TUMOUR AND OVARIAN CYSTS
Ques. 1 What are ovarian cysts or tumours?
Ans. Ovarian tumour mostly benign or malignant are new growths from the ovary, there may be also dysfunctional cysts.
Ques. 2 What is the classification of ovarian tumours?
Ans. Classification –
- Benign Growth -
- Solid –
- Cystic – (a) Benign neoplasm – e.g. pseudomucinous cystadenoma, serous cystadenoma. Dermoid cyst, endometrial cyst etc. (b) dysfunctions cysts, e.g. bilateral lutein cyst, corpus luteum cyst, polycystic ovaries etc.
- Malignant growth –
- Solid – (i) primary carcinoma; (ii) secondary carcinoma (Krukenberg tumour); (iii) teratoma, (iv) sarcoma.
- Cystic – (i) malignant dermoid cyst. (ii) pseudomucinous or papilliferous cystadeno-carcinoma;
- Special type of tumours-
- Germ-cell tumours: dys-germinoma, teratoma, gonadoblastoma, teratoma, choriocarcinoma.
- Functional tumours – feminizing masculinizing carcinoid tumours.
Ques. 3 What are the clinical features of ovarian cysts?
Ans. CLINICAL FEATURES (of benign ovarian tumour):
- Age – all ages, more common in middle age (usually 20 to 40 years).
- History – relatively long.
Ques. 4 What are the signs and symptoms of ovarian cysts?
Ans. Symptoms –
- Menstrual abnormality may be present, e.g. dysmenorrhoea, amenorrhoea, menorrhagia, metrorrhagia etc.
- Dull aching abdominal pain may be present.
- Progressive wasting with huge abdominal swelling.
- Symptoms due to complications may be present.
- Gradual swelling starting on one side of lower abdomen.
- Usually unilateral, may be bilateral.
Signs : P/V – (i) Swelling is mobile from side to side. P/V – swelling can be felt separate from the uterus.(ii) Cystic swelling on one side of the abdomen.
Ques. 5 What are the clinical features of ovarian tumours?
Ans. CLINICAL FEATURES (of malignant ovarian tumour) : Age – at any age, more common in advanced age (40 to 60 years).
- Progressive loss of weight.
- Abnormal uterine bleeding.
- Symptoms of bowel obstruction.
- In early stage – asymptomatic.
- Rapid growth.
- Oedema of leg may be present.
- P/A – (a) Intra-abdominal swelling felt solid and hard, (b) fixed and irregular surface. (c) ascites.
- P/V – uterus felt separate from a fixed pelvic/pelvi-abdominal mass.
- Cachexia and anaemia.
Ques. 6 What are the complications of ovarian cysts?
Ans. Complications of ovarian cysts –
- Infection and suppuration.
- Pseudomyxoma peritoneal. 8. Malignant changes.
- Torsion of the pedicle.
Ques. 7 How can we manage a case of ovarian cysts?
Ans. MANAGEMENT – Treatment of ovarian tumours/cyst is surgical except in the case of obviously inoperable malignant growth. Even in clinically inoperable case most surgeons would prefer to perform laparotomy to confirm the true stage of affairs by Intra-abdominal examination and by biopsy of tumour. Sometime the most hopeless case is amenable to palliative local operation, which relieves the patient of her tumour and much of her pain and discomfort. Obviously benign of her tumour and much of her pain and discomfort.
General Principle :
- Investigation – anaemia, benign of maligment.
- Benign tumour – excision of the cyst (ovariotomy) followed by biopsy excepting for hormone producing tumour.
- Malignant tumours – prophylaxis – removal of all benign neoplastic tumour of ovary.
Surgery (operable cases) –Stage I – Growth without local or peritoneal involvement – panhysterectomy, Stage – II – growth with pelvic metastasis – Panhysterectomy and removal of metastasis. Inoperable cases : Stage – III – removal of growth. State IV- Exploratory laparotomy. Rediotherapy, Chemotherapy.
Ques. 8 What types of Ovarian Tumors are common during pregnancy?
Ans – Dermoid cyst, Simple serous cyst, Pseudomucinous cyst.
Ques. 9 What are the effects of Ovarian Tumor upon pregnancy?
Ans. The effects of Ovarian Tumor upon pregnancy are:-
- Pressure symptom- usually are less than with fibroid uterus.
- Abortion in early months or premature labor in later months may occur in cases of complicated ovarian tumors.
- Overdistension of the abdomen which may cause disturbance in the cardio-respiratory system.
Ques. 10 What are the effects of pregnancy upon Ovarian Tumor?
Ans. The effects of pregnancy upon Ovarian Tumor are:-
- Necrosis of the tumour esp. In the puerperium.
- Suppuration esp. during puerperium.
- Incarceration of the tumor if situated below the presenting part.
- Increase in the size of the tumor.
- Torsion of pedicle.
- Rupture of the cyst.
Ques. 11 Which Homoeopathic remedies are useful in ovarian tumours or cysts?
Ans. Homoeopathic Remedies :
- COLOCYNTH – Ovarian cysts, with pain in abdomen upon straightening up, walks bent, with hands pressed to painful side, attacks of pains, cutting and griping, obliged to bend double and screams with agony, bilious vomiting during paroxysm.
- PHYTOLACCA – Swelling and induration of the glands, shooting lancinating pains, worse after sleeping, great exhaustion and prostration.
- LACHESIS – Ovarian tumor developing itself at climaxis; pains increase rapidly until relieved by profuse discharge of blood; violent pain as if a knife were thrust though abdomen, which has to be relieved from all pressure, coughing or sneezing causes stitches in the affected parts.
- PLATINA – Ovarian tumors and cysts; black and clotted metrorrhagia; induration and ulceration of uterus, mental symptoms characteristic.
Ques. 12 Which Biochemic medicines are useful ovarian cysts?
Ans. Biochemic Remedies
- CALCAREA FLUOR – Ovarian tumor, round swelling of encysted tumors.
- CALCAREA PHOS – Tumors in scrofulous constitution, Acute or chronic cysts require this remedy.
- NATRUM PHOS – Has proved of use in ovarian cyst, with pain in abdomen upon straightening up, cutting and griping pain.