Kistoma of an ovary
Kistoma of an ovary – the true tumor of an ovary developing from epitelialny fabrics and having proliferative growth. At early stages of a kistom of an ovary proceeds asymptomatically; over time increase in the sizes of a stomach, feeling of a raspiraniye, nagging pains, dizurichesky frustration, defecation violation can develop. Diagnostics includes carrying out gynecologic survey, ultrasonography of bodies of a small pelvis and abdominal cavity, the analysis of an onkomarker of cancer of ovary (SA-125), laparoscopy. Processes of an ozlokachestvleniye, a necrosis, perforation, hemorrhage can serve as complications of a kistoma of an ovary, pereknut tumor legs, a sdavleniye of the next bodies. Treatment of a kistoma of an ovary strictly quick. The forecast is defined by histologic structure of education.
Kistoma of an ovary
Kistoma of an ovary, along with uterus fibroma, belong to the most often found tumors of a female reproductive system. Kistoma treat benign tumors of ovaries, however are quite often inclined to a secondary malignization. As distinctive feature of a kistoma of an ovary serves the rapid proliferative growth therefore it quite often reaches the big sizes. Kistoma of an ovary can develop on the basis of earlier existing ovary cyst. Kistoma unites to an ovary by means of an anatomic leg which sheaves enter (suspending, a part wide, own ligament of an ovary), uterine and yaichnikovy arteries, nerves and lymphatic vessels.
Types to cysts of yainik
The modern gynecology classifies ovary kistoma taking into account type of a current, character of contents, a vystilka of their cavity, localization. As a current of a kistoma of an ovary can be good-quality, proliferating (boundary) and malignizirovanny. Good-quality kistoma of an ovary can turn in proliferating eventually, and then - in malignant. On contents it is accepted to allocate kistoma of ovaries of serous and mutsinozny character.
Serous kistoma are covered by a pipe or superficial epithelium of an ovary, filled with transparent serous liquid of straw color. More often they single-chamber, can increase to 30 and more centimeters in the diameter. Usually come to light at women of 40-50 years. Malignant regeneration proliferating serous to cysts of an ovary occurs at 10-15% of patients.
In gynecology the mutsinozny (psevdomutsinozny) kistoma of an ovary having the epitelialny vystilka reminding cages of the cervical channel meet more often. Mutsinozny kistoma of an ovary, as a rule, multichamber, contain a muciform secret. Can be diagnosed for women in any age period, but nevertheless are defined in a postmenopause more often. Mutsinozny kistoma of an ovary are less often subject to an ozlokachestvleniye (in 3-5% of cases).
On character of a vystilka of a cavity glandulyarny (ferruterous), mezonefroidny, tsilioepitelialny (smooth-bore), endometrioidny, papillary kistoma of an ovary differ. Kistoma of an ovary (unilateral) or both ovaries can develop on one ovary (bilateral), have identical or various structure. Mutsinozny kistoma affect one ovary, serous more often – both.
Reasons of development of a kistoma of an ovary
Precisely the reasons of formation of a kistoma of an ovary are not established. It is noticed that the greatest predisposition to development of a kistoma is noted at women with violations of the hormonal function of ovaries burdened by heredity, carriers of a virus of herpes of the II type and VPCh.
In risk group on development to ovary cysts there are also patients with chronic female diseases (a colpitis, oofority, an endometritis), an irregular menstrual cycle, a breast cancer, transferred termination of pregnancy, ovary operations or extra-uterine pregnancy. The probability of development of a kistoma of an ovary increases in a premenopauza and a menopause. Observation at the gynecologist is shown to women with the increased risk of emergence of a kistoma of an ovary.
Ovary kistoma symptoms
Small by the ovary kistoma sizes, as a rule, do not cause subjective complaints and frustration of a menstrual cycle. At early stages of a kistom of an ovary, as a rule, incidentally it is found during planned gynecologic survey or inspection in connection with infertility.
At achievement of big size of a kistom of an ovary can cause various symptomatology – the aching and nagging pains in the bottom of an abdominal cavity with irradiation to the inguinal or lumbar area, increase in the sizes of a stomach, heavy feeling and a raspiraniye in a stomach, violations of a menstrual cycle. Sdavleny kistomy an ovary of a bladder it is shown by the speeded-up urination; a large intestine – locks (sometimes ponosam); large vessels - hypostases of legs. At serous kistoma of an ovary ascites, quite often develops.
At overwind legs of a kistoma of an ovary there are sharply expressed clinical symptoms – shrill pain, temperature increase, nausea, tachycardia, tension of muscles of a belly wall. The physical overstrain, a stomach injury, careless gynecologic survey can provoke a rupture of the capsule of a kistoma - an ovary apopleksiya.
Diagnostics of a kistoma of an ovary
When carrying out gynecologic survey on a chair existence of the opukholevidny education with an anatomic leg lying in a sacral hollow of a kzada from a uterus is palpatorno defined. Depending on size and the number of cameras of a kistom of an ovary has an elastichesky or dense consistence, a smooth surface.
For objective confirmation of existence of a kistoma of an ovary and determination of its sizes ultrasonography of bodies of a small pelvis, KT or the MRT-research is carried out. Character of a kistoma of an ovary is specified by means of blood test on an onkomarker of SA-125, a puncture of an abdominal cavity through the back arch of a vagina with the cytologic analysis of liquid. According to indications the biopsy of endometrium, ultrasonography of mammary glands are carried out.
In the course of diagnostics kisty an ovary it is necessary to differentiate from cancer of an ovary, a follicular cyst and a cyst of a yellow body, myoma of a uterus, uterine and extra-uterine pregnancy, an adneksit, metastatic tumors of a stomach, tumors of intestines and a bladder. Therefore performing ultrasonography of an abdominal cavity, gastroscopy, X-ray analysis of a stomach, an irrigoskopiya, consultation of the gastroenterologist, proctologist, urologist in addition can be required.
At reasonable doubts in the diagnosis the diagnostic laparoscopy with an ovary biopsy which can pass into medical is made. The final diagnosis is exposed after expeditious treatment of a kistoma of an ovary taking into account a histologic structure of a remote tumor.
Treatment of a kistoma of an ovary
Irrespective of the size and clinic of a kistoma of an ovary surgical tactics is shown. Need of removal of a kistoma of an ovary is dictated by a possibility of its malignization, excessive growth, violation of work of pelvic bodies. During operation removal of a kistoma, specification of its nature is made, malignant process is excluded. The volume of the forthcoming intervention at a kistoma of an ovary is defined by a look, the tumor size, age of the woman, pregnancy planning. Operations at kistoma of ovaries are carried out by means of a laparoscopy or a laparotomy.
For scoping of operation carrying out an urgent intraoperative histologic research of tumoral fabrics is shown. At young patients at an exception of factors is an onkonastorozhennost and existence of a serous smooth-bore kistoma performance of a kistektomiya – removal of education with preservation of ovarialny fabric is possible. Serous papillary and mutsinozny kistoma demand removal of the affected ovary (ooforektomiya) from women of reproductive age. In a postmenopause the optimum volume of treatment of a kistoma of an ovary is removal of a uterus by a pan-hysterectomy method.
In case of a perekrut of a leg or a rupture of the capsule of a kistoma of an ovary intervention has the emergency character. At boundary or malignant kistoma of an ovary the chemotherapy, hormonal therapy, radiation therapy is carried out.
Ovary kistoma complications
The greatest threat for life is posed by an ovary kistoma malignization therefore its treatment can be only quick. Besides, at a physical tension or the sharp movements the probability of twisting of a leg of a kistoma, hemorrhage in a cavity or the capsule of a kistoma of an ovary is high.
At a hematogenic or limfogenny drift of an infection from an intestinal path contents of a kistoma can suppurate. In case of a trauma of a tumor or violation traffic of its walls there is a rupture of the capsule of a kistoma of an ovary which is followed by the acute pain, intra belly bleeding, shock, consciousness loss, peritonitis.
Growth of a kistoma of an ovary to the huge sizes is followed by functional violations from intestines, a bladder, a blood-groove. Ovary kistoma complications always involve the bigger volume of operation, than planned treatment a disease.
Prevention and the forecast at an ovary kistoma
Regular surveys of the gynecologist and ultrasonography are the key to prevention of a kistoma of an ovary. The exception of an adverse background requires timely therapy of chronic inflammatory diseases of ovaries, appendages and a uterus, competent selection of contraception, prevention of abortions.
Timeliness of performance of operation provides recovery and the favorable forecast. After surgical treatment of a kistoma of an ovary patients need observation of the gynecologist (onkoginekolog), the mammologist.