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Inzidenz und Outcome von Teratomen des Ovars - eine retrospektive Datenanalyse / Incidence and outcome of ovarian teratomas - a retrospective data analysisFehrmann, Marion Valerie January 2018 (has links) (PDF)
In der vorliegenden Arbeit " Inzidenz und Outcome von Teratomen des Ovars - eine retrospektive Datenanalyse " werden die Ergebnisse einer retrospektiven Datenanalyse für ein Zeitfenster von 10 Jahren diskutiert.
Gegenstand war die Auswertung der Patientenakten aller ovariellen Neubildungen, welche in den Jahren 2005-2015 in der Abteilung für Kinderchirurgie der chirurgischen Universitätsklinik Würzburg (Chirurgische Klinik I) behandelt wurden. Die Filterung der Datenbanken nach den erforderlichen Kriterien ergab einen Patientenstamm von 28 Fällen.
Zentrale Untersuchungsparameter stellten das Patientenalter zum Erkrankungszeitpunkt, die diagnoseweisenden Symptome, die präoperative Diagnostik, die Wahl der Operationsmethode, der postoperative Verlauf der Krankengeschichte, das Nachsorgeprogramm sowie die Untersuchung auf rezidivierende Prozesse dar.
Die gewonnenen Ergebnisse des betrachteten Patientenstamms wurden objektiv zusammengefasst, auf mögliche Gesetzmäßigkeiten untersucht, präsentiert und durch Grafiken bildlich veranschaulicht.
In der Diskussion erfolgte die Einordnung in die aktuelle wissenschaftliche Studienlage und der Vergleich mit themenspezifischen bekannten Erkenntnissen und Literatur. / Incidence and outcome of ovarian teratomas - a retrospective data analysis:
This work is an objective-based analysis which describes the clinical records of 28 individuals, who have been under medical treatment in the Universitätsklinik Würzburg, Zentrum operative Medizin, because of an ovarian teratoma. The collection and processing of data covers the time span between the years 2005-2015.
The study investigates supposed relationships and possible associations concerning determined questions. Comparing the cases, the focus is on the observed symptoms, age of the patients, tumor side, histology of the neoplasia, surgical technique, postoperative recovery and potential recrudescence during the follow-up.
Mature cystic teratoma is the most common germ cell neoplasm identified in women younger than 20 years.
In the majority of cases mature cystic teratomas of the ovaries are asymptomatic. Consequently, they often are discovered by incidence. If they have reached a certain dimension, they may present theirselves as an asymmetric abdominal swelling. Ovarian torsion is considered as the most common complication and often causes abdominal pain.
In clinical routine, ultrasonography (US) is the preferred modality to visualize and detect the tumor. The appearance at US is characterized by echogenic sebaceous material and calcification.
The diagnosis is fixed at the base of the histological treatment. The less developed the tumor-cells look in microscopic analysis, the higher the grade and the higher the malignant potential of the neoplasia. It also has turned out to be habitual, that the cyst is composed of tissue which contains elements of all three germ layers (ectoderm, mesoderm, and endoderm).
Due to the histological grading, two types of ovarian teratomas are distinguished:
On the one hand, there are mature teratomas, which are benign tumors and usually can be cured by surgery, and on the other hand the immature teratomas, which are cancerous and require the application of a platin-based chemotherapy in combination to surgery. Fortunately, this form is much less common (<1% of ovarian teratomas).
Structurally, the tumors appear in various patterns. In mature teratomas commonly dominates the cystic component, whereas immature teratomas may also host huge areas of solid organized tissue or appear as complex adnexal mass.
Although it is desirable to preserve the affected ovary in order to keep fertility, it often has to be removed completely because of a tight adhesion with the tumor.
At conclusion, most teratomas are curable and have an excellent prognosis.
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