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Abstract: The patient was a 20-year-old female who came to our hospital with irregular menstruation for 1 year and lower abdominal pain. She underwent ultrasound, gynecologic tumor marker tests, and gynecologic examinations, and was diagnosed with a cystic teratoma of the left ovary. Most of the teratomas are benign tumors with slow growth rate, but they may become malignant, so surgery is needed.
[Basic information] Female, 20 years old
Disease Type】Ovarian Cystic Teratoma
Hospital】Guangzhou Huadu District People’s Hospital
Date of Consultation】July 2003
Treatment plan】Surgical treatment (ovarian cystic teratoma removal) + medication (glucose injection + compound sodium chloride injection + compound amino acid injection (18AA) + cefuroxime sodium for injection)
Treatment period】Inpatient treatment for 8 days, postoperative review for 1 and 3 months
Treatment effect】The patient was cured and discharged after surgery
I. Initial consultation
On July 24, 2003, a 20-year-old unmarried female patient accompanied by her family visited the clinic, complaining of irregular menstruation for 1 year and lower abdominal pain for 15 days. The last menstrual period was on July 10, 2003, with normal menstrual flow, the current menstrual period is 9 days, the first menstrual period is at the age of 14, the menstrual cycle varies from 27 to 35 days in the past year, the last 15 days have no obvious cause of vague pain in the lower abdomen, occasionally the pain worsens during menstruation, the urine and stool are normal, body temperature: 36℃, pulse: 79 times/min, respiration: 20 times/min, blood pressure: 128/68mmHg, general condition is good, development Normal, no abnormal heart and lung auscultation, flat and soft upper abdomen, no abnormalities palpable in the liver and spleen, no percussion pain in the kidney area, pressure pain in the left lower abdomen (±), palpable 8×7×8 cm size mass, no adhesions with surrounding tissues, anal examination: normal size of anterior uterus, no abnormalities palpable in the right adnexal area, palpable 8×8×9 cm size mass active in the left adnexal area, clear normal borders, smooth surface, pressure pain (±). Hemoglobin: 12g, abdominal color ultrasound examination: cyst with intact envelope, size 9×8×8 cm was seen in the left ovary. there were a few strong echogenic clusters inside the cyst, ultrasound diagnosis of cystic teratoma of the left ovary was likely, gynecologic tumor markers were negative.
II. Treatment history
On July 28, after the patient and her family signed the consent, she underwent an epidural anesthesia and underwent an exploratory surgery, during which a 9×8×8cm cystic mass and a 3×3×3cm solid local nodule were seen in the left ovary. The cyst was carefully excised and the ovarian tissue was sutured. After surgery, glucose injection, compound sodium chloride injection and compound amino acid injection (18AA) were infused intravenously, and cefuroxime sodium for injection was also given to prevent infection. The pathology report on the 6th day after surgery: mature teratoma was considered, and no anomalous cells were seen.
III. Treatment results
The patient had no abdominal pain and recovered well. The incision healed in one stage, no fever, no lower abdominal pain and vaginal bleeding, normal urine and stool, and was discharged after 8 days of hospitalization. Ultrasound examination of the uterine adnexa did not show any abnormality 1 month after the operation, and the sex hormone six laboratory tests were normal. The patient reported that her menstruation was basically normal during the follow-up period of 3 months.
IV. Notes
We are glad that after the surgical treatment, the ovarian mature teratoma was successfully removed and the menstruation was basically normalized. After discharge from the hospital, the patient needs to rest for 10 days and keep the vulva clean, wash the vulva with warm water 1-2 times a day. The diet should be nutritious, with more protein, such as fish and eggs, and more milk, and it is recommended to eat more foods with vitamins to strengthen the body’s resistance, so that the body can recover as soon as possible, but do not eat spicy and sour food, and do not take blood-activating drugs. Return to the hospital for ultrasound examination 1 month after surgery. Although the teratoma has been removed, it is recurrent, so it is necessary to follow the doctor’s prescription for regular review.
V. Personal insight
The cystic teratoma of ovary has developed to the size of a newborn’s head, and if it continues to increase, it may lead to rupture of the cyst and acute peritonitis, which will cause great difficulty in surgery and also pose great danger to the patient’s life. In addition, ovarian cystic teratoma is divided into immature teratoma and mature teratoma.