Twisted/tortured ovarian cyst - misc.

Question 1

What is the vascular obstruction that occurs with a tortured ovarian cyst?

Answer 1

Blood flow from the ovary (venous) is slowed

If disease progresses, arterial flow is also disrupted

Ovarian area becomes haemmorhagic + necrotic

Question 2

What is the underlying pathology of a tortured ovarian cyst?

Answer 2

the cyst is attached by a pedicle blood vessels

• which twists around
• and increases pressure.

Venous flow away is decreased

• if it twists further even the arterial flow into the ovary will be reduced

Question 3

What does decreased venous return cause?

Answer 3

–> Congestion because blood is still continually pumped in.

Question 4

What happens to the ovary as a result of the vascular disruption?

Answer 4

Perfusion is reduced, so the ovary becomes haemmorhagic + necrotic

Question 5

What are the causes of a tortured ovarian cyst?

Answer 5

• Mature cystic teratoma
• Lesion

Question 6

What is a mature cystic teratoma?

Answer 6

• the most common neoplasm of the ovary
• form of ovarian germ cell tumour
• also called ‘dermatoid cysts’
• includes >2 well- differentiated germ cell layers.
• Different combinations of mature tissue derivatives w varying arrangements in the tumour –> a wide spectrum of radiological presentations ranging from:

1. a purely cystic mass to
2. complex cystic mass with a considerable solid component

Question 7

What is the

a) most common tissue element of a mature cystic teratoma

and as a result,

b)what two substances are commonly produced?

Answer 7

a) skin
b) hair, sebum

Question 8

What is the difference between a mature and immature cystic teratoma?

Answer 8

immature:

• solid
• poorly differentiated
• more aggressive

–> carcinamatous areas