Mature teratoma of the ovary

　　1. Abnormal function of the hypothalamus-pituitary-ovary axis

　　The basic pathophysiological changes in many patients with polycystic ovary syndrome are the overproduction of androgens by the ovaries, and the excessive production of androgens is the result of the synergistic action of various endocrine system functional abnormalities in the body.

　　2. Repeated stimulation of the serous cavity epithelium by menstrual blood hormones or chronic inflammation

　　It can be transformed into endometrial tissue to form endometriosis, 80% of which occurs in the ovaries and the metaplastic potential of the ovarian germinal epithelium, but many scholars believe that peritoneal stimulation combined with endometriosis is the result rather than the cause, and peritoneal stimulation occurs in sites outside the ectopic focus.

　　3. Environmental factors

　　An unreasonable dietary structure, high cholesterol diet, lack of vitamins A, C, and E, smoking, ionizing radiation, and other environmental factors are related to its occurrence;

　　4. Long-term dietary structure

　　Poor living habits, excessive psychological stress, and other factors cause excessive acidification of the body, leading to a decrease in overall body function, causing kidney deficiency. Since the kidney and liver have the same origin, kidney deficiency also leads to liver deficiency, and further causes the slow metabolism and circulation of the lower jiao, leading to ovarian diseases and endocrine disorders, decreased immune function, and ultimately abnormal hyperplasia of ovarian tissue, resulting in ovarian cysts, and even cancer.

　　5. Endocrine factors

　　The incidence rate increases in nulliparous or childless women, while pregnancy seems to have a protective effect on ovarian cancer; early menarche (before 12 years old), menopause after 50 years of age, frequent menstruation, use of ovulation-inducing agents for more than 3 cycles (discuss with your doctor when using), precocious puberty, or masculinization, and other factors are also related to the occurrence of ovarian cysts.

　　1. Tumor rupture

　　Approximately 3% of ovarian tumors may rupture, and ovarian tumors can undergo torsion of the pedicle, with rupture being of traumatic and spontaneous types. Traumatic rupture often occurs due to abdominal blows, delivery, sexual intercourse, gynecological examination, and puncture, while spontaneous rupture is often due to rapid growth of the tumor, with most cases being infiltrative growth of the tumor piercing the cyst wall. The severity of symptoms depends on the size of the rupture, the nature and quantity of the fluid that enters the abdominal cavity, and the cyst. In the case of small cysts or simple serous cystadenomas, the patient may only experience mild abdominal pain. In the case of large cysts or mature teratoma, rupture often leads to severe abdominal pain, nausea and vomiting, and sometimes internal hemorrhage, peritonitis, and shock.

　　Gynecological examination may reveal abdominal tenderness, muscle tension, or signs of ascites, as well as the original mass being unpalpable or palpable as a reduced, flat mass. Immediate laparotomy should be performed if tumor rupture is suspected. During the operation, it is advisable to aspirate the cyst fluid as much as possible, make a smear for cytological examination, clean the abdominal and pelvic cavities, and remove the specimen for pathological examination, with particular attention to whether there is malignant change at the edge of the break.

　　2. Infection

　　Less common, often caused by tumor torsion or rupture, or can come from adjacent organ infection foci such as appendiceal abscess spread. Clinical manifestations include fever, abdominal pain, mass, abdominal tenderness, muscle tension, and elevated white blood cell count. Treatment should first be with antibiotics, followed by surgical resection of the tumor. If infection cannot be controlled within a short period, immediate surgery should be performed.

　　3. Pedicle torsion

　　It is common and is one of the gynecological acute abdominal conditions. About 10% of ovarian tumors are complicated by torsion. It is more common in cystic tumors with long pedicles, moderate size, high mobility, and a center of gravity偏向一侧, occurring more often during sudden changes in body position, in the early stages of pregnancy, or after delivery. The pedicle of the ovarian tumor consists of the infundibulopelvic ligament, the ovarian固有ligament, and the fallopian tube. After acute torsion, venous return is obstructed, leading to severe congestion within the tumor or vascular rupture, causing the tumor to rapidly increase in size, intratumoral hemorrhage, and eventually leading to obstruction of arterial blood flow, necrosis of the tumor, and a purple-black discoloration, which is prone to rupture and secondary infection.

　　The typical symptom is sudden onset of severe lower abdominal pain, often accompanied by nausea, vomiting, and even shock, which is caused by peritoneal traction and strangulation. Gynecological examination reveals a mass with high tension and tenderness, most prominent at the pedicle, with muscle tension. Sometimes the torsion may naturally reset, and abdominal pain may subside accordingly. Once torsion is diagnosed, laparotomy should be performed as soon as possible.

　　4. Malignant transformation

　　Malignant transformation of benign ovarian tumors often occurs in older individuals, especially postmenopausal women, where the tumor rapidly increases in size within a short period, causing abdominal distension, loss of appetite, and a significantly increased tumor volume, which is fixed and often accompanied by ascites. In cases suspected of malignant transformation, timely treatment should be sought.

　　1. The tumor is mostly unilateral, with similar incidence rates on the left and right sides, and is benign.

　　2. No torsion or infection and other complications occur, and there are usually no special symptoms.

　　3. Large tumor volume can cause abdominal distension, mild abdominal pain, and compression symptoms.

　　4. Complicated pregnancy: It is the most common type of pregnancy complicated with ovarian tumor.

　　5. In extremely rare cases, the ovarian stroma with tumor development may have flavinoid changes, leading to signs of excessive hair growth.

　　Mature teratoma of the ovary is part of the ovarian teratoma family, originating from germ cells with pluripotent differentiation function. Prevention should include regular physical examinations, early detection and treatment, and good follow-up.

　　1. Ultrasound

　　Symmetric enlargement of both ovaries can be observed, with multiple small cysts of varying sizes, ranging from 2 to 6mm in diameter, distributed around the ovarian cortex.

　　2. Laparoscopic examination

　　Both ovaries can be directly seen as polycystic and enlarged, with thickened capsules and a grayish-white appearance.

　　3. Hormone testing

　　Abnormal levels of luteinizing hormone and follicle-stimulating hormone can be detected, with low follicle-stimulating hormone and slightly elevated luteinizing hormone, and increased androgen levels.

　　4. Endometrial biopsy

　　Endometrial biopsy performed before or during menstruation suggests unovulatory proliferative endometrium or hyperplastic endometrium.

　　5. Ultrasound examination

　　Both ovaries are polycystic and enlarged, with thickened capsules and strong echo. Subcapsular cystic follicles with diameters of 2 to 7mm are visible. The ovarian stroma has uneven echo, and the endometrium is thick.

　　6. Hysterosalpingography

　　Observe the shape and size of the ovary and adrenal glands to diagnose hyperandrogenism.

　　1. Dietary taboos for ovarian teratoma

　　1. Avoid warm and blood-activating foods such as mutton, dog meat, chives, and pepper.

　　2. Avoid刺激性食物 such as scallions, garlic, peppers, and cassia.

　　3. Avoid smoking and drinking.

　　4. Avoid greasy, fried, moldy, and salted foods.

　　2. Foods to eat for ovarian teratoma

　　1. Eat more foods with anti-tumor effects: turtle, horseshoe crab, dragon pearl tea, hippocampus, hawthorn, etc.

　　2. For bleeding, eat goat blood, snails, squids, shrimps, celery, lotus root, malan head, hickory, mushrooms, stone ear, persimmon cake, etc.

　　3. For infection, eat eels, warty clams, carp, water snakes, celery, toon, sesame, buckwheat, rapeseed, mung beans, red beans, etc.

　　4. For abdominal pain and bloating, eat pork kidneys, myrica, hawthorn, walnuts, chestnuts, etc. The dietary issues for ovarian teratoma cannot be generalized. Different diets are required for different conditions, follow the doctor's advice.

　　1. Abdominal Surgery

　　It is advisable to perform tumor stripping surgery and retain the normal tissue of the affected side of the ovary.

　　1. Method

　　Choose the thinnest part of the ovarian capsule below to make a shallow incision, and continue to strip the tumor after entering the correct level under the capsule. After the tumor is stripped, the remaining normal ovarian tissue is sutured together. Early detection of ovarian tumor in early pregnancy: wait until about 4 months of pregnancy before surgery. Late pregnancy tumor detection, tumor has been pushed outside the pelvic cavity without blocking the birth canal: perform tumor surgery and resection after delivery. Late pregnancy tumor detection, tumor blocking the birth canal: perform cesarean section during term pregnancy or in the late stage of labor, and simultaneously remove the tumor.

　　2. Precautions

　　Avoid breaking the tumor and contaminating the peritoneal cavity with tumor contents. For patients with unilateral mature teratoma, the opposite ovary should be incised and explored during surgery. When exploring, it should be noted not to be too deep at the ovarian hilum to avoid excessive ligation due to excessive bleeding at this location, which may affect the blood supply to the ovary.

　　2. Laparoscopic Surgery

　　Using an electric knife to cut, separate, and stop bleeding.