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Arun Kumar D, Aiyappan SK. Imaging findings of granulosa cell tumour of right ovary with rupture and torsion presenting as acute abdomen. BMJ Case Rep 2024; 17:e259517. [PMID: 38490713 PMCID: PMC10946348 DOI: 10.1136/bcr-2023-259517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Deepthi Arun Kumar
- Radiodiagnosis, SRM Medical college hospital and research centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Senthil Kumar Aiyappan
- Radiodiagnosis, SRM Medical college hospital and research centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
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2
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Bourgioti C, Konidari M, Moulopoulos LA. Manifestations of Ovarian Cancer in Relation to Other Pelvic Diseases by MRI. Cancers (Basel) 2023; 15:cancers15072106. [PMID: 37046767 PMCID: PMC10093428 DOI: 10.3390/cancers15072106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Imaging plays a pivotal role in the diagnostic approach of women with suspected ovarian cancer. MRI is widely used for preoperative characterization and risk stratification of adnexal masses. While epithelial ovarian cancer (EOC) has typical findings on MRI; there are several benign and malignant pelvic conditions that may mimic its appearance on imaging. Knowledge of the origin and imaging characteristics of a pelvic mass will help radiologists diagnose ovarian cancer promptly and accurately. Finally, in special subgroups, including adolescents and gravid population, the prevalence of various ovarian tumors differs from that of the general population and there are conditions which uniquely manifest during these periods of life.
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Affiliation(s)
- Charis Bourgioti
- Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 76 Vas. Sofias Ave., 11528 Athens, Greece
| | - Marianna Konidari
- Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 76 Vas. Sofias Ave., 11528 Athens, Greece
| | - Lia Angela Moulopoulos
- Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Aretaieion Hospital, 76 Vas. Sofias Ave., 11528 Athens, Greece
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Liu R, Ye L, Yan J, Cao Y, Huang S, Qian Z, Qian T. Transition of ovarian granulosa cell tumor from a solid mass to a cystic mass in two months on MR imaging in an adult woman: A case report. Radiol Case Rep 2023; 18:397-401. [DOI: 10.1016/j.radcr.2022.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022] Open
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4
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Matsuoka A, Tate S, Nishikimi K, Kobayashi T, Otsuka S, Shozu M. Serum FSH as a Useful Marker for the Differential Diagnosis of Ovarian Granulosa Cell Tumors. Cancers (Basel) 2022; 14:cancers14184480. [PMID: 36139639 PMCID: PMC9496984 DOI: 10.3390/cancers14184480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
Background: We evaluated whether the serum hormone levels are useful in the differential diagnosis of granulosa cell tumors (GCTs), regardless of menopausal status. Methods: Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, estradiol, and progesterone were measured preoperatively in all patients (n = 471) who underwent surgery for ovarian tumors at Chiba University Hospital between 2009 and 2021. These were compared in two groups, a GCT group (n = 13) and a group with other histological types (non-GCT) (n = 458). Results: The GCT group had significantly lower serum LH and FSH (p = 0.03 and p < 0.001, respectively) and significantly higher testosterone, estradiol, and progesterone (p < 0.001, p < 0.001, and p = 0.045, respectively) than the non-GCT group. Multivariate analysis revealed that serum FSH and estradiol were significantly associated with GCT (FSH, odds ratio (OR) = 0.0046, 95% confidence interval (CI) = 0.0026−0.22, p = 0.004; estradiol, OR = 0.98, 95% CI = 0.96−0.998, p = 0.046). Receiver-operating characteristic curve analysis for GCTs showed that the area under the curve of serum FSH was 0.99, with a sensitivity of 100% and a specificity of 98%, when the cutoff level was set at 2.0 IU/L. Conclusions: Preoperative serum FSH level is an extremely useful marker for differentiating GCTs from all ovarian tumors.
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Abstract
PURPOSE OF REVIEW Sex cord-stromal tumours (SCSTs) are rare ovarian cancers. As in the literature, only small case series or case reports are published, gathering solid evidence about their management is challenging. Surgery plays a pivotal role, and accurate staging is one of the most important prognostic factors. This review focuses on the current evidence for surgical staging in the management of SCSTs. RECENT FINDINGS Staging procedures have been inferred by epithelial ovarian cancers; however, they are often only partially performed, and most SCSTs therefore end up incompletely staged, raising the issue of the need for restaging or further treatments. In addition, some parts of the staging procedure have been questioned over the years, and lymphadenectomy is now considered unnecessary for SCSTs.The generally favourable prognosis of SCSTs, the introduction of minimally invasive surgery and fertility-sparing approaches is empowering the question of which staging procedures are beneficial for these patients. We reviewed the role of each staging procedure proposed by the guidelines in light of new scientific updates. SUMMARY Surgical staging should always be performed. It includes peritoneal samplings (peritoneal washing, multiple peritoneal biopsies, omental biopsy and biopsy of any suspicious area), whereas lymphadenectomy could be omitted. Laparoscopy may be considered a feasible approach.
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The Molecular Quality and Mitochondrial Activity of Porcine Cumulus-Oocyte Complexes Are Affected by Their Exposure to Three Endocrine-Active Compounds under 3D In Vitro Maturation Conditions. Int J Mol Sci 2022; 23:ijms23094572. [PMID: 35562963 PMCID: PMC9100547 DOI: 10.3390/ijms23094572] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
Thus far, the potential short- and long-term detrimental effects of a variety of environmental chemicals designated as endocrine-active compounds (EACs) have been found to interfere with histo- and anatomo-physiological functions of the reproductive system in humans and wildlife species. For those reasons, this study sought to examine whether selected EACs, which encompass the fungicide vinclozolin (Vnz), the androgenic anabolic steroid nandrolone (Ndn) and the immunosuppressant cyclosporin A (CsA), affect the developmental competence and molecular quality (MQ) of porcine cumulus–oocyte complexes (COCs) subjected to in vitro maturation (IVM) under 3D culture conditions. The COCs underwent 3D-IVM in the presence of Vnz, Ndn or CsA for 48 h. To explore whether the selected EACs induce internucleosomal DNA fragmentation in cumulus cells (CCs), TUNEL-assisted detection of late apoptotic cells was performed. Additionally, for the detailed evaluation of pro- and antiapoptotic pathways in COCs, apoptosis proteome profiler arrays were used. To determine changes in intracellular metabolism in COCs, comprehensive assessments of mitochondrial ultrastructure and activity were carried out. Moreover, the relative abundances (RAs) of mRNAs transcribed from genes that are involved in scavenging reactive oxygen species (ROS), such as SIRT3 and FOXO3, and intramitochondrial bioenergetic balance, such as ATP synthase subunit (ATP5A1), were ascertained. Finally, to investigate the extent of progression of oocyte maturation, the intraooplasmic levels of cAMP and the RAs of mRNA transcripts encoding regulatory and biocatalytic subunits of a heterodimeric meiosis-promoting factor, termed cyclin B1 (CCNB1) and cyclin-dependent kinase 1 (CDC2), were also estimated. The obtained results provide, for the first time, strong evidence that both Vnz and Ndn decrease the developmental competence of oocytes and stimulate apoptosis processes in CCs. The present study is also the first to highlight that Vnz accelerates the maturation process in immature oocytes due to both increased ROS production and the augmented RA of the CCNB1 gene. Furthermore, Vnz was proven to trigger proapoptotic events in CCs by prompting the activity of the FOXO3 transcription factor, which regulates the mitochondrial apoptosis pathway. In turn, Ndn was shown to inhibit oocyte maturation by inducing molecular events that ultimately lead to an increase in the intraooplasmic cAMP concentration. However, due to the simultaneous enhancement of the expression of TNF-β and HSP27 proteins in CCs, Ndn might be responsible for the onset of their neoplastic transformation. Finally, our current investigation is the first to clearly demonstrate that although CsA did not interfere with the nuclear and cytoplasmic maturation of oocytes, by inducing mitophagy in CCs, it disrupted oocyte metabolism, consequently attenuating the parameters related to the MQ of COCs. Summing up, Vnz, Ndn and CsA reduced not only the processes of growth and IVM but also the MQ of porcine COCs, which might make them unsuitable for assisted reproductive technologies (ARTs) such as in vitro fertilization by either gamete co-incubation or intracytoplasmic sperm injection (ICSI) and cloning by somatic cell nuclear transfer (SCNT).
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Mansour FR, Nabiuni M, Amini E. Ovarian Toxicity Induced by Aluminum Chloride: Alteration of Cyp19a1, Pcna, Puma, and Map1lc3b genes Expression. Toxicology 2021; 466:153084. [PMID: 34958889 DOI: 10.1016/j.tox.2021.153084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022]
Abstract
Aluminum (Al) is an abundant metal with wide application in our daily lives including medicine, industry, cosmetics, and packaging. After entrance to the body, aluminum binds to transferrin and reaches different tissues. Al is a metalloestrogen that can lead to oxidative stress (OxS) and endocrine disruption. No detailed study can be found addressing the effect of Al on the ovary and granulosa cells (GCs). In this study, the focus is on the treated ovaries and GCs of NMRI mice exposed to low, middle, and high doses of aluminum chloride (AlCl3) via in vitro and in vivo assays. The steroidogenic, proliferative, apoptotic, and autophagic-related genes were examined. Up-regulated expression of steroidogenic and proliferative genes was detected. The observed apoptotic and autophagic genes had variable expression. Interrupted ovarian structure, disrupted folliculogenesis, presence of Call-Exner bodies, overexpression of steroidogenic gene, and unbalanced apoptosis/autophagy and proliferation resembled features of granulosa cell tumor (GCT).
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Affiliation(s)
- Farima Rahimi Mansour
- Department of Cell & Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Mohammad Nabiuni
- Department of Cell & Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran.
| | - Elaheh Amini
- Department of Animal Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
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Yang ST, Cheng M, Lai CR, Shen SH, Lee WL, Wang PH. Meigs' syndrome and adult-type granulosa cell tumor. Taiwan J Obstet Gynecol 2021; 60:1116-1120. [PMID: 34794749 DOI: 10.1016/j.tjog.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Adult-type granulosa cell tumors (GCT) are sex cord-stromal tumors and often accompanied with abdominal distention and hyperestrogenism-related symptoms. Adult-type GCT-presenting ascites and pleural effusion is extremely rare. CASE REPORT A 56-year-old perimenopausal woman presented with abdominal distention and abnormal vaginal spotting. Ultrasound and abdominal computed tomography showed a complex cystic mass in the left ovary accompanied with bilateral pleural effusion and ascites. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, left pelvic lymph node dissection, omentectomy and appendectomy. Final histopathological diagnosis was adult-type GCT. The patient had postoperative hormone and anti-angiogenesis agent therapy with free of disease. CONCLUSION Ovarian cystic complex mass accompanied with ascites and pleural effusion often results from malignant ovarian tumors or benign ovarian fibroma. Based on the aforementioned report, the rare types of ovarian tumors, such as adult-type granulosa cell tumor of the ovary should be taken into consideration.
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Affiliation(s)
- Szu-Ting Yang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Min Cheng
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Ru Lai
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taiwan
| | - Shu-Huei Shen
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taiwan
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan.
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Female Cancer Foundation, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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9
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Ueda M, Sato Y, Iwami S, Dodo T, Shirase T, Fujita K. Temporal changes in magnetic resonance imaging appearance of adult granulosa cell tumor. J Obstet Gynaecol Res 2021; 47:4110-4117. [PMID: 34428859 DOI: 10.1111/jog.14995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/04/2021] [Accepted: 08/10/2021] [Indexed: 01/18/2023]
Abstract
Granulosa cell tumors (GCTs) can have a wide variety of appearances on magnetic resonance imaging (MRI), ranging from entirely solid to multilocular cystic, suggesting that GCTs undergo remarkable morphological changes during growth. These temporal changes in MRI appearance of individual GCTs have not been documented. A 54-year-old asymptomatic postmenopausal woman was referred to our department for a small ovarian mass. This 3-cm solid mass showed high intensity on diffusion-weighted MRI and low intensity on apparent diffusion coefficient mapping. Close clinical follow-up was recommended, but she did not return to our hospital until the age of 63, when she was referred for a large ovarian tumor. MRI showed a 15-cm multilocular cyst containing a solid component with hemorrhaging. Postoperative diagnosis was adult GCT (AGCT). These temporal changes demonstrate a possible reason why GCTs can have such a wide range of MRI appearance. This knowledge might promote accurate preoperative diagnosis of AGCTs.
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Affiliation(s)
- Masashi Ueda
- Department of Obstetrics and Gynecology, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Yukiyasu Sato
- Department of Obstetrics and Gynecology, Japanese Red Cross Otsu Hospital, Otsu, Japan.,Department of Obstetrics and Gynecology, Takamatsu Red Cross Hospital, Takamatsu, Japan
| | - Shuichiro Iwami
- Department of Obstetrics and Gynecology, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Toshiki Dodo
- Department of Radiology, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Tomoyuki Shirase
- Department of Pathology, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Kohei Fujita
- Department of Obstetrics and Gynecology, Japanese Red Cross Otsu Hospital, Otsu, Japan
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Abstract
The role of hybrid imaging with 2-[18F] flourodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) is continuously evolving and now considered standard practice in evaluation of disease stage, treatment response, recurrent disease and follow-up for numerous primary malignancies. In gynecological malignancies FDG PET/CT plays an important role, not only in the assessment of disease in the pre-and post-therapy setting, but also in radiation therapy (RT) planning by defining the metabolically active gross tumor volume (GTV. The glucose analogue radiotracer, FDG, is by far the most utilized radiotracer in PET/CT and is typically seen with high uptake in malignant cells. The radiotracer FDG has a high sensitivity but low specificity for malignancy, as benign processes with an inflammatory response for example infection, are also FDG-avid. In the evaluation of the female pelvic region an awareness of potential confounding factors in the interpretation of FDG is essential as variations of FDG uptake occur in accordance with the menstrual cycle and the menopausal state. Incidental imaging findings in the female genital can pose differential diagnostic challenges as false-positive and false-negative findings in benign and malignant processes are not uncommon. Gynecological malignancies continue to pose major public health problems with cervical cancer as the fourth most common cancer in women ranking after breast cancer, colorectal cancer and lung cancer. Familiarity with frequently encountered benign and malignant variants and pitfalls in FDG PET/CT in the female pelvic region can aid the reader in differential diagnostic considerations.
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Affiliation(s)
- Danijela Dejanovic
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Naja Liv Hansen
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Annika Loft
- Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Fujii S, Mukuda N, Murakami A, Yunaga H, Kitao S, Miyoshi H, Nosaka K. CT and MR imaging findings of bilateral ovarian metastasis from renal cell carcinoma: a case report. Acta Radiol Open 2021; 10:2058460121990293. [PMID: 33628461 PMCID: PMC7883165 DOI: 10.1177/2058460121990293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/07/2021] [Indexed: 11/23/2022] Open
Abstract
Secondary ovarian involvement by renal cell carcinoma rarely occurs. Here, we describe the computed tomography and magnetic resonance imaging findings of bilateral ovarian metastases from renal cell carcinoma that demonstrated heterogeneous strong contrast enhancing tumors with flow voids around and within the tumors. In addition, the apparent diffusion coefficients of the malignant tumors were high. These findings were similar to those of renal cell carcinomas at primary and other metastatic sites.
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Affiliation(s)
- Shinya Fujii
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.,Department of Pathology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Naoko Mukuda
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Atsushi Murakami
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Hiroto Yunaga
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shinichiro Kitao
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Hidenao Miyoshi
- Division of Radiology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kanae Nosaka
- Department of Pathology, Faculty of Medicine, Tottori University, Yonago, Japan
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Zhang X, Zhang TJ, Liu W, Ning YN, Bian YH, Cao YZ, Liu HB, Ma JL, Zhang HB. Mutational analysis of the GATA4 gene in Chinese men with nonobstructive azoospermia. Asian J Androl 2021; 23:205-210. [PMID: 32859868 PMCID: PMC7991814 DOI: 10.4103/aja.aja_33_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
As a crucial transcription factor for spermatogenesis, GATA-binding protein 4 (GATA4) plays important roles in the functioning of Sertoli and Leydig cells. Conditional knockout of GATA4 in mice results in age-dependent testicular atrophy and loss of fertility. However, whether GATA4 is associated with human azoospermia has not been reported. Herein, we analyzed the GATA4 gene by direct sequencing of samples obtained from 184 Chinese men with idiopathic nonobstructive azoospermia (NOA). We identified a missense mutation (c.191G>A, p.G64E), nine single-nucleotide polymorphisms (SNPs), and one rare variant (c.*84C>T) in the 3´ untranslated region (UTR). Functional studies demonstrated that the p.G64E mutation did not affect transactivation ability of GATA4 for spermatogenesis-related genes (claudin-11 and steroidogenic acute regulatory protein, Star), and the 3´ UTR rare variant c.*84C>T did not generate microRNA-binding sites to repress GATA4 expression. To our knowledge, this is thefirst report to investigate the association between GATA4 and azoospermia; our results indicate that mutations in GATA4 may not be pathogenic for NOA in Chinese men.
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Affiliation(s)
- Xu Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China.,Shandong Provincial Key Laboratory of Animal Cells and Developmental Biology, School of Life Sciences, Shandong University, Qingdao 266237, China
| | - Tai-Jian Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Wen Liu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Yun-Na Ning
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Yue-Hong Bian
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Yong-Zhi Cao
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Hong-Bin Liu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Jin-Long Ma
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
| | - Hao-Bo Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250012, China
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13
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Kilinc YB, Sari L, Toprak H, Gultekin MA, Karabulut UE, Sahin N. Ovarian Granulosa Cell Tumor: A Clinicoradiologic Series with Literature Review. Curr Med Imaging 2020; 17:790-797. [PMID: 33371855 DOI: 10.2174/1573405616666201228153755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 10/15/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Ovarian granulosa cell tumors that originate from the sex cord-stromal cells represent 2% to 5% of all ovarian cancers. These tumors constitute two subgroups according to their clinical and histopathological features: juvenile granulosa cell tumors (JGCT) and adult granulosa cell tumors (AGCT). Granulosa cell tumor (GCT) is considered to be a low-grade malignancy with a favorable prognosis. METHODS This case series includes four patients who were admitted to our university hospital and had an MRI examination within 5 years. RESULTS The histopathological subtype of granulosa tumor was the adult type in 3 patients and juvenile type in 1 patient. Even though it is extremely rare, bone metastases were present in one of our patients. Liver metastases were also detected in one patient. The MRI examination of tumors revealed a heterogeneous solid mass that contained cystic components in 3 patients. In one of our patients, the tumor had a multiseptated cystic feature, and all of the tumors were ovoid or round with smooth margins. T1 signal hyperintensity, not suppressed on fat saturation sequences, was observed in 3 patients, which represents its hemorrhagic content. CONCLUSION Even though granulosa cell tumor shows a wide spectrum in terms of tumor appearance, some common findings have been shown and especially a hemorrhagic content could be a clue for us. The tumor is known to have a good prognosis, but it may have an unpredictable clinical course, so close follow-up is greatly important.
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Affiliation(s)
- Yagmur Basak Kilinc
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Lutfullah Sari
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Huseyin Toprak
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Mehmet Ali Gultekin
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Ummuhan Ebru Karabulut
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Nurhan Sahin
- Department of Pathology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
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14
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Taylor EC, Irshaid L, Mathur M. Multimodality Imaging Approach to Ovarian Neoplasms with Pathologic Correlation. Radiographics 2020; 41:289-315. [PMID: 33186060 DOI: 10.1148/rg.2021200086] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Ovarian neoplasms can be categorized on the basis of histopathologic features into epithelial surface cell tumors, germ cell tumors, sex cord-stromal tumors, and metastases. While their imaging appearance is often nonspecific, it closely parallels the gross pathologic appearance, and radiologic-pathologic correlation is helpful to aid in a deeper understanding of the subtypes. Epithelial cell neoplasms are the most common category, and they can be benign, borderline, or malignant. Specific subtypes include serous (most common), mucinous, seromucinous, endometrioid, clear cell, Brenner, and undifferentiated. High-grade serous cystadenocarcinoma accounts for the majority of malignant ovarian tumors and the most ovarian cancer deaths. While serous neoplasms are often unilocular and bilateral, mucinous neoplasms are larger, unilateral, and multilocular. Solid components, thickened septa, and papillary projections, particularly with vascularity, indicate borderline or malignant varieties. Endometrioid and clear cell carcinomas can arise within endometriomas. Fibrous tumors (cystadenofibroma, adenofibroma, fibroma or fibrothecoma, and Brenner tumors) demonstrate low T2-weighted signal intensity of their solid components, while teratomas contain lipid. The nonspecific imaging appearance of additional malignant ovarian germ cell tumors can be narrowed with tumor marker profiles. Sex cord-stromal tumors are often solid, and secondary signs from their hormonal secretion can be a clue to their diagnosis. The authors review the anatomy of the ovary and distal fallopian tube, the proposed origins of the histologic subtypes of tumors, the clinical features and epidemiology of ovarian neoplasms, and the applications of US, CT, and MRI in imaging ovarian neoplasms. The main focus is on the radiologic and pathologic features of the multiple ovarian neoplasm subtypes. An algorithmic approach to the diagnosis of ovarian neoplasms is presented. Online supplemental material is available for this article. ©RSNA, 2020.
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Affiliation(s)
- Erin C Taylor
- From the Department of Radiology and Biomedical Imaging (E.C.T., M.M.) and Department of Pathology (L.I.), Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520
| | - Lina Irshaid
- From the Department of Radiology and Biomedical Imaging (E.C.T., M.M.) and Department of Pathology (L.I.), Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520
| | - Mahan Mathur
- From the Department of Radiology and Biomedical Imaging (E.C.T., M.M.) and Department of Pathology (L.I.), Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520
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