Rev Med UAS; Vol. 10: No. 3. Julio-Septiembre 2020
ISSN 2007-8013


Manejo quirúrgico conservador del teratoma quístico maduro y riesgo de recurrencia

Conservative surgical management of mature cystic teratoma and risk of recurrence

Mercedes García-Verdugo1*, Everardo Quevedo-Castro1, Fred Morgan-Ortiz1, Javier Conde-Romero2, Guadalupe López-Manjarrez1, Josefina Báez-Barraza3

  1. Departamento de Ginecología y Obstetricia, Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa
  2. Hospital General de Zona No. 1 del Instituto Mexicano del Seguro Social, Culiacán, Sinaloa
  3. Ginecología y Obstetricia, Hospital Angeles Culiacán

*Correspondencia: Dra. Mercedes García Verdugo.
Eustaquio Buelna No. 91, Col. Gabriel Leyva, Culiacán, Sinaloa, México, CP: 80030
Tel. 6677132606; Correo electrónico: merce_verdugo@hotmail.com

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v10.n3.008

Recibido 07 de Mayo 2020, aceptado 22 de Junio 2020


RESUMEN
Los teratomas quísticos maduros, también llamados quistes dermoides, son las neoplasias ováricas más comunes y representan el 30% de los tumores benignos de ovario. Generalmente afecta a mujeres en edad reproductiva, suelen ser asintomáticos (pudiendo causar abdomen agudo en caso de torsión, ruptura o infección) y se diagnostican por ecografía pélvica o transvaginal, siendo por lo regular un hallazgo. Para su diagnóstico diferencial se puede recurrir a marcadores tumorales, sin embargo, su diagnóstico final es histopatológico.
Su tratamiento es mediante cirugía conservadora de ovario (cistectomía), es decir, escisión del teratoma quístico maduro, como tratamiento de primera línea, sin embargo, en algunos casos puede requerir de ooforectomía, reservándose la misma por tratarse por lo general de pacientes en edad reproductiva.
Se ha encontrado una tasa de recurrencia posquirúrgica alrededor del 3-4%, lo cual ha sido asociada con factores clínicos como la bilateralidad de las lesiones, edad de la mujer menor de 30 años y un tamaño del teratoma mayor de 8 centímetros. Es importante conocer lo anterior para llevar a cabo un mejor control posquirúrgico y una detección precoz de la recurrencia.
Palabras clave: Quiste dermoide, teratoma, recurrencia, tratamiento.

ABSTRACT
Mature cystic teratomas, also called dermoid cysts, are the most common ovarian neoplasms, representing 30% of benign ovarian tumors. Generally, mature cystic teratomas affect women in their reproductive age, these cystic teratomas tend to be asyntomatic, (they might cause an acute abdomen in the case or evento of torsion, ruptura or infection) and they are diagnosed by pelvic or transvaginal ultrasounds. Additionally, fot it´s differential diagnosis, tumor markers can be used, howeber, it´s last diagnosis is histopathological.
Mature cystic teratomas´ treatment usually consist in ovarian-conserving surgery (cystectomy). In other words, excision of the mature cystic teratoma as first-line treatment. However, in some cases it may be necessary the use of oophorectomy, however, this treatment is generally not recommended in patients in their reproductive age.
According to quantitative data, it has been found that the postoperative recurrence rate isa round 3-4%, which has been associated with clinical factors, such as bilateral lesions, woman´s middle age or younger and a teratoma sice greater than 8 centimeters. It is important to know these facts previously mentioned to accomplish a better postoperative control and an early detection of recurrence.
Keywords: Dermoid cysts, teratoma, recurrence, treatment.


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