Pelvic Tumors

　　The incidence of endometrioma-like cysts ranks second, with about 2/3 of the cases having a history of dysmenorrhea, 1/3 of the cases having menstrual irregularities, manifested as prolonged menstrual periods, persistent spotting, a small number of cases showing no obvious symptoms, and occasionally, symptoms such as lower abdominal坠胀. Ultrasound (B-ultrasound) indicates that most cases show anechoic areas, some mixed echo areas, thick and irregular capsules, more common on both sides, and a slight increase in CA125. Chronic pelvic inflammatory mass ranks third, accounting for 16.48%, mostly due to chronic pelvic inflammatory disease. The main cause is that the symptoms during the acute stage are not severe, leading to neglect and no treatment, or incomplete cure and extension during the acute stage.

　　11. Infection: It is less common and often secondary to tumor pedicle torsion or rupture. The main symptoms include fever, abdominal pain, elevated white blood cell count, and varying degrees of peritonitis. Active control of infection and scheduled surgical exploration should be carried out.

　　10. Tumor rupture: It can be caused by ischemic necrosis of the cyst wall or tumor erosion and penetration through the cyst wall, leading to spontaneous rupture; or due to external trauma caused by compression, delivery, gynecological examination, and puncture. After rupture, the cyst fluid flows into the peritoneal cavity, stimulating the peritoneum, which can cause severe abdominal pain, nausea, vomiting, and even shock. During examination, there are signs of peritoneal irritation such as abdominal wall tension, tenderness, and rebound pain. The original mass may shrink or disappear. After diagnosis, an immediate laparotomy should be performed to remove the cyst and clean the peritoneal cavity.

　　9. Pedicle torsion: It is relatively common and is one of the gynecological acute abdominal diseases. It is more common in cystic tumors with long pedicles, medium size, high mobility, and center of gravity biased to one side, and often occurs during sudden changes in body position, in the early stage of pregnancy, or after childbirth. After pedicle torsion, due to the obstruction of venous return, congestion occurs, presenting purple-brown discoloration, and even bleeding due to vessel rupture. Necrosis and infection can occur due to arterial obstruction. In acute pedicle torsion, patients suddenly experience severe lower abdominal pain, which can be accompanied by nausea, vomiting, and even shock. During examination, the affected side has muscle tension and significant tenderness, and the mass has high tension. Once diagnosed, the tumor should be surgically removed immediately. Do not turn the twisted pedicle back during surgery, and it is better to clamp and cut it near the site of torsion to prevent thrombus detachment into the blood circulation.

　　8. Malignant lesions: The occurrence of malignant transformation of ovarian benign tumors often occurs in older women, especially postmenopausal women. The tumor rapidly increases in size in a short period of time, causing symptoms such as abdominal distension, loss of appetite, and a significant increase in tumor volume. There is often ascites.

　　The main manifestation is pelvic masses. Ovarian tumors are the most common, among which 3.7% are malignant ovarian tumors, which is lower than the reported 10%. In addition to a history of pelvic mass, there are symptoms such as abdominal distension, significant elevation of CA125, and B-ultrasound showing solid or mixed mass.

　　The proportion of endometriotic cysts is the second, with about 1/2 of the cases having a history of dysmenorrhea, 1/3 of the cases have menstrual disorders, showing prolonged menstrual periods, intermittent bleeding, a small number of cases have no obvious symptoms, and occasionally there are symptoms such as lower abdominal distension. Ultrasound shows that most cases have anechoic areas, some have mixed echo, thick capsule, irregular shape, more on both sides, and CA125 slightly elevated. Chronic pelvic inflammatory masses rank third, accounting for 16.48%, mostly due to chronic pelvic inflammation. The main reason is that the symptoms during the acute stage are not serious and are ignored without treatment, or the acute stage is not completely cured and prolonged.

　　1. To prevent pelvic tumors, it is necessary to极力 avoid early pregnancy and multiple births. According to relevant surveys, younger women, even those who are not yet adults, have not fully developed reproductive systems and are less resistant to bacteria. If pregnancy occurs, it is easy to cause pelvic tumors.

　　2. To prevent pelvic tumors, it is necessary to start with hygiene. Women have weaker resistance in all aspects during their menstrual period, and they are prone to invasion of bacteria from external factors. Therefore, it is necessary to do a good job of cleaning and hygiene work to keep the area dry.

　　3. In terms of sexual activity, attention should also be paid to prevent pelvic tumors. It should not be too intense, and attention should be paid to environmental hygiene and other aspects.

　　4. To prevent pelvic tumors, it should also be avoided to have contact with men with reproductive diseases, which may lead to the spread of bacteria.

　　Ultrasound, CT, and MRI can mostly make correct judgments on the location, benign or malignant nature, and the extent of involvement of pelvic tumors. They can also suggest the histological type of most tumors, providing a basis for the clinical selection of reasonable treatment plans.

　　When the etiology is unclear and the effect of drug treatment is not significant, laparotomy exploration is a viable option for early detection of ovarian malignant tumors, which is extremely important for improving the prognosis. At the same time, resection of the lesion is also an effective treatment method for chronic pelvic inflammation and endometriosis.

　　During the fever period, it is advisable to eat light and easy-to-digest foods. For patients with high fever and injury to body fluid, pear juice, apple juice, watermelon juice, and other beverages can be given, but they should not be served chilled. Patients with yellowish leukorrhea, large amount, and thick quality belong to damp-heat syndrome, and they should avoid fried, greasy, and spicy foods. Patients with cold pain in the lower abdomen, fear of cold, and lower back pain belong to the type of cold conglomeration and qi stasis, and warm foods such as ginger soup, brown sugar water, and longan meat can be given in diet. Patients with feverish feeling in the five hearts and back pain mostly belong to kidney Yin deficiency, and they can eat meat and egg products that are rich in blood and flesh, which can nourish and strengthen the body.

　　Cryotherapy for malignant pelvic tumors:

　　Cryosurgery under direct vision during surgery: for the frozen tumor, it can be excised or not, or the entire organ can be removed after freezing.

　　Percutaneous cryosurgery is often performed under the guidance of ultrasound, CT, or MRI. The argon-helium cryosystem is the preferred cryosurgical device. According to the size of the tumor, insert 1 or more cryoprobe(s), perform 2 cycles of freezing-thawing, and ensure that the ice ball covers the entire tumor and at least 0.5-1.0 cm of normal tissue around it.