pain (>33%), bloating (>30%), vaginal bleeding (~ 20%) To diagnosis of ovarian cysts USG/CT Scan, CA-125 levels can be helpful for distinguishing between benign and malignant The laparoscopic is used for benign ovarian cysts that are less than 10 cm in diameter Another surgery is ovariotomy with indication of malignancy and over 35th

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