The treatment is conservative and surgical. Conservative methods include primarily hormone therapy. Of the hormonal drugs, clomiphene is the most widely used – a synthetic non-steroidal drug. Clomiphene is prescribed at 50 mg per day for 5 days, starting from the 5th day of the menstrual cycle (explicit or latent). Spend two to three courses of treatment. Ovulation occurs 6-7 days after discontinuation of treatment. Clomiphene gives a positive result in 50-80% of cases. Cyclophenyl (sexoid) is used to normalize the menstrual cycle. The effect of this drug is similar to that of clomiphene and consists in enhancing the secretion of LH.
In order to treat hirsutism, ovosiston is prescribed. In this case, hypertrichosis is significantly reduced in 80% of cases. Ovosiston corrects the metabolism of steroids in the ovaries and adrenal glands. For greater effectiveness in the treatment of hirsutism, some authors (A. S. Blind) use metronidazole (Trichopolum) according to a special scheme.
With a combination of sclerocystic ovaries with functional disorders of the cortical substance of the adrenal glands, prednisone or prednisone is prescribed according to the scheme.
In complicated forms of sclerocystic ovaries, 17-a-hydroxyprogesterone caproiate (125 mg) is sometimes prescribed in the second phase of the menstrual cycle (can be combined with prednisolone).
The sequential administration of these drugs allows (in almost all cases) to achieve a stable normalization of menstrual function.
Sometimes menstruation is caused by the administration of infectundin or bisecurin, a combined synthetic estrogen and progestogen. In some cases, chorionic gonadotropin – choriogonin is effective (500 ME intramuscularly daily for 6-7 days).
Treatment of patients with steroid hormones is ineffective.
Currently, a surgical treatment method is widespread: ovarian decapsulation – removal of a thickened ovarian albumen; dissection of the ovaries and their subsequent stitching “back to back”; wedge-shaped ovarian resection (with removal of 2/3 of the ovarian tissue. Some authors instead of wedge-shaped resection offer subtotal ovarian resection); Ovarian decortication, which is often combined with resection.
Kruckenberg cancer is a metastatic cancer in the ovaries from the alimentary canal. Often, cancer of the stomach or intestines is diagnosed after removal of its metastases in the ovary.
Kruckenberg Cancer Diagnosis
Diagnosis of Kruckenberg metastatic cancer before surgery is usually difficult. A tumor is usually diagnosed on an operating table. Metastasizes from the stomach or intestines by the lymphogenous, hematogenous or implantation route.
Histologically, the tumor is characterized by the presence of ring-shaped cells with inclusions of mucus in the cytoplasm, with a nucleus pushed to the periphery, the cells are scattered separately (and in groups) in the loose fibrous edema stroma. Kruckenberg cancer is prone to rapid growth, usually affects both ovaries. The shape of the tumor is oval, round or irregular. The consistency due to edema of the stroma is elastic. Tumors are often accompanied by ascites.
Kruckenberg Cancer Treatment
Surgical treatment. The volume of operation depends on the stage of spread of the primary maternal tumor of the stomach. The operation is preferably carried out in conjunction with the surgeon, who decides the amount of surgery (gastroectomy, bowel resection, etc.). In the postoperative period, chemo- or radiation therapy is performed.