1
|
Dimitrakopoulos FI, Goussia A, Koliou GA, Dadouli K, Batistatou A, Kourea HP, Bobos M, Arapantoni-Dadioti P, Tzaida O, Koletsa T, Chrisafi S, Sotiropoulou M, Papoudou-Bai A, Nicolaou I, Charchanti A, Mauri D, Aravantinos G, Binas I, Res E, Psyrri A, Pectasides D, Bafaloukos D, Koumarianou A, Bompolaki I, Rigakos G, Karanikiotis C, Koutras A, Zagouri F, Gogas H, Fountzilas G. Ten-year clinical outcome, toxicity and compliance of dose-dense sequential adjuvant administration of cyclophosphamide & epirubicin followed by docetaxel in patients with early breast cancer: A hellenic cooperative oncology group observational study (HE 10/10) with concurrent investigation of significance of tumor infiltrating lymphocytes. Breast 2024; 73:103668. [PMID: 38176305 PMCID: PMC10791571 DOI: 10.1016/j.breast.2023.103668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Dose-dense sequential (dds) chemotherapy has changed the clinical outcome of patients with early breast cancer (BC). To investigate the impact of dose intensity (DI) in the adjuvant setting of BC, this observational trial (HE 10/10) was conducted assessing the long-term survival outcome, safety and toxicity of a currently widely used chemotherapeutic regimen. In addition, the prognostic significance of tumor infiltrating lymphocytes (TILs) and infiltrating CD8+ lymphocytes were also evaluated in the same cohort. PATIENTS AND METHODS Totally, 1054 patients were prospectively enrolled in the current study with 1024 patients being eligible, while adequate tissue was available for 596 of them. TILs, CD8+ lymphocytes in intratumoral areas in contact with malignant cells (iCD8), CD8+ lymphocytes in tumor stroma (sCD8) as well as the total number of CD8+ lymphocytes within the tumor area (total CD8) were assessed by immunohistochemistry. RESULTS Within a median follow-up of 125.18 months, a total of 200 disease-free survival (DFS) events (19.5%) were reported. Importantly, the 10-year DFS and OS rates were 78.4% (95% CI 75.0-81.5) and 81.7% (95% CI 79.0-84.1), respectively. Interestingly, higher CD8+ T cells as well as TILs in the tumor microenvironment were associated with an improved long-term survival outcome. CONCLUSIONS In conclusion, this study confirms the significance of dds adjuvant chemotherapeutic regimen in terms of long-term survival outcome, safety and toxicity as well as the prognostic significance of TILs and infiltrating CD8+ lymphocytes in BC patients with early-stage disease.
Collapse
Affiliation(s)
- Foteinos-Ioannis Dimitrakopoulos
- Division of Oncology, University Hospital of Patras "Panagia the Help", University of Patras, Patras, Greece; Molecular Oncology Laboratory, Department of Medicine, University of Patras, Patras, Greece.
| | - Anna Goussia
- Department of Pathology, Ioannina University Hospital, Ioannina, Greece; Department of Pathology, German Oncology Center, Limassol, Cyprus
| | | | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Anna Batistatou
- Department of Pathology, Ioannina University Hospital, Ioannina, Greece
| | - Helen P Kourea
- Department of Pathology, University Hospital of Patras, Rion, Greece
| | - Mattheos Bobos
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | | | - Olympia Tzaida
- Department of Pathology, Metaxas Cancer Hospital, Piraeus, Greece
| | - Triantafyllia Koletsa
- Department of Pathology, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, Thessaloniki, Greece
| | - Sofia Chrisafi
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Irene Nicolaou
- Department of Histopathology, Agii Anargiri Hospital, Athens, Greece
| | - Antonia Charchanti
- Department of Anatomy-Histology-Embryology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Davide Mauri
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece
| | - Gerasimos Aravantinos
- Second Department of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Greece
| | - Ioannis Binas
- Second Department of Medical Oncology, Metropolitan Hospital, Piraeus, Greece
| | - Eleni Res
- Third Department of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Greece
| | - Amanda Psyrri
- Section of Medical Oncology, Department of Internal Medicine, Attikon University Hospital, Faculty of Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Dimitrios Pectasides
- Oncology Section, Second Department of Internal Medicine, Hippokratio Hospital, Athens, Greece
| | | | - Anna Koumarianou
- Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | | | - Georgios Rigakos
- Third Department of Medical Oncology, Hygeia Hospital, Athens, Greece
| | | | - Angelos Koutras
- Division of Oncology, University Hospital of Patras "Panagia the Help", University of Patras, Patras, Greece
| | - Flora Zagouri
- Department of Clinical Therapeutics, Alexandra Hospital, National Andistrian U Kapodniversity of Athens School of Medicine, Athens, Greece
| | - Helen Gogas
- First Department of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research/Aristotle University of Thessaloniki, Thessaloniki, Greece; Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Medical Oncology, German Oncology Center, Limassol, Cyprus
| |
Collapse
|
2
|
Psomiadou V, Lekka S, Panoskaltsis T, Tsouma H, Novkovic N, Trihia HJ, Tzaida O, Korfias D, Giannakas P, Iavazzo C, Papadimitriou C, Vlahos N, Vorgias G. Fallopian tube cytology as a diagnostic tool for adnexal malignancy: the CytoSaLPs score. J Am Soc Cytopathol 2023; 12:368-377. [PMID: 37422370 DOI: 10.1016/j.jasc.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/30/2023] [Accepted: 05/16/2023] [Indexed: 07/10/2023]
Abstract
INTRODUCTION During the past decade, the theory that high-grade extrauterine pelvic tumors originate from the fallopian tube has been strongly suggested. Our study aims to illuminate the possible role of tubal cytology as an accessory identification tool for gynecologic extrauterine malignancies, allowing in the long term the implementation of population-level cytologic tube evaluation during all benign gynecologic surgeries that do not result in salpingectomy. MATERIALS AND METHODS We ex vivo collect salpingeal epithelial cells from the fibria directly from fresh fallopian tube specimens from women undergoing salpingectomy for any indication. The cytomorphologic characteristics of the salpingeal cells are subsequently evaluated and categorized into malignant and non-malignant. Finally, the ipsilateral adnexa are examined with the SEE-FIM (Sectioning and Extensively Examining the FIMbriated End) protocol and the pathology reports are corelated with the cytologic findings. Our research protocol is ongoing and is designed to include a total of 300 patients in order to confirm the sensitivity and specificity of salpingeal cytology as a method in the early diagnosis of extrauterine gynecologic malignancies. RESULTS So far, we have obtained 343 salpingeal brushings from a total of 214 patients. The sensitivity of cytology regarding distinguishing malignant from non-malignant tumors is 69.64% (95% CI: 55.90%-81.22%), and its specificity 75.96% (95% CI: 70.59%-80.79%). Cytology's positive predictive value (PPV) is 16.33% (95% CI: 12.57%-20.67%), while the negative predictive value (NPP) reached 92.77% (95% CI: 89.56%-95.04%). In general, the diagnostic accuracy of the cytologic evaluation reaches 74.93% (95% CI: 66.99%-79.43%). CONCLUSIONS Salpingeal cytomorphologic evaluation appears to be a promising method for early detection of adnexal cancer.
Collapse
Affiliation(s)
- Victoria Psomiadou
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece.
| | - Sofia Lekka
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - Helen Tsouma
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Natasa Novkovic
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Helen J Trihia
- Pathology Department of Metaxa Cancer Hospital of Piraeus
| | - Olympia Tzaida
- Pathology Department of Metaxa Cancer Hospital of Piraeus
| | - Dimitrios Korfias
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Panagiotis Giannakas
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Iavazzo
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Papadimitriou
- Oncology Unit, Second Department of Surgery Aretaieion Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - George Vorgias
- Gynecoligical Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| |
Collapse
|
3
|
Stefanopoulos A, Telakis E, Zlatinoudis C, Theodoulou A, Tzaida O, Filippakou A, Tsironi E. Diminutive Colon Metastasis From Breast Cancer: An Unexpected Finding in a Patient Undergoing Ulcerative Colitis Surveillance. ACG Case Rep J 2023; 10:e01077. [PMID: 37312754 PMCID: PMC10259632 DOI: 10.14309/crj.0000000000001077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/17/2023] [Indexed: 06/15/2023] Open
Abstract
Metastatic lesions to the colon are far less common than primary tumors. Breast cancer metastasis to the colon is rarely reported, and it is often atypical in presentation and difficult to diagnose. We present a case of a diminutive asymptomatic breast cancer metastasis to the colon found during surveillance colonoscopy in a patient with long-lasting ulcerative colitis, which was initially regarded as a colitis-associated dysplastic lesion. Because early detection of metastatic disease plays a key role in the treatment of patients with breast cancer, a high index of suspicion must be maintained for atypical metastatic presentations to the gastrointestinal tract.
Collapse
Affiliation(s)
| | - Emmanouil Telakis
- Department of Gastroenterology, “Metaxa” Cancer Hospital of Piraeus, Piraeus, Greece
| | | | - Aggelos Theodoulou
- Department of Gastroenterology, “Metaxa” Cancer Hospital of Piraeus, Piraeus, Greece
| | - Olympia Tzaida
- Department of Pathology, “Metaxa” Cancer Hospital of Piraeus, Piraeus, Greece
| | - Aikaterini Filippakou
- Department of Gastroenterology, “Metaxa” Cancer Hospital of Piraeus, Piraeus, Greece
| | - Eftychia Tsironi
- Department of Gastroenterology, “Metaxa” Cancer Hospital of Piraeus, Piraeus, Greece
| |
Collapse
|
4
|
Psomiadou V, Lekka S, Panoskaltsis T, Tsouma H, Novkovic N, Trihia HJ, Tzaida O, Korfias D, Giannakas P, Iavazzo C, Papadimitriou C, Vlahos N, Vorgias G. The Utility of Fallopian Tube Cytology in the Early Detection of Extrauterine Serous Gynecological Malignancies: A Narrative Literature Review. Acta Cytol 2023; 67:519-527. [PMID: 37044076 DOI: 10.1159/000530600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION The aim of the study was to analyze the published evidence for the use of fallopian tube brush cytology for the early detection of extrauterine serous gynecological cancer. METHODS We systematically searched the literature and, additionally, cross-checked on the bibliographies of selected articles. The inclusion criteria involved studies assessing the utility of fallopian tube brush cytology and its applications in the diagnosis, screening, or follow-up of extrauterine serous gynecological cancer. RESULTS The search strategy resulted in 21 abstracts or full-text articles, 5 of which met the inclusion criteria. The year of publication ranged from 2016 to 2022, and a total of 193 fallopian tube samples were investigated. Cytobrush, Tubebrush©, and Cytuity™ were used to obtain salpingeal samples for liquid-based cytology evaluation. CONCLUSIONS Our findings indicate that, at present, there is a lack of satisfying evidence-based data in the literature which would support the implementation of fallopian tube brush cytology as an adjunctive tool for early detection of extrauterine serous gynecological cancer. Thus, we believe that there is need for well-designed clinical studies to assess the effectiveness and diagnostic accuracy of the method as well as to validate the cytological criteria for the diagnosis and prediction of gynecological malignancies.
Collapse
Affiliation(s)
- Victoria Psomiadou
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Sofia Lekka
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - Helen Tsouma
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Natasa Novkovic
- Cytopathology Laboratory, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Helen J Trihia
- Pathology Department of Metaxa Cancer Hospital of Piraeus, Athens, Greece
| | - Olympia Tzaida
- Pathology Department of Metaxa Cancer Hospital of Piraeus, Athens, Greece
| | - Dimitrios Korfias
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Panagiotis Giannakas
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Iavazzo
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| | - Christos Papadimitriou
- Oncology Unit, 2nd Department of Surgery Aretaieion Hospital, The National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, Medical School, University of Athens "Aretaieio" Hospital, Athens, Greece
| | - George Vorgias
- Gynecological Oncology Department, Metaxa Memorial Cancer Hospital of Piraeus, Athens, Greece
| |
Collapse
|
5
|
Psomiadou V, Lekka S, Panoskaltsis T, Tsouma E, Novkovic N, Trihia H, Tzaida O, Korfias D, Giannakas P, Iavazzo C, Papadimitriou C, Vlahos N, Vorgias G. 2022-RA-442-ESGO Fallopian tube cytological findings in women undergoing salpingectomy and correlation with the adnexal pathology. Pathology 2022. [DOI: 10.1136/ijgc-2022-esgo.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
6
|
Psomiadou V, Lekka S, Tsouma E, Liakea A, Trihia H, Tzaida O, Iavazzo C, Papadimitriou C, Panoskaltsis T, Vorgias G, Vlahos N. 565 Fallopian tube cytological findings in women undergoing salpingectomy. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Varvara PV, Karaolanis G, Valavanis C, Stanc G, Tzaida O, Trihia H, Patapis P, Dimitroulis D, Perrea D. gamma-H2AX: A potential biomarker in breast cancer. Tumour Biol 2019; 41:1010428319878536. [PMID: 31552812 DOI: 10.1177/1010428319878536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Histone H2AX undergoes phosphorylation as an answer to DNA double-strand breaks, which in turn are part of the oncogenic procedure. The detection of gamma-H2AX can potentially serve as a biomarker for transformation of normal tissue to premalignant and consequently to malignant tissues. The aim of this study was to evaluate the clinical significance of gamma-H2AX expression in breast cancer. Gamma-H2AX expression in tissues from 110 breast cancer patients was analyzed by immunohistochemistry and correlated with clinicopathological variables. Greater tumor size, higher grade, and the number of affected lymph nodes are significantly associated with greater values of gamma-H2AX. In addition, gamma-H2AX differs significantly among patients' International Federation of Gynecology and Obstetrics stage. Higher values of estrogen receptor and progesterone receptor are significantly associated with lower gamma-H2AX values. In conclusion, a positive association between gamma-H2AX expression and infaust histopathological parameters was observed.
Collapse
Affiliation(s)
- Palla Viktoria Varvara
- Department of Obstetrics and Gynecology, Diakonie-Klinikum Schwäbisch Hall, Schwäbisch Hall, Germany
| | - Georgios Karaolanis
- 1st Department of Surgery, Vascular Unit, Laiko General Hospital, Medical School of Athens, Athens, Greece
| | | | - Gabriela Stanc
- Department of Pathology, Metaxa Cancer Hospital, Piraeus, Greece
| | - Olympia Tzaida
- Department of Pathology, Metaxa Cancer Hospital, Piraeus, Greece
| | - Helen Trihia
- Department of Pathology, Metaxa Cancer Hospital, Piraeus, Greece
| | - Paul Patapis
- 3rd Department of Surgery, Attikon General Hospital, University of Athens, Athens, Greece
| | | | - Despoina Perrea
- 2nd Department of Surgery, Laiko Hospital, University of Athens, Athens, Greece
| |
Collapse
|
8
|
Kopanakis N, Tzaida O, Nikolaou G, Ermidis D, Manou V, Efstathiou E, Spiliotis J. Male breast cancer originating in an ectopic breast tissue in the umbilicus A Case Report. Ann Ital Chir 2016; 87:S2239253X16024920. [PMID: 28098564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Accessory breast tissue is a rare finding in the general population with an incidence of 1-2%. Carcinomas of accessory breast tissue account for ∼0.3% of breast cancers, 5% of which are arising within a supernumerary breast. They are usually diagnosed at a later stage compared with breast cancer, due to their rarity and low clinical suspicion. CASE PRESENTATION We present the case of a 58 years old male who was admitted to our hospital for an umbilical hernia, surgical repair. During surgery a small skin biopsy was excised and sent for pathological examination as routine procedure. The histological report revealed the presence of a poorly differentiated carcinoma. Immunochemical analysis confirmed adenocarcinoma of breast origin. CONCLUSION Carcinomas of accessory breast tissue are rare and therefore they are usually of advanced stage in time of diagnosis. Few cases have been reported in literature of accessory breast tissue carcinomas in men. To the best of our knowledge, this is the only case in the literature, of ectopic breast tissue cancer in the umbilicus. KEY WORDS Ectopic breast, Male breast cancer, Umbilicus.
Collapse
|
9
|
Papazian M, Kalantzis I, Galanopoulos G, Mani I, Tzaida O, Iacovidou I, Ziras N. Malignant myoepithelioma of the breast: A case report and review of the literature. Mol Clin Oncol 2016; 4:723-727. [PMID: 27123270 PMCID: PMC4840516 DOI: 10.3892/mco.2016.808] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/27/2015] [Indexed: 01/14/2023] Open
Abstract
Malignant myoepithelioma of the breast is an extremely rare tumor composed entirely or almost entirely of malignant spindle cells with myoepithelial differentiation. Only a limited number of case reports have been descibed to date; therefore the biological behavior and treatment outcomes of this rare tumor have not been clearly determined. Herein, we present a case of a 74-year-old woman who was admitted with inflammatory-like cancer of the breast, presenting with invasion of the chest wall and axillary lymph node metastasis at the time of diagnosis. The histological examination revealed a tumor composed of epithelioid and spindle cells with moderate to marked nuclear atypia, with foci of hemorrhage and necrosis. The tumor cells were immunoreactive for vimentin, p63, p53, CD10, cytokeratin (CK)8/18, CKAE1-3 and S-100. Finally, a diagnosis of myoepithelial carcinoma of the breast was established. Neoadjuvant chemotherapy was first administered and proved to be ineffective. Due to locoregional progression that was associated with the development of an abscess and subsequent excessive bleeding, a palliative mastectomy was performed. Postoperatively, one more cycle of systemic chemotherapy was administered. However, the patient experienced an early relapse to the chest wall and succumbed to septic shock due to persistent local infection. The aggressiveness and chemoresistance of the tumor in this case was consistent with the existing bibliography.
Collapse
Affiliation(s)
- Maria Papazian
- Department of Pathology, 'METAXA' Anticancer Hospital, 18537 Piraeus, Greece
| | - Ioannis Kalantzis
- Department of Oncology, 'METAXA' Anticancer Hospital, 18537 Piraeus, Greece
| | | | - Iliana Mani
- Department of Oncology, 'METAXA' Anticancer Hospital, 18537 Piraeus, Greece
| | - Olympia Tzaida
- Department of Pathology, 'METAXA' Anticancer Hospital, 18537 Piraeus, Greece
| | - Ioanna Iacovidou
- Department of Pathology, 'METAXA' Anticancer Hospital, 18537 Piraeus, Greece
| | - Nikolaos Ziras
- Department of Oncology, 'METAXA' Anticancer Hospital, 18537 Piraeus, Greece
| |
Collapse
|
10
|
Triantafillou E, Papadakis G, Tzaida O, Papazian M, Megalakaki A, Moustakas K, Keramidas I, Kaltzidou V, Tertipi A, Pappas A. Primary thyroid lymphoma: The two ends of the spectrum. J BUON 2015; 20:1164-1168. [PMID: 26416071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We describe two different cases of prinary thyroid lymphoma (PTL). PTL is a rare malignancy. Nevertheless, it frequently presents diagnostic and therapeutic challenges. The first patient, a 79-year-old female, presented with a large, painless thyroid mass accompanied by severe obstructive symptoms of the upper respiratory and gastrointestinal track. The second patient (67-year-old female) presented with nodular goiter. Thyroidectomy - performed on the first patient for alleviation of obstructive symptoms - revealed the presence of a diffuse large B-cell lymphoma. Although she was administered standard chemotherapy she deceased four months later. In the second patient, primary thyroid lymphoma was an incidental finding following thyroidectomy performed for nodular goiter. These two cases illustrate the variable course of PTL, the possibility of which should be kept into consideration in clinical practice.
Collapse
|
11
|
Fountzilas G, Timotheadou E, Gourgioti G, Arapantoni-Dadioti P, Lakis S, Batistatou A, Koletsa T, Tzaida O, Bobos M, Papoudou-Bai A, Tsolaki E, Chrisafi S, Fountzilas E, Efstratiou I, Gogas H, Zagouri F, Pectasides D. Abstract P3-09-07: Prognostic value of immunophenotypically defined subtypes in patients treated with dose-dense sequential adjuvant chemotherapy in the trastuzumab era. A Hellenic Cooperative Oncology Group study. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p3-09-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background-Aim: The aim of the present study was to explore the efficacy of dose-dense sequential adjuvant chemotherapy followed by trastuzumab in HER2-positive patients according to the immunohistochemically (IHC) defined subtypes.
Patients and methods: A total of 771 formalin-fixed paraffin-embedded (FFPE) tumor tissue samples, prospectively collected from 990 eligible patients with high-risk N0 or N1 operable breast cancer participating in a phase III trial (HE10/05), were centrally assessed in tissue microarrays by IHC for 6 biological markers, that is, estrogen receptor (ER), progesterone receptor (PgR), HER2, Ki67, cytokeratin 5 (CK5) and EGFR. All cases were further evaluated for HER2 amplification by FISH. Patients were classified as: luminal A (ER/PgR-positive, HER2-negative, Ki67low, N=382, 49.5%); luminal B (ER/PgR-positive, HER2-negative, Ki67high, N=136, 17.6%); luminal-HER2 (ER/PgR-positive, HER2-positive, N=125, 16.2%); HER2-enriched (ER-negative, PgR-negative, HER2-positive, N=63, 8.2%); triple-negative (TNBC) (ER-negative, PgR-negative, HER2-negative, N=65, 8.4%); and basal core phenotype (BCP) (TNBC, CK5-positive and/or EGFR-positive, N=53, 6.9%).
Results: At a median follow-up of 60.5 months, the 3-year disease-free survival (DFS) and overall survival (OS) rates for the total patient population were 88.3% and 96.0%, respectively. The 3-year DFS rates for luminal A, luminal B, luminal-HER2, HER2-enriched, TNBC and BCP patients were 91.1%, 88.2%, 86.4%, 93.7%, 87.7%, and 89.4%, respectively, while the corresponding 3-year OS rates were 95.8%, 95.6%, 97.6%, 95.2%, 95.4%, and 95.0%, respectively. No significant differences were detected for either 3-year DFS or OS in the immunohistochemically defined subtypes, except a trend for significantly worse DFS in patients with luminal-HER2 tumors compared to patients with HER2-enriched tumors (log-rank, p=0.069).
Conclusions: In the post-trastuzumab era, at a relatively short follow-up, the luminal-HER2 patients show a trend for worse DFS compared to patients with HER2-enriched tumors treated with dose-dense sequential adjuvant chemotherapy followed by trastuzumab. No other significant differences were detected, with follow-up however being continued.
Citation Format: George Fountzilas, Eleni Timotheadou, Georgia Gourgioti, Petroula Arapantoni-Dadioti, Sotiris Lakis, Anna Batistatou, Triantafyllia Koletsa, Olympia Tzaida, Mattheos Bobos, Alexandra Papoudou-Bai, Eleftheria Tsolaki, Sofia Chrisafi, Elena Fountzilas, Ioannis Efstratiou, Helen Gogas, Flora Zagouri, Dimitrios Pectasides. Prognostic value of immunophenotypically defined subtypes in patients treated with dose-dense sequential adjuvant chemotherapy in the trastuzumab era. A Hellenic Cooperative Oncology Group study [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-09-07.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Helen Gogas
- 1Hellenic Cooperative Oncology Group (HeCOG)
| | | | | |
Collapse
|
12
|
Arapantoni-Dadioti P, Valavanis C, Gavressea T, Tzaida O, Trihia H, Lekka I. Discordant expression of hormone receptors and HER2 in breast cancer. A retrospective comparison of primary tumors with paired metachronous recurrences or metastases. J BUON 2012; 17:277-283. [PMID: 22740206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Expression of biomarkers in breast cancer, such as the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), can impact therapeutic decisions; however, it has been reported that their expression may change with disease progression. The aim of this retrospective study was to investigate the expression of these biomarkers in primary breast cancer and in its metachronous recurrences or metastases, and to estimate the percentage of cases with discordant expression. METHODS Paired primary and metastatic tumor samples were collected from patients with primary breast cancer and subsequent metachronous distant metastases, diagnosed at the Metaxa Cancer Hospital, Piraeus, Greece, from 1988 to 2008. Two cases of local recurrence were also included. ER, PR and HER2 expression were assessed by immunohistochemistry (IHC) according to ASCO-CAP 2007 guidelines. Statistical comparisons were made using McNemar's exact test and Bowker's test for symmetry. RESULTS Tumor samples from 110 patients were analysed. In the primary tumor, ER, PR and HER2 were positively expressed in 64.5%, 58.2% and 32.7% of cases, respectively, and expression of these biomarkers was lost in 18.2%, 21.8% and 10.9% of the corresponding metastases, respectively. Overall, a change of ER, PR and HER2 expression from positive to negative and vice versa occurred in 27.3% (p = 0.0987), 25.5% (p < 0.001) and 18.2% (p = 0.5034) of the cases, respectively. CONCLUSION The expression of ER, PR and HER2 in metachronous recurrences or metastases can be discordant from that observed in the primary tumor. As such changes can occur during disease progression, the evaluation of biomarkers in metastatic sites should be mandatory, whenever possible, to ensure that patients are receiving the most effective treatment at all times.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/secondary
- Disease Progression
- Female
- Follow-Up Studies
- Greece
- Humans
- Immunoenzyme Techniques
- Middle Aged
- Neoplasm Grading
- Neoplasm Metastasis
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
Collapse
|
13
|
Fountzilas G, Valavanis C, Kotoula V, Eleftheraki AG, Kalogeras KT, Tzaida O, Batistatou A, Kronenwett R, Wirtz RM, Bobos M, Timotheadou E, Soupos N, Pentheroudakis G, Gogas H, Vlachodimitropoulos D, Polychronidou G, Aravantinos G, Koutras A, Christodoulou C, Pectasides D, Arapantoni P. HER2 and TOP2A in high-risk early breast cancer patients treated with adjuvant epirubicin-based dose-dense sequential chemotherapy. J Transl Med 2012; 10:10. [PMID: 22240029 PMCID: PMC3275536 DOI: 10.1186/1479-5876-10-10] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 01/12/2012] [Indexed: 11/29/2022] Open
Abstract
Background HER2 and TOP2A parameters (gene status, mRNA and protein expression) have individually been associated with the outcome of patients treated with anthracyclines. The aim of this study was to comprehensively evaluate the prognostic/predictive significance of the above parameters in early, high-risk breast cancer patients treated with epirubicin-based, dose-dense sequential adjuvant chemotherapy. Methods In a series of 352 breast carcinoma tissues from patients that had been post-operatively treated with epirubicin-CMF with or without paclitaxel, we assessed HER2 and TOP2A gene status (chromogenic in situ hybridization), mRNA expression (quantitative reverse transcription PCR), as well as HER2 and TopoIIa protein expression (immunohistochemistry). Results HER2 and TOP2A amplification did not share the same effects on their downstream molecules, with consistent patterns observed in HER2 mRNA and protein expression according to HER2 amplification (all parameters strongly inter-related, p values < 0.001), but inconsistent patterns in the case of TOP2A. TOP2A gene amplification (7% of all cases) was not related to TOP2A mRNA and TopoIIa protein expression, while TOP2A mRNA and TopoIIa protein were strongly related to each other (p < 0.001). Hence, TOP2A amplified tumors did not correspond to tumors with high TOP2A mRNA or TopoIIa protein expression, while the latter were characterized by high Ki67 scores (p = 0.003 and p < 0.001, respectively). Multivariate analysis adjusted for nodal involvement, hormone receptor status, Ki67 score and HER2/TOP2A parameters revealed HER2/TOP2A co-amplification (21.2% of HER2 amplified tumors) as an independent favorable prognostic factor for DFS (HR = 0.13, 95% CI: 0.02-0.96, p = 0.046); in contrast, increased HER2/TOP2A mRNA co-expression was identified as an independent adverse prognostic factor for both DFS (HR = 2.41, 95% CI: 1.31-4.42, p = 0.005) and OS (HR = 2.83, 95% CI: 1.42-5.63, p = 0.003), while high TOP2A mRNA expression was an independent adverse prognostic factor for OS (HR = 2.06, 95% CI: 1.23-3.46, p = 0.006). None of the parameters tested was associated with response to paclitaxel. Conclusions This study confirms the favorable prognostic value of HER2/TOP2A co-amplification and the adverse prognostic value of high TOP2A mRNA expression extending it to the adjuvant treatment setting in early high-risk breast cancer. The strong adverse prognostic impact of high HER2/TOP2A mRNA co-expression needs further validation in studies designed to evaluate markers predictive for anthracyclines. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12611000506998.
Collapse
Affiliation(s)
- George Fountzilas
- Department of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Skarlos P, Christodoulou C, Kalogeras KT, Eleftheraki AG, Bobos M, Batistatou A, Valavanis C, Tzaida O, Timotheadou E, Kronenwett R, Wirtz RM, Kostopoulos I, Televantou D, Koutselini E, Papaspirou I, Papadimitriou CA, Pectasides D, Gogas H, Aravantinos G, Pavlidis N, Arapantoni P, Skarlos DV, Fountzilas G. Triple-negative phenotype is of adverse prognostic value in patients treated with dose-dense sequential adjuvant chemotherapy: a translational research analysis in the context of a Hellenic Cooperative Oncology Group (HeCOG) randomized phase III trial. Cancer Chemother Pharmacol 2011; 69:533-46. [DOI: 10.1007/s00280-011-1730-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/18/2011] [Indexed: 12/22/2022]
|
15
|
Tzaida O, Valavanis C, Bobos M, Batistatou A, Kotoula V, Dimopoulos MA, Pectasides DG, Timotheadou E, Pentheroudakis G, Gogas H, Samantas E, Christodoulou C, Arapantoni P, Fountzilas G. Evaluation of the prognostic/predictive value of HER2/TOP2A gene amplification and protein overexpression in patients with high-risk breast cancer treated with dose-dense sequential adjuvant chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
16
|
Tzaida O, Gogas H, Dafni U, Kyroudi A, Papaspyrou I, Kyriakou V, Malamou-Mitsi V, Alamani M, Skopa C, Kostopoulos I, Kastritis E, Pectasides D, Briasoulis E, Kalofonos HP, Aravantinos G, Fountzilas G, Arapantoni-Dadioti P. Evaluation of the prognostic and predictive value of HER-1/EGFR in breast cancer patients participating in a randomized study with dose-dense sequential adjuvant chemotherapy. Oncology 2008; 72:388-96. [PMID: 18187961 DOI: 10.1159/000113148] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Accepted: 07/25/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND To assess the prognostic and predictive significance of HER-1/EGFR protein levels in high-risk patients with breast cancer treated with dose-dense sequential adjuvant chemotherapy. METHODS 595 high-risk breast cancer patients were treated with adjuvant anthracycline-based dose-dense sequential chemotherapy (E-CMF vs. E-T-CMF). Disease-free survival (DFS) was the primary end point. HER-1/EGFR was assessed by immunohistochemistry (IHC) in 312 patients. RESULTS HER-1/EGFR expression was detected in 54 of 312 patients (17%). Positive expression of HER-1/EGFR was significantly associated with negative receptor status (52 vs. 17%, p < 0.001), worse histological grade (70 vs. 45%, p = 0.001), HER-2 overexpression (46 vs. 27%, p = 0.01) and positive p53 expression (48 vs. 19%, p < 0.001). With a median follow-up of 7 years, the total number of relapses was 105 (34%), and the total number of deaths 69 (22%). The analysis for DFS provides significant evidence that the HER-1/EGFR effect on the risk of disease progression was different according to treatment (interaction p = 0.02). Regarding overall survival, a trend towards a significant difference for an interaction of HER-1/EGFR and treatment was found (p = 0.07). CONCLUSION The present study demonstrated a differential effect of positive HER-1/EGFR expression in the two treatment groups, with HER-1/EGFR being a negative prognostic marker in the absence of paclitaxel.
Collapse
|
17
|
Tzaida O, Vogiatzis P, Zarganis P, Britsou M, Nisiotis A, Arapantoni-Dadioti P, Athanassiou AE. Haemagiopericytoma: a rare tumor with an eventual malignant clinical behavior. J BUON 2007; 12:419-420. [PMID: 17918301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
|
18
|
Malamou-Mitsi V, Gogas H, Dafni U, Bourli A, Fillipidis T, Sotiropoulou M, Vlachodimitropoulos D, Papadopoulos S, Tzaida O, Kafiri G, Kyriakou V, Markaki S, Papaspyrou I, Karagianni E, Pavlakis K, Toliou T, Scopa C, Papakostas P, Bafaloukos D, Christodoulou C, Fountzilas G. Evaluation of the prognostic and predictive value of p53 and Bcl-2 in breast cancer patients participating in a randomized study with dose-dense sequential adjuvant chemotherapy. Ann Oncol 2006; 17:1504-11. [PMID: 16968874 DOI: 10.1093/annonc/mdl147] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To assess the prognostic and predictive significance of p53 and Bcl-2 protein expression in high risk patients with breast cancer treated with dose-dense sequential chemotherapy. PATIENTS AND METHODS From June 1997 until November 2000, 595 patients were randomized to three cycles of epirubicin (E) 110 mg/m2 followed by three cycles of paclitaxel (P) 250 mg/m2 followed by three cycles of 'intensified' CMF (cyclophosphamide 840 mg/m2, methotrexate 47 mg/m2 and fluorouracil 840 mg/m2) or to four cycles of E, followed by four cycles of CMF. p53 and Bcl-2 expression was investigated by immunohistochemistry in 392 and 397 patients respectively. RESULTS Positive expression of p53 was detected in 104 (26.5%) patients and was significantly associated with negative hormonal status, worse histologic grade, higher incidence of disease relapse and higher rate of death. p53 positive expression was a significant negative predictor of overall survival (OS) (P = 0.002) and disease-free survival (DFS) (P = 0.001). Negative expression of Bcl-2 was detected in 203 (51%) patients and was significantly associated with negative hormonal status. Multivariate analysis revealed that, positive p53 expression, higher number of positive nodes and worse tumor grade were related to significantly poorer OS and DFS. CONCLUSIONS For both treatments, p53 positive expression was a significant negative prognostic factor for OS and DFS while Bcl-2 was not. No predictive ability of p53 status or Bcl-2 status for paclitaxel treatment was evident.
Collapse
MESH Headings
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/diagnosis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Chemotherapy, Adjuvant
- Cyclophosphamide/administration & dosage
- Dose-Response Relationship, Drug
- Epirubicin/administration & dosage
- Female
- Fluorouracil/administration & dosage
- Gene Expression
- Humans
- Methotrexate/administration & dosage
- Middle Aged
- Molecular Diagnostic Techniques/methods
- Paclitaxel/administration & dosage
- Predictive Value of Tests
- Prognosis
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Survival Analysis
- Tumor Suppressor Protein p53/metabolism
Collapse
Affiliation(s)
- V Malamou-Mitsi
- Department of Pathology, School of Medicine, University of Ioannina, Ioannina, Greece.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Savanis G, Simatos G, Tzaida O, Tsikkinis C, Ammari S, Mylonas A, Kafasis E, Nisiotis A. Gastrointestinal tract metastasis as first presentation of breast cancer. J BUON 2006; 11:79-81. [PMID: 17318957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Gastrointestinal metastases of breast cancer are a rare occurrence. It is even rarer to be the first manifestation of an unknown breast cancer. We present 2 cases of metastatic breast cancer of the lobular type to the stomach and large bowel in 2 women, initially considered as primary disease. The establishment of diagnosis required experienced histopathologic and immunohistochemical examination. The management follows the principles of the primary disease. Surgery is spared for complications. Mean survival is one year. Prognosis is better for patients with positive hormonal receptors.
Collapse
Affiliation(s)
- G Savanis
- 3rd Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Varras M, Kassanos D, Tzaida O, Bournas N, Panagiotopoulos N, Chrelias C, Salamalekis E. Ultrasonographic evaluation of a uterine malignant melanoma presenting as a large pelvic mass. J Clin Ultrasound 2005; 33:424-6. [PMID: 16240424 DOI: 10.1002/jcu.20143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The uterus is an extremely rare location for a primary or metastatic melanoma. We describe the ultrasonographic appearance of a malignant melanoma of the uterus presenting clinically as a large mass in a 78-year-old woman. Transabdominal sonography revealed a solid uterine mass measuring 13 x 11.5 x 8.5 cm with inhomogeneous echotexture and bright internal echoes. The tumor showed a diffuse spread inside the uterine corpus, and the endometrium was not demonstrated ultrasonographically.
Collapse
Affiliation(s)
- Michail Varras
- Third Department of Obstetrics and Gynecology, University of Athens, ATTIKON General University Hospital, Platonos 33, Politia (Kifisia) 14563, Athens, Greece
| | | | | | | | | | | | | |
Collapse
|
21
|
Bournas N, Varras M, Kassanos D, Chrelias C, Tzaida O, Salamalekis E. Multiple dermoid cysts within the same ovary: our experience of a rare case with review of the literature. CLIN EXP OBSTET GYN 2004; 31:305-8. [PMID: 15672975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE Ovarian dermoid cysts are relatively frequent ovarian lesions that can be easily diagnosed by transvaginal ultrasonography. However, the recognition of multiple dermoid cysts, separated by normal ovarian tissue, within a single ovary is rare. CASE We present a case with bilateral dermoid cysts, four dermoid cysts within the right ovary and one in the contralateral ovary. Transvaginal ultrasonography showed hyperechogenic areas in the right ovary with a hypoechogenic area in front of them; the hyperechogenic areas were separated by areas with the echogenicity of normal ovarian tissue and indentation, suggesting the presence of multiple dermoid cysts within the same ovary. CONCLUSION Preoperative ultrasonographic suspicion of multiple dermoid cysts within the same ovary might contribute to a better decision about the surgical approach.
Collapse
Affiliation(s)
- N Bournas
- Third Department of Obstetrics and Gynaecology, University General Hospital ATTIKON, Athens, Greece
| | | | | | | | | | | |
Collapse
|