A Study of Patients with Ovarian Mature Cystic Teratoma at a Teaching Hospital in Eastern Nepal during April 2016-March 2017

Main Article Content

Manisha Chhetry
Prajmi Shrestha
Amar Nath Chaudhary
Shanti Subedi

Abstract

Aim: This study was done to study the profile of the patients who underwent surgery for ovarian mature cystic teratoma. This specifically included: socio-demographic profile, complaints at the time of presentation to health facility and details of peri-operative findings. 

Study Design: Retrospective observational.

Study Place and Duration: Department of obstetrics and gynecology, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Retrospective review of hospital records from April 2016-March 2017 was done.

Methods: It is a retrospective study, started after ethical clearance in May 2017; where all patients who underwent surgical intervention for ovarian mass during April 2016-March 2017 were included with their demographic profiles. The detailed operative findings of those with the histo-pathological diagnosis of dermoid were studied. The procedure performed and the complications were taken into account.

Results: A total of 162 patients underwent to laparotomy for adnexal mass, 110 had ovarian pathology but complete documentation was available for only 95 patients. Out of those 95 patients, 38 had a histo-pathological diagnosis of dermoid. The incidence of mature cystic teratoma was 40% with mean age 38.82±11.83 years. Most patients were nulliparous (34.2%) and mean parity was 1.68. Moreover 84.2% patients were pre-menopausal and only 10.5% of patients were diagnosed as dermoid preoperatively in ultrasound. 73.7% suffered with pelvic pain less than six months of duration was the most common presentation along with Torsion which was seen in 10% of cases. The Oophorectomy was performed in 50% of patients, followed by cystectomy (28%) and laparotomy (76.22%). Besides 13% patients showed peritoneal spillage with no evidence of chemical peritonitis.

Conclusion: Mature cystic teratoma was the commonest ovarian pathology found in premenopausal patients undergoing surgery for adnexal mass and Oophorectomy was the most commonly performed surgery. Pelvic Pain of duration less than six months was the most common presenting complaint.

Keywords:
Dermoid, laparoscopy, mature cystic teratoma, ovarian cystectomy, oophorectomy

Article Details

How to Cite
Chhetry, M., Shrestha, P., Chaudhary, A. N., & Subedi, S. (2020). A Study of Patients with Ovarian Mature Cystic Teratoma at a Teaching Hospital in Eastern Nepal during April 2016-March 2017. Asian Research Journal of Gynaecology and Obstetrics, 3(4), 19-25. Retrieved from https://journalarjgo.com/index.php/ARJGO/article/view/30125
Section
Original Research Article

References

Royal College of Obstetricians and Gynaecologists (RCOG), Management of Adnexal Masses in Premenopausal Women, Green Top Guidelines (62), Royal College of Obstetricians and Gynaecologists (RCOG), London, UK; 2011.

Talerman A, Vang R. Germ cell tumors of the ovary in Blaustein's Pathology of the Female Genital Tract, Kurman RJ, Ronnett BM, Eds. Springer, Berlin, Germany. 2011; 847–907.

Shalev E, Bustan M, Romano S, Goldberg V, Ben-Shlomo I. Laparoscopic resection of ovarian benign cystic teratomas: Experience with 84 cases. Human Reproduction. 1998;13(7):1810–1812.

DOI: 10.1093/humrep/13.7.1810

Canis M, Mage G, Pouly JL, Wattiez A, Manhes H, Bruhat MA. Laparoscopic diagnosis of adnexal cystic masses: A 12-year experience with long-term follow-up. Obstet Gynecol. 1994;83(5 Pt 1):707-712.

Pfeifer SM, Gosman GG. Evaluation of adnexal masses in adolescents. Pediatr Clin North Am. 1999;46(3):573-592.

DOI: 10.1016/s0031-3955(05)70138-3

Jha R, Karki S. Histological pattern of ovarian tumors and their age distribution. Nepal Med Coll J. 2008;10(2):81-5.

PMID: 18828427.

Ahmad Z, Kayani N, Hasan SH, Muzaffar S, Gill MS. Histological pattern of ovarian neoplasma. J Pak Med Assoc. 2000; 50(12):416-9.

PMID: 11191442.

Jagtap SV, Kshirsagar NS, Jagtap SS, Boral S, Nasre N. Ovarian teratomas: Clinicopathological study at tertiary care center. Int J Reprod Contracept Obstet Gynecol. 2019;8:3318-22.

Crouet H, de Ranieri E, de Ranieri J. Secondary cancers arising in mature benign cystic teratomas of the ovary (dermoid cysts). Review of the literature apropos of a new case. J Gynecol Obstet Biol Reprod (Paris). 1986;15:1055-66.

PMID: 3546474

Petersen WF, Prevost EC, Edmunds FT, Hundley JM Jr, Morris FK. Benign cystic teratomas of the ovary; A clinico-statistical study of 1007 cases with a review of the literature. Am J Obstet Gynecol. 1955;70: 368-82.

PMID: 13238472.

Benezra V, Verma U, Whitted RW. Comparison of laparoscopy versus laparotomy for the surgical treatment of ovarian dermoid cysts. Gynecological Surgery. 2005;2(2):89–92.

DOI: 10.1007/s10397-005-0091-y

Li RY, Nikam Y, Kapurubandara S. Spontaneously ruptured dermoid cysts and their potential complications: a review of the literature with a case report. Case Rep Obstet Gynecol. 2020;2020:6591280.

DOI: 10.1155/2020/6591280

Canis M, Botchorishvili R, Manhes H, Wattiez A, Mage G, Pouly J, Bruhat M. Management of adnexal masses: Role and risk of laparoscopy. Semin. Surg. Oncol. 2000;19:28-35.

DOI:10.1002/1098-2388(200007/08)19:1<28::AID-SSU5>3.0.CO;2-C

Milingos S, Protopapas A, Drakakis P, et al. Laparoscopic treatment of ovarian dermoid cysts: Eleven years' experience. J Am Assoc Gynecol Laparosc. 2004;11(4): 478-485.

DOI: 10.1016/s1074-3804(05)60079-5

Chang CK, Teng SW, Leu FJ. Laparoscopy versus laparotomy for cystic ovarian teratomas. Int J Gynaecol Obstet. 2005;88(1):69-70.

DOI: 10.1016/j.ijgo.2004.09.026

Lin P, Falcone T, Tulandi T. Excision of ovarian dermoid cyst by laparoscopy and by laparotomy. Am J Obstet Gynecol. 1995;173(3 Pt 1):769-771.

DOI: 10.1016/0002-9378(95)90338-0

Liyi P, Sasaki H, Qing LC, et al. Management of ovarian dermoid cysts by laparoscopy compared with laparotomy. Diagn Ther Endosc. 1996;3(1):19-27.

DOI: 10.1155/DTE.3.19

Albini SM, Benadiva CA, Haverly K, Luciano AA. Management of benign ovarian cystic teratomas: Laparoscopy compared with laparotomy. J Am Assoc Gynecol Laparosc. 1994;1(3):219-222.

DOI: 10.1016/s1074-3804(05)81013-8

Laberge PY, Levesque S. Short-term morbidity and long-term recurrence rate of ovarian dermoid cysts treated by laparoscopy versus laparotomy. J Obstet Gynaecol Can. 2006;28(9):789-793.

DOI: 10.1016/S1701-2163(16)32253-8

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin. Management of adnexal masses. Obstetrics & Gynecology. 2007;110(1): 201–214.

PMID: 17601923

DOI:10.1097/01.AOG.0000263913.92942.40

Savasi I, Lacy JA, Gerstle JT, Stephens D, Kives S, Allen L. Management of ovarian dermoid cysts in the pediatric and adolescent population. J Pediatr Adolesc Gynecol. 2009;22(6):360-364.

DOI: 10.1016/j.jpag.2008.12.008

Tsin DA, Espinoza de los Monteros JA, Colombero L. Laparoscopic techniques for extracting ovarian teratomas. J Am Assoc Gynecol Laparosc. 1996;3(2):283-286.

DOI: 10.1016/s1074-3804(96)80014-4

Campo S, Garcea N. Laparoscopic conservative excision of ovarian dermoid cysts with and without an endobag. J Am Assoc Gynecol Laparosc. 1998;5(2):165-170.

DOI: 10.1016/s1074-3804(98)80084-4

Shawki O, Ramadan A, Askalany A, Bahnassi A. Laparoscopic management of ovarian dermoid cysts: potential fear of dermoid spill, myths and facts. Gynecological Surgery. 2007;4(4):255–260.

DOI: 10.1007/s10397-007-0295-4

Kim HE, Seo M, Kwack JY, Kwon YS. Granulomatous peritonitis caused by iatrogenic spillage of ovarian dermoid cystectomy: A case report and literature review. Korean J Obstet Gynecol; 2020.

Available:https://doi.org/10.5468/ogs.19189

Chapron C, Dubuisson JB, Samouh N, et al. Treatment of ovarian dermoid cysts. Place and modalities of operative laparoscopy. Surgical Endoscopy. 1994; 8(9):1092–1095.

DOI: 10.1007/BF00705727

Howard FM. Surgical management of benign cystic teratoma: Laparoscopy vs. laparotomy. Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 1995;40(7):495–499.

PMID: 7473436.

Moridi A, Arab M, Fazli G, Khayamzadeh M. Clinical points in dermoid cyst management: A review article. Journal of Obstetrics, Gynecology and Cancer Research; 2016.

Available:https://doi.org/10.17795/ogcr-1003

Jorge S, Jones NL, Chen L, et al. Characteristics, treatment and outcomes of women with immature ovarian teratoma, 1998-2012. Gynecol Oncol. 2016;142(2): 261-266.

DOI: 10.1016/j.ygyno.2016.05.024

Hackethal A, Brueggmann D, Bohlmann MK, Franke FE, Tinneberg HR, Münstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: Systematic review and analysis of published data. [Published Correction Appears in Lancet Oncol. 2009;10(5):446]. Lancet Oncol. 2008;9(12):1173-1180.

DOI: 10.1016/S1470-2045(08)70306-1