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Gideonsson I, Israelsson P, Strandberg SN, Ottander U. Long-Term Follow-Up of Tamoxifen Treatment and the Use of Imaging in Psammocarcinoma: A Case Report, Review of the Literature and Discussion of Diagnostic and Therapeutic Challenges. Curr Oncol 2023; 30:10260-10271. [PMID: 38132381 PMCID: PMC10742443 DOI: 10.3390/curroncol30120747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
Psammocarcinoma (PsC) represents a rare form of low-grade serous tumor of the ovary or peritoneum. Although ovarian cancer generally has a poor prognosis in its late stages, PsC seems to have a more indolent course. We present a patient with a history of unspecific abdominal pain for more than a year, with sudden acute onset of severe inguinal pain. On admission to the hospital, a computed tomography (CT) revealed a pelvic mass of suspected ovarian origin. Radical surgery was attempted but not achieved due to widespread tumor growth. Histopathological evaluation revealed estrogen receptor-positive stage III PsC. Tamoxifen treatment was thus initiated, still maintaining stable disease 10 years later. The patient has undergone extensive radiological work-up, including CT, chest X-ray, 18F-fluoro-deoxy-glucose positron emission tomography (PET)/CT, 99mTc- hydroxymethylene diphosphonate (HDP) bone scintigraphy, 18F-fluoro-thymidine (FLT) PET/CT, Tc-99m depreotide scintigraphy and magnetic resonance imaging. In conclusion, we demonstrate that PsC has characteristic radiological features and different imaging modalities can be suitable in different clinical situations. In contrast to most other ovarian cancers, PsC does not always warrant adjuvant chemotherapy, even in advanced stages. This emphasizes the need for a deeper knowledge of the biological behavior of this rare tumor, to select the optimal treatment strategy.
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Affiliation(s)
- Ida Gideonsson
- Center of Obstetrics and Gynecology, Umeå University Hospital, 901 85 Umeå, Sweden;
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 85 Umeå, Sweden;
| | - Pernilla Israelsson
- Department of Radiation Sciences, Oncology, Umeå University, 901 85 Umeå, Sweden
| | - Sara N. Strandberg
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, 901 85 Umeå, Sweden;
| | - Ulrika Ottander
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 85 Umeå, Sweden;
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Helal I, Khanchel F, Jouini R, Ben Thayer M, Mbarki C, Bettaieb H, Rebii S, Ben Ismail I, Ben Brahim E, Chedli-Debbiche A. Case Report: Incidental discovery of primary peritoneal psammocarcinoma. F1000Res 2023; 11:696. [PMID: 39233872 PMCID: PMC11372342 DOI: 10.12688/f1000research.110362.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 09/06/2024] Open
Abstract
Psammocarcinoma is an uncommon subtype of low-grade serous carcinoma. It is characterized by the presence of extensive psammoma bodies and can have either an ovarian or peritoneal origin. To our knowledge fewer than 30 cases of primary peritoneal psammocarcinoma (PPP) have been reported in the English literature. We report a rare case of PPP in a 74-year-old female, discovered fortuitously within a laparotomy for gallbladder lithiasis. At laparotomy, multiple nodular implants involving the omentum, the peritoneum and a magma of intestinal loops in the right iliac fossa were noted. A biopsy from nodules was performed. Gross examination showed multiple nodules of different sizes in the fat tissue. Pathologic examination showed massive psammoma bodies representing more than 75% of the tumor. The final diagnosis was psammocarcinoma. Our patient was referred to the gynecologic department for further investigation and to ascertain whether the tumor arose from the ovaries or peritoneum. Hysterectomy, bilateral adnexectomy and omentectomy were performed. Macroscopic examination showed that both ovaries were intact having a normal size. No invasion of ovarian stroma was shown in microscopic examination. The patient died of SARS-CoV-2 (COVID-19) six days after the surgery. PPP is a rare type of low-grade serous carcinoma. The behavior of this tumor is unclear, and the treatment is not standardized because of its rarity and lack of long-term follow-up. More cases need to be studied for better understanding and improvement of the management protocols.
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Affiliation(s)
- Imen Helal
- Department of Pathology, Habib Thameur Hospital, Tunis, 1008, Tunisia
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
| | - Fatma Khanchel
- Department of Pathology, Habib Thameur Hospital, Tunis, 1008, Tunisia
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Tunis, 1008, Tunisia
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
| | - Maissa Ben Thayer
- Department of Pathology, Habib Thameur Hospital, Tunis, 1008, Tunisia
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
| | - Chaouki Mbarki
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
- Department of Obstetrics and Gynecology, Yasminette's hospital, Ben Arous, 2063, Tunisia
| | - Hajer Bettaieb
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
- Department of Obstetrics and Gynecology, Yasminette's hospital, Ben Arous, 2063, Tunisia
| | - Saber Rebii
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
- Department of Surgery, Center for Traumatology and Major Burns, Ben Arous, 2013, Tunisia
| | - Imen Ben Ismail
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
- Department of Surgery, Center for Traumatology and Major Burns, Ben Arous, 2013, Tunisia
| | - Ehsen Ben Brahim
- Department of Pathology, Habib Thameur Hospital, Tunis, 1008, Tunisia
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
| | - Aschraf Chedli-Debbiche
- Department of Pathology, Habib Thameur Hospital, Tunis, 1008, Tunisia
- Faculty of medicine of Tunis, Tunis El Manar University, Tunis, 1007, Tunisia
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Ovarian and peritoneal psammocarcinoma: Results of a multicenter study on 25 patients. Eur J Surg Oncol 2019; 46:862-867. [PMID: 31902591 DOI: 10.1016/j.ejso.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/29/2019] [Accepted: 12/04/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Psammocarcinoma (PK) is a rare disease of unknown origin. We aimed to report the characteristics, management and survival of patients operated on for PK within the French Network for Rare Peritoneal Malignancies (RENAPE) expert centers. PATIENTS AND METHODS All consecutive cases of PK operated within all 26 RENAPE centers between 1997 and 2018 were retrospectively analyzed. RESULTS Twenty-five patients were identified. The median age was 53 years [range 17-78]. None of the patients had extra peritoneal metastases at diagnosis. A median of 6 cycles of carboplatin-based systemic chemotherapy was delivered in 52% preoperatively (n = 13) and 56% postoperatively (n = 14); associated with placlitaxel for 12 patients. All patients were operated on. The median PCI was 23 [0-33]. Eighty-four percent had a complete cytoreductive surgery through digestive (n = 7), spleen (n = 3), pancreas (n = 1) resections and/or multiple peritonectomies (n = 11). Five patients (20%) had intraperitoneal chemotherapy. Morbidity (Dindo-Clavien ≥3) was 12%. No postoperative death occurred. After a median follow-up of 42 months (range [2-194]), the median overall (OS) and progression-free (DFS) survival times were respectively 128 months and 31 months. Eighteen patients recurred (72%), mainly in the peritoneum (n = 16). Four of them (22%) were reoperated. The 5 and 10-year DFS rates were both 20.3%. The 5 and 10-year OS rates were 62% and 51.7%, respectively. A complete cytoreductive surgery was associated with a better OS and DFS in a univariate analysis. CONCLUSION Complete cytoreductive surgery is the cornerstone of the PK's management as a primary treatment. Recurrence remains common and new adjuvant strategies seem needed.
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