B. Gerber et al., HISTOLOGY AND CYTOLOGY OF LAPAROSCOPICALL Y OPERATED SIMPLE OVARIAN CYSTS, Geburtshilfe und Frauenheilkunde, 55(7), 1995, pp. 369-373
In a retrospective study the histopathological findings of 127 laparos
copically operated unilocular anechoic smooth-walled ovarian cysts hav
e been correlated with clinical characteristics (age, duration of obse
rvation, complaints, hormonal treatment), size by ultrasound, kind and
colour of cysts content as well as cytological findings. The age of p
atients differed from 16-61 years ((x) over bar+s: 36+/-16). The histo
pathologic findings yielded 15 (11.8 %) functional cysts, 30 (23,6 %)
persistent corpus luteum cysts, 9 (7,1 %) endometriomas, 7 (5.5 %) cys
tic teratomas, 9 (7.1 %) undifferenciated cysts and 57 (44,9%) cystade
nomas. There were no differences between histopathologic diagnosis gro
ups according to age and cysts size by ultrasound. Functional cysts wi
th complaints (n = 6) may explain that the observation time in 60 % of
all functional cysts was smaller than 6 weeks, whereas persistent cor
pus luteum cysts, endometriomas, cystic teratoma and cystadenomas had
been observed for longer than 6 weeks in more than two thirds. Intraop
erative evaluation of cysts content as ''chocolate''-like was suspicio
us of endometriomas, but was also present in cysts of other histopatho
logical findings. By means of cytology, endometrioma (siderophages) wa
s suspected in 44.4 % and a cystadenoma in 42.1 % of all histopatholog
ically verified cases. In all, the cytologic findings were useful for
correct histopathological diagnosis in only 33.9 % of all 127 cases. I
t is concluded that differential diagnosis of simple ovarian cysts is
not possible by clinical characteristics, neither by ultrasound nor by
cytological evaluation. Ovarian cysts should be observed for at least
two hormonal cycles. A hormonal treatment by combination preparations
containing high doses of oestrogen is also recommended. In cases of p
ersisting ovarian cysts laparoscopic removal is necessary.