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Wens FSPL, Hulsker CCC, Fiocco M, Zsiros J, Smetsers SE, de Krijger RR, van der Steeg AFW, Zweemer RP, Baas IO, Roes EM, Looijenga LHJ, Gerestein CG, Mavinkurve-Groothuis AMC. Small Cell Carcinoma of the Ovary, Hypercalcemic Type (SCCOHT): Patient Characteristics, Treatment, and Outcome-A Systematic Review. Cancers (Basel) 2023; 15:3794. [PMID: 37568608 PMCID: PMC10417391 DOI: 10.3390/cancers15153794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare aggressive ovarian malignancy mainly affecting children, adolescents, and young adults. Since the discovery of mutations in the SMARCA4 gene in 2014, SCCOHT has become the subject of extensive investigation. However, international uniform treatment guidelines for SCCOHT are lacking and the outcome remains poor. The aim of this systematic review is to generate an overview of all reported patients with SCCOHT from 1990 onwards, describing the clinical presentation, genetic characteristics, treatment, and outcome. METHODS A systematic search was performed in the databases Embase, Medline, Web of Science, and Cochrane for studies that focus on SCCOHT. Patient characteristics and treatment data were extracted from the included studies. Survival was estimated using Kaplan-Meier's methodology. To assess the difference between survival, the log-rank test was used. To quantify the effect of the FIGO stage, the Cox proportional hazard regression model was estimated. The chi-squared test was used to study the association between the FIGO stage and the surgical procedures. RESULTS Sixty-seven studies describing a total of 306 patients were included. The median patient age was 25 years (range 1-60 years). The patients mostly presented with non-specific symptoms such as abdominal pain and sometimes showed hypercalcemia and elevated CA-125. A great diversity in the diagnostic work-up and therapeutic approaches was reported. The chemotherapy regimens were very diverse, all containing a platinum-based (cisplatin or carboplatin) backbone. Survival was strongly associated with the FIGO stage at diagnosis. CONCLUSIONS SCCOHT is a rare and aggressive ovarian cancer, with a poor prognosis, and information on adequate treatment for this cancer is lacking. The testing of mutations in SMARCA4 is crucial for an accurate diagnosis and may lead to new treatment options. Harmonization and international collaboration to obtain high-quality data on diagnostic investigations, treatment, and outcome are warranted to be able to develop international treatment guidelines to improve the survival chances of young women with SCCOHT.
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Affiliation(s)
- Francis S. P. L. Wens
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Caroline C. C. Hulsker
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
- Mathematical Institute, Leiden University, 2311 EZ Leiden, The Netherlands
- Biomedical Data Science Department, Section Medical Statistics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - József Zsiros
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Stephanie E. Smetsers
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
- Department of Pathology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Alida F. W. van der Steeg
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Ronald P. Zweemer
- Department of Gynecologic Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands; (R.P.Z.); (C.G.G.)
| | - Inge O. Baas
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands;
| | - Eva Maria Roes
- Department of Gynecologic Oncology, Erasmus Medical Center Cancer Institute, 3015 GD Rotterdam, The Netherlands;
| | - Leendert H. J. Looijenga
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Cornelis G. Gerestein
- Department of Gynecologic Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands; (R.P.Z.); (C.G.G.)
| | - Annelies M. C. Mavinkurve-Groothuis
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
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Keikha F, Hadizadeh A, Akhavan S, Nili F, Eshghinejad A, Ghaemi M. Ovarian small cell carcinoma by ovarian torsion feature: A cytopathology challenging case. Int J Surg Case Rep 2022; 96:107337. [PMID: 35797874 PMCID: PMC9284065 DOI: 10.1016/j.ijscr.2022.107337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/18/2022] [Accepted: 06/18/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Ovarian small cell carcinomas are a rare type of ovarian cancer that is highly aggressive and consists of two distinct types the hypercalcemic type (SCCOHT) and pulmonary type (SCCOPT). CASE PRESENTATION A 23 years old girl was admitted to the emergency room with the presentation of acute abdomen. The ultrasound and Magnetic resonance imaging revealed a right adnexal huge mass with adnexal torsion. In laparotomy, she underwent unilateral salpingo-oophorectomy due to ovarian torsion and possible malignancy. The histopathological evaluation was challenging and was finalized by a team of pathologists as hypercalcemic small cell carcinoma. She refused reoperation and unfortunately relapsed during chemotherapy and died 6 months after the initial diagnosis. CLINICAL DISCUSSION Conclusion: We do not yet have comprehensive information on small cell ovarian cancer. Cytopathology diagnosis is still challenging and the treatments are not usually effective. Further clinical trials and studies are recommended to find appropriate treatments for these patients.
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Affiliation(s)
- Fatemeh Keikha
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Hadizadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Akhavan
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nili
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arefeh Eshghinejad
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghaemi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Aggarwal D, Gupta P, Chhabra P, Peters NJ, Bansal D, Srinivasan R, Kakkar N. Small Cell Carcinoma of Ovary, Hypercalcemic Type: Cytologic, Histopathologic, and Immunohistochemical Landscapes of a Rare Case. J Pediatr Adolesc Gynecol 2021; 34:98-102. [PMID: 32750414 DOI: 10.1016/j.jpag.2020.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/06/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Small cell carcinoma of ovary, hypercalcemia type (SCCOHT), also known as the malignant rhabdoid tumor of the ovary, is a rare and highly aggressive malignancy affecting younger women. The pathogenesis involves mutations in SWI/SNF-related, matrix-associated, actin-dependent regulator chromatin group A4 (SMARCA4)/Brahma-related gene 1 (BRG1) and/or SWI/SNF-related, matrix-associated, actin-dependent regulator chromatin group A2 (SMARCA2)/Brahma homolog (BRM). CASE A 10-year-old girl presented with lower abdominal pain and a mass for the past 2 weeks. She underwent ultrasound-guided fine needle aspiration and core needle biopsy from the pelvic mass followed by surgery. On the basis of the characteristic morphologic and immunohistochemical features, a diagnosis of SCCOHT was rendered. Chemotherapy was started, however, she succumbed to the disease.
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Affiliation(s)
- Divya Aggarwal
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India.
| | - Prashant Chhabra
- Department of Pediatric Hemato-Oncology, PGIMER, Chandigarh, India
| | | | - Deepak Bansal
- Department of Pediatric Hemato-Oncology, PGIMER, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
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