Wednesday, November 21, 2012

Tubo-Ovarian Cyst - Definition & Symptoms

Roger Mitnick  /  at  5:16 PM  /  No comments


The tubo ovarian cysts have an interest peculiar to them- selves. They were first defined by Ad. Eichard and Labbe as Kystes tubo-ovariennes.

 Eokitansky and Klob found in several instances the distended end of the Fallopian tube connected with and opening into a cavity within the ovary. The walls of the cysts therefore were formed jointly by the tubes and the ovarian stroma.

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  The ovarian portion of the cyst walls possessed either reticulated or smooth, yellow, yellowish red, or russet coloured lining membrane which did not continue into the tubal part of the cyst. The distal third only of the tube was dilated, and the middle third hardly ever showed in the formation of the cyst. Eichard only observed the middle third to be implicated, in which case the fluid of the sac passed freely into the uterine cavity. But in the case mentioned by Blasius there were nearly similar conditions.

 The junction of the tubal end with the rest of the cyst is marked by a slight con- striction, or is sometimes indistinct. In one case Eokitansky found the cyst wall at that part partially thinner, as if about to sever. 


The genesis of such cysts is explicable. The pigmented portion of the cyst wall represents the yellow layer of a corpus luteum. The fimbriated extremity of the Fallopian tube had been embracing that portion of the ovary where the rupture of a ripe Graafian follicle was imminent, during a catamenial period.

  Another Good Definition of Tubo-Ovarian Mass is Instead of retracting, the fimbriae remained adherent to the ovary, excessive secretion of fluid followed, and a cyst was formed. It is curious that in such cases the dilatation takes place most rapidly in the ovarian portion of the cyst, though it might have been expected that the tubal walls would have yielded more readily to the pressure of the fluid.

 The rupture of an ovarian cyst previously formed in a corpus luteum is a very probable occurrence. Eichard has observed two such cases, and Boinet has published an account of the case of a young married lady, which he explained as the forma- tion of a tubo-ovarian cyst by the bursting of a Graafian follicle into the adherent tube.Now that we have completed reading about tubo-ovarian cyst definition,Let's Now skip onto Tubo-Ovarian Cyst Symptoms .


Tubo-Ovarian Cyst has many symptoms which you would understand reading the following paragraph . 

Some years ago I saw a lady in consultation with Mr- Arthur, of the Commercial Eoad. She had a large cyst in the abdomen, which we believed to be ovarian, and I went one day prepared to tap her, when I found that discharge of serum had suddenly come on from the vagina some hours before, and was still continuing, while the abdomen was manifestly dimin- ishing in size. The fluid had very much the character of the liquor amnii, and, on introducing a speculum, Mr. Arthur and I both saw it very distinctly coming out of the os uteri, and along the speculum. The discharge continued for several days, the abdomen regained its natural size, the lady recovered good health, and there has been no reappearance of the cyst, which was assuredly one made up by the union of the tube with an ovarian cavity.

 A case with good symptoms of tubo-ovarian cysts which occurred in the practice of Mr. Anderson, of York Place, furnished ocular demonstration of this tubo- ovarian form of tumour. A woman with symptoms so urgent as to require tapping sent, on the day fixed for the operation, to say that she was passing such a quantity of urine that all her distress had vanished. At the visit it was found that the discharge still continued. It proved to be, as Mr. Anderson writes, ' simply highly albumenised serum, with cholesterine plates. The case went on, the woman's size lessening till she gained flesh again. After some six months she died from a sudden outburst of hsemoptysis. On post-mortem examination, a large empty cyst, with thick walls, and including some lesser cysts, was found lying collapsed and loose in the belly. The cyst on being slit open, where the escape had taken place, became immediately obvious, and a good-sized staff (No. 10 or 11) passed with the greatest facility along one of the Fallopian tubes into the uterus and vagina. The parts were sent to the College of Surgeons, and now lie hidden and undiscoverable among the mass of accumulated specimens.' 

The following case of tubo-ovarian cysts recorded by Dr. L. Beale in the ' Pathological Transactions ' for 1867-8 is curious : 

 The patient, a married woman, aged thirty, died under Dr. Beale's care in King's College Hospital of chronic renal disease. For the last year of her life she had not menstruated ; there was no history of any uterine affection ; and she had never been pregnant. After death two tumours were found in the pelvis

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Posted in: Posted on: Wednesday, November 21, 2012


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