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文献考察：卵巣腫瘍破裂
１）【どこまでわかる?急性腹症のCT診断】 婦人科疾患
Author：安田晶信(湘南鎌倉総合病院 放射線科), 木幡豊
Source：画像診断(0285-0524)24巻5号 Page621-630(2004.04)
まとめ：良性および悪性腫瘍，内膜症性嚢胞が破裂する．頻度としてはdermoid cyst（成熟嚢胞性奇形腫）の破裂が多い．dermois cystの脂肪を含む内容物が腹腔内に漏れ出ると腹膜を刺激して（chemical peritonitis）強い腹痛を起こす．
２）dermoid cystの合併症は10.7%に起こる．捻転が最も多く（4.9%），破裂は2.5%．
Eur J Obstet Gynecol Reprod Biol. 2000 Feb;88(2):153-7.
Mature cystic teratomas of the ovary: case series from one institution over 34 years.
Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A.
OBJECTIVE: To evaluate bilaterality, complications and malignant changes of mature cystic teratomas of the ovary. STUDY DESIGN: Retrospective study of 501 patients operated at Hacettepe University Hospital between the years of 1964 and 1998. RESULTS: The median age was 35 years (range 13-76). One hundred and six cases (21.1%) were asymptomatic. The mean tumor diameter was 7.0+/-4.5 cm. The decision for cystectomy or oophorectomy was related with the patient age, gravidity and parity. The bilaterality rate when both ovaries were evaluated histopathologically was 13.2% (44/331). Total complication rate was 10.7%, torsion being the most frequent (4.9%). The rate of malignant transformation was 1.4%. CONCLUSION: Ovarian mature cystic teratomas are common tumors especially during the reproductive period with low rates of covert bilaterality, complications and malignant transformation. The treatment should be directed on the basis of age, fertility desire or presence of another pelvic pathology rather than the size or bilaterality.PMID: 10690674
３） J Pediatr Surg. 2001 May;36(5):693-9.
Surgery for ovarian masses in infants, children, and adolescents: 102 consecutive patients treated in a 15-year period.
Cass DL, Hawkins E, Brandt ML, Chintagumpala M, Bloss RS, Milewicz AL, Minifee PK, Wesson DE, Nuchtern JG.
BACKGROUND/PURPOSE: Ovarian pathology, although rare in children, must be included in the differential diagnosis of all girls who present with abdominal pain, an abdominal mass, or precocious puberty. METHODS: To improve clinical appreciation of these lesions, the authors reviewed the presentation, evaluation, and outcome of all patients with ovarian pathology surgically treated at their institution since 1985. RESULTS: One hundred two girls (aged 9.8 +/- 5.5 years; range, 2 days to 20 years) underwent 106 separate ovarian operations (43 salpingo-oophorectomies, 21 oophorectomies, 33 ovarian cystectomies, and 9 ovarian biopsies). Of those presenting with acute abdominal pain (n = 59), 25 (42%) had ovarian torsion (14 associated with a mature teratoma), and only 1 (2%) had a malignant tumor. In contrast, of those presenting with an abdominal mass (n = 23), 6 (26%) had malignancies. There was no age difference between those with benign disease (9.9 +/- 5.6 years; n = 96) and those with malignant tumors (8.6 +/- 3.9 years, n = 10). Nine children had 10 operations for presumed malignant tumors (3 dysgerminomas, 2 immature teratomas with foci of yolk sac tumor, 2 juvenile granulosa cell tumors, 1 yolk sac tumor, and 1 Sertoli-Leydig cell tumor). These patients all had unilateral salpingo-oophorectomy, 4 had chemotherapy, and all are now disease free at 8.4 +/- 4.1 years follow-up. CONCLUSION: Ovarian pathology remains a rare indication for surgery in girls less than 20 years of age. Because most of these lesions are benign, ovarian-preserving operations should be performed whenever feasible. PMID: 11329568
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