NOT TUMOR CYSTS

A. Inclusion cyst germinal.
B. Cyst folicular.
C. Cyst of the body lúteo.
D. Luteoma of the pregnancy.
E. Cysts luteínicos of the teak.
F. Ovary escleroquístico.

TUMORS DERIVED FROM THE EPITHELIUM CELÓMICO

A. Tumors quísticos.

• Serous Cistadenoma.
• Cistadenoma mucinoso.
• Endometrioma.
• Mixed forms.

B. Tumors with hypergrowth of the estroma.

• Fibroma, adenofibroma.
• Tumor of Brenner.

DERIVATIVES OF THE CELLS THEY GERMINATE

• Dermoides (benign cysts and teratomas).

TUMORS DERIVED FROM THE ESTROMA GONADAL

• Tumors of cells of the teak (tecomas).

The ovarian tumor represents one of the biggest diagnostic and therapeutic challenges for the gynecologist. Although sometimes they can produce pain or menstrual aberrations, in other occasions they present scarce clinical declarations that they face to a precocious diagnosis.

• Cysts luteínicos of the teak
  They coincide with an illness of the womb called mola hidatidiforme. There are bilateral cysts of more than 15 cm in diameter. They do not need treatment; the cysts occur rarely reabsorberse when there talks each other the primary cause (eradication of the mola).

TUMORS DERIVED FROM THE EPITHELIUM CELÓMICO

• Serous Cistadenoma
  70 % of the serous tumors is benign. It is a cyst of thin walls, of watery content, and superfice smooth.

• Cistadenoma mucinoso
  They constitute of 15 25 % of all the tumors of the ovary; 85 % is benign. There are the ovarian tumors of major size (cases from 45 to 130 kg), sometimes bilateral, there are round or ovoid masses, with superfice smooth, translucent, of bluish gray color. The interior is divided by dividing walls and contains liquid mucinoso thickly and viscously.

• Endometrioma
  They can be the only or multiple and with adhesions to the surface. They contain a liquid thick color chocolate. If there are of big size the treatment it is surgical.

• Solid tumors
  Very rare. The most frequent is the ovarian fibroma, which sometimes collaborates with liquid accumulation in the pleura (membrane that makes a detour to the lungs) and the peritoneum (membrane that makes a detour to the intestines), in the called Meigs syndrome.

TERATOMAS (CYSTS DERMOIDES)

They constitute 15 % of the tumors of the ovary, present before themselves in the first 3 decades of the life and 80 % in reproductive age. 95 to 98 % are benign.

For his embryonic origin, they prove to be a stranger contained by means of sebaceous material mixed with hair, cartilage, bone and teeth. The pelvic ultrasound scan (examination with ultrasounds) and the radiographies are of big value on having detected the presence of teeth or calcifications. The treatment is the surgical excision.

The following resources must be used:

• Finished physical exploration
• Pelvic ultrasound scan
• Axial scanner computarizada abdómino-pelvic (Scanner).
• Laparoscopy: direct examination of the abdomen with optical fibre across a small incision in the abdominal wall. It is done under regional anesthesia (epidural). It can be indicated if a serious injury is suspected.
• Exploratory Laparotomía: Surgical intervention on the abdomen to diagnose and in his case, to treat, cysts or tumors of the ovary.

• The treatment of the benign tumors of the ovary is the salpingooforectomía (surgical eradication of the ovaries and the horns of affected Falopio).

• In young women, and in all those that the reproductive function is of interest, the gynecologist will realize a careful eradication of the cyst or tumor with later reconstruction of the ovary, whenever it is possible.

• In patients pre or posmenopáusicas, the whole counterfoil will be extirpated along with two ovaries and the horns of Falopio.