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Abstract: A 37-year-old female patient was in good health and had regular medical checkups, which did not reveal any abnormalities. However, in the last few days, the patient suddenly developed abdominal distension and pain, and an ultrasound examination revealed a cystic solid mass with good mobility in the left ovary. Tumor marker measurement revealed a mild elevation of methemoglobin. Based on the examination results and her symptoms, she was diagnosed with ovarian teratoma. The patient was actively treated with surgery and medication. The patient recovered well after surgery and was discharged successfully.
Basic information】Female, 37 years old
Type of disease】Ovarian teratoma
Hospital】Shengjing Hospital of China Medical University
Date of consultation】August 2019
Treatment plan】Surgical treatment (laparoscopic ovarian teratoma resection) + intravenous drug treatment (ornidazole injection, tranexamic acid sodium chloride injection)
Treatment period】6 days of inpatient treatment, 3 months of follow-up
Results】Ovarian teratoma was successfully removed and the patient was discharged from the hospital.
I. Initial consultation
The patient, a 37-year-old female, reported that she had been suffering from abdominal distension and pain for the last few days, and the pain could not be relieved, so she came to the clinic. Ultrasound examination was performed and showed a mass in the left ovary, about 4.2×2.1 cm in size, cystic in nature, with good mobility, and a small amount of fluid in the pelvis with bilateral adnexal masses. We asked the patient in detail and learned that she had regular gynecological examination, was in good health, had regular menstruation, and had no dysmenorrhea. The patient had 3 pregnancies and 1 delivery, with a history of 2 abortions and no other past medical or surgical history. Based on the patient’s examination results and symptoms, the patient was judged to have ovarian teratoma, which required surgical treatment. After communication with the patient, the patient agreed to undergo surgery, and was admitted to the hospital.
Treatment
After admission, the patient was given preoperative tests such as routine blood count, blood group, coagulation function, electrocardiogram, virus-related tests, and chest X-ray. Preoperatively, the patient was given intravenous ornidazole injection to prevent infection.
After the patient fasted for 8 hours, laparoscopic ovarian teratoma resection was performed under general anesthesia. The tumor was removed from the ovarian tissue and sent for pathological examination to clarify its nature. The operation went smoothly, with little intraoperative bleeding, and the patient was returned to the ward after the operation. After the operation, the patient was given intravenous ornidazole injection to prevent postoperative infection, and tranexamic acid sodium chloride injection to stop bleeding to prevent postoperative bleeding.
III. Treatment effect
On the second day of postoperative checkup, the patient was in good spirits, and the wound site did not show any exudation or exudate, and only showed slight pain. However, because the results of the pathological examination were not yet available, the patient was more nervous and anxious, and after giving him comfort, his mood was stable. On the 4th day of postoperative checkup, the pathological examination showed that the patient had a benign ovarian mature cystic teratoma, and told the patient that since the pathological result was benign, there was no need for chemotherapy and other adjuvant treatment. On the 5th day of postoperative checkup, it was found that the patient’s abdominal wound recovered well and no abnormal pelvic manifestation was seen on the repeat abdominal ultrasound, which indicated that the treatment was effective and the patient was discharged.
IV. Notes
We are glad that after active treatment, the patient’s ovarian teratoma was successfully removed and she recovered well after surgery. However, since the patient had not fully recovered at the time of discharge, the patient still needs to pay attention to the following points after discharge.
1. In terms of life, early bed rest is recommended, avoiding strenuous exercise and heavy physical labor to avoid affecting the postoperative wound recovery. After the wound has further improved, you can exercise appropriately according to your own situation, such as walking and tai chi. At the same time, communicate more with family members and friends to relieve emotions and maintain an optimistic and positive attitude to help the body recover. In addition, patients should pay close attention to their physical condition and seek medical consultation if abnormalities occur.
2. In terms of diet, achieve balanced nutrition, eat more fresh vegetables and fruits rich in vitamins and fiber, such as apples, cabbage, bananas, etc., to prevent constipation, and avoid eating spicy, stimulating and oily foods.
V. Personal insight
Ovarian teratoma usually has no obvious signs and symptoms in the early stage, especially benign ovarian teratoma, mainly due to its slow growth rate. However, if the tumor is twisted, or if necrosis, rupture or infection occurs, it may manifest itself as abdominal pain and other uncomfortable symptoms, which can usually be confirmed by gynecological ultrasound examination.
When ovarian teratoma is found, it is more thoroughly treated by surgery. In this case, the patient was in good health and did not have irregular menstruation or dysmenorrhea, but suddenly developed abdominal distension and pain, and then actively came to the clinic for examination.