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Showing 2 results for Ovarian Cyst
Radiologists’ intra-rater agreement and category distinguishability in diagnosis of ovarian mass by ultrasonography
A Akbarzadeh Bagheban, G Babaei, A Kazemnejad, S Faghihzadeh, F Baradaran Anaraki, Z Elahipanah,
Volume 64, Issue 3 (5-2006)
Abstract

Background: Intra-rater agreement in observing and decision making in diagnosis of any disease is of great importance.This investigation is to observe and read ultrasound pictures of ovarian cysts and distinguish its category for any radiologist. Distinguishability is one of the related entities in this matter and radiologists&apos ability in correct diagnosis is of great concern. In this study, we evaluated radiologist’s distinguishability of ordered categories of ovarian cyst diseases (benign, borderline and malignant) in ultrasonography. To do this, we measured intra-rater agreement of radiologists by Weighted Kappa coefficient, and then by the help of “square scores association model” and “agreement plus square scores association model” we evaluated their distinguishability in diagnosis of the severity of the ovarian cyst’s diseases.

Methods: In this analytical cross-sectional study, two radiologists and three radiology residents assessed ultrasounds of 40 patients separately and independently in two periods (with the interval of one week). Patients selected from those who were referred to Mirza Koochak Khan Hospital in January 2005. Ultrasounds were performed by an expert radiologist and by a single apparatus.

Result: Data from radiologists was evaluated by “square scores association model” due to their superior results of distinguishability. Mean of Weighted Kappa coefficient was 0.81 and intra-rater agreement was 0.99 for our radiologists, but due to weaker results of our residents, we used “agreement plus square scores association model” for analyzing and mean of Weighted Kappa coefficient was 0.65 and intra-rater agreement was 0.97 for them.

Conclusion: Although radiologists had a better function than their residents, all of them showed appropriate distinguishability and intra-rater agreement in diagnosis and categorizing of the ovarian cyst’s disease. To distinguish benign category from borderline was more difficult than to distinguish malignant category from borderline and radiologists showed better results in this than their residents did.


Huge mucinous cystadenoma of ovary, describing a young patient: case report
Soheila Aminimoghaddam, Saeedehsadat Batayee , Mahsa Velaei ,
Volume 75, Issue 5 (8-2017)
Abstract
Background: About 90% ovarian cancers are epithelial and 10-15% of this group are mucinous. The treatment is the hysterectomy with bilateral salpingo-oophorectomy.  However, most of these tumors occur in young women that have not yet given birth in which preservation of fertility should be considered. We present a case of huge mucinous cystadenoma and massive ascites managed by preserving uterus and ovaries. Meigs’ syndrome is found in fibroma, and thecoma of ovary, however, in rare occasion this syndrome is occurred in mucinous cystadenoma.
Case presentation: A 21-year-old unmarried woman presented with the complaint about weight gains and irregular menstruation for four months to gynecology clinic of Firoozgar hospital in Tehran in October 2016. Preop lab data including tumor marker was gathered, and sonography with CT scanning of pelvic and chest was performed. The ascitic fluid was negative for malignancy. Also, laparotomy with staging the ovarian tumors was carried out including cytology of ascitic-fluid, cytology of diaphragm, ovarian cystectomy, biopsy of the paracolic gutter, exploring abdomen and pelvis. Histopathology report revealed mucinous cystadenoma. Moreover, according to the normal appearance of the appendix in this case, the appendectomy was not performed.
Conclusion: Ovarian cysts in young women who are associated with elevated levels of tumor markers and ascites require careful evaluation. Management of ovarian cysts depends on patient's age, size of the cyst, and its histopathological nature. Conservative surgery such as ovarian cystectomy or salpingo-oophorectomy is adequate in mucinous tumors of ovary. Multiple frozen sections are very important to know the malignant variation of this tumor and helps accurate patient management. Surgical expertise is required to prevent complications in huge tumors has distorted the anatomy, so gynecologic oncologist plays a prominent role in management. In this case, beside of the huge tumor and massive ascites uterine and ovaries were preserved by gynecologist oncologist and patient is well up to now.

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