CASE REFRECTION 1

OVARIAN CYST
Pembimbing :
Dr. dr. Cahyono Hadi, SH, Sp.OG-(K)

Disusun Oleh :
Yokvi
406162072
Fakultas Kedokteran Universitas Tarumanagara
Kepaniteraan Obstetri dan Ginekologi
RSUD RAA SOEWONDO PATI
 PASIEN
ANAMNESIS PEMERIKSAAN FISIK
Seorang wanita usia 67 tahun P3A0 KU : Compos mentis, GCS 15
datang dengan keluhan nyeri perut TD : 130/80, HR: 80X/m, RR: 20x/m, S:36,7c
bagian bawah ABDOMEN : palpasi nyeri tekan dan
Riw mens : menopause teraba masa pada perut bagian bawah
PEMERIKSAAN PENUNJANG
Riw operasi :-
Lab CA 125
Riw penyakit dahulu : DM , HT ,
Jantung , Asma . Foto Rongsen

DIAGNOSIS KERJA TATALAKSANA

Kista Ovarii suspek malignancy Pro Kistektomi

 OVARIAN CYST
Definition : An ovarian cyst is a sac or pouch filled with
fluid or other tissue that forms on the ovary

Physiological Pathological
cysts cysts

follicular luteal benign, malignant,

cysts cysts and borderline

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
 EPIDEMIOLOGY
Functional ovarian cysts are common
in women of reproductive age, but rare
after menopause.

benign
cysts
functional
cysts

malignant

Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
Rofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment. Open Journal of Obstetrics and
Gynecology, 2013, 3, 17-22
 RISK FACTOR

Hypothyroidism

Cigarette
Pregnancy
smoking

Infertility Ovarian Lifestyle

treatment Cyst
 Follicular cysts
PATHOPHYSIOLOGY
excessive FSH
stimulation or decreased
lack of the frequency of
cysts continue estradiol
normal LH surge menstruation
to grow production
at midcycle just and
before menorrhagia
ovulation

Corpus luteal cysts

If the ovum is
The cyst can
fertilized, the
cause dull,
corpus luteum
unilateral pelvic
continues to
Failure of a corpus luteal pain and may be
secrete
dissolution cyst complicated by
progesterone for 5-
rupture, which
9 weeks, until its
causes acute pain
eventual
an
dissolution

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
http://www.radiologyassistant.nl/en/p4cdf9b5de7d3b/ovarian-cysts-common-lesions.html
 PATHOPHYSIOLOGY

Endometriomas
Endometriomas are
Theca lutein cyst associated with
endometriosis, which can
cause dysmenorrhea and
dyspareunia.
excessive luteinization
These cysts are
stimulation and
from human hypertrophy of Theca-lutein
predisposed to Dermoid cysts
torsion,
chorionic the theca cysts contain substances such
hemorrhage,
gonadotropin interna cell as nails and dental,
and rupture.
(hCG) layer cartilagelike, and
bonelike structures
 DIAGNOSIS
Vaginal
ultrasound

A serum AMH level above 0.5

ng/mL is consistent with good
CT Scan /
ovarian reserve, while lower Laparoscopy
MRI
levels suggest the presence of
a depleted ovarian follicle DIAGNOSIS
pool.

Anti-
mullerian Blood test
hormone CA 125
(AMH)

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Rofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment. Open
Journal of Obstetrics and Gynecology, 2013, 3, 17-22
 CLINICAL PRESENTATION
If pressing on the bladder it may
also cause frequency of
urination.
3 signs and symptoms of ovarian
cysts may include; pelvic pain, Asymptomatic
dysmenorrheal, and dyspareunia

Other symptoms are nausea,

vomiting, or breast tenderness,
fullness and heaviness in the a dull or sharp ache in the
abdomen and frequency and abdomen and pain
difficulty emptying of the Larger cysts may cause
bladder. torsion (twisting) of the ovary
Symptomatic that causes pain.
Cysts that bleed or rupture
(burst) may lead to serious
problems requiring prompt
treatment.

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
 MANAGEMENT

Management :
combined oral contraceptives
are still a possible treatment
Conservative
option for already existing
functional cyst.

There is no medical treatment

for benign cystic teratoma
Medical
(dermoid) except for
expectant follow up.

Medical treatment for

endometriosis includes oral
Surgical : cystectomy.
contraceptives, progesterone,
GnRH agonists or antagonists.

Rofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment. Open
Journal of Obstetrics and Gynecology, 2013, 3, 17-22
The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
 COMPLICATION

infertility.
Torsion
Hemorrhage

ofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive
technology treatment. Open Journal of Obstetrics and Gynecology, 2013, 3, 17-22
THANKYOU