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Yu X, Zou Y, Wang L, Yang H, Jiao J, Yu H, Zhang S. Radiomics nomogram for preoperative differentiation of early-stage serous borderline ovarian tumors and serous malignant ovarian tumors. Front Oncol 2024; 13:1269589. [PMID: 38288103 PMCID: PMC10822955 DOI: 10.3389/fonc.2023.1269589] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024] Open
Abstract
Objectives This study aimed to construct a radiomics nomogram and validate its performance in the preoperative differentiation between early-stage (I and II) serous borderline ovarian tumors (SBOTs) and serous malignant ovarian tumors (SMOTs). Methods Data were collected from 80 patients with early-stage SBOTs and 102 with early-stage SMOTs (training set: n = 127; validation set: n = 55). Univariate and multivariate analyses were performed to identify the independent clinicoradiological factors. A radiomics signature model was constructed using radiomics features extracted from multidetector computed tomography images of the venous phase, in which the least absolute shrinkage and selection operator regression was employed to lessen the dimensionality of the data and choose the radiomics features. A nomogram model was established by combining independent clinicoradiological factors with the radiomics signature. The performance of nomogram calibration, discrimination, and clinical usefulness was evaluated using training and validation sets. Results In terms of clinicoradiological characteristics, age (p = 0.001), the diameter of the solid component (p = 0.009), and human epididymis protein 4 level (p < 0.001) were identified as the independent risk factors of SMOT, for which the area under the curves (AUCs) were calculated to be 0.850 and 0.836 in the training and validation sets, respectively. Nine features were finally selected to construct the radiomics signature model, which exhibited AUCs of 0.879 and 0.826 for the training and validation sets, respectively. The nomogram model demonstrated considerable calibration and discrimination with AUCs of 0.940 and 0.909 for the training and validation sets, respectively. The nomogram model displayed more prominent clinical usefulness than the clinicoradiological and radiomics signature models according to the decision curve analysis. Conclusions The nomogram model can be employed as an individualized preoperative non-invasive tool for differentiating early-stage SBOTs from SMOTs.
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Affiliation(s)
- Xinping Yu
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuwei Zou
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lei Wang
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hongjuan Yang
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinwen Jiao
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haiyang Yu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shuai Zhang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Almnashef R, Menchaf R, Idres FA, Aljammal G, Mansour M, Farho MA, Ibrahim ZA, Abbassi H. Follicular thyroid carcinoma within a struma ovarii: a case report. J Surg Case Rep 2023; 2023:rjad584. [PMID: 37873049 PMCID: PMC10590632 DOI: 10.1093/jscr/rjad584] [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] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/12/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
Struma ovarii comprises 1% of all ovarian tumors and 3% of ovarian teratomas. It occurs in older females. Struma ovarii is often asymptomatic, unilateral, and accidentally detected through abdominal ultrasound or computed tomography. It presents with palpable abdominal pain or irregular menstrual cycles. Generally, it is treated with surgical resection, even though the best procedure in these cases remains under discussion. In this study, we present a case of a 28-year-old female with severe pain in the right iliac fossa. Physical examination and radiological images showed a large mass. A bilateral salpingo-oophorectomy with omentectomy, a total mass resection, and an abdominal hysterectomy were performed. A biopsy confirmed the diagnosis of a follicular thyroid tumor. The management decision is based on clinical and pathological data. This is particularly challenging due to its rarity and the insufficient guidelines regarding the management of this type of cancer.
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Affiliation(s)
- Rasha Almnashef
- Department of Obstetrics and Gynecology, Damascus University Hospital, Damascus, Syrian Arab Republic
- Faculty of Medicine, Al-Baath University, Homs, Syrian Arab Republic
| | - Ruba Menchaf
- Faculty of Medicine, Al-Baath University, Homs, Syrian Arab Republic
- Department of Gastroenterology, Al-Basel Hospital, Homs, Syrian Arab Republic
| | - Fatima A Idres
- Faculty of Medicine, Al-Baath University, Homs, Syrian Arab Republic
| | - Ghina Aljammal
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Marah Mansour
- Faculty of Medicine, Tartous University, Tartous, Syrian Arab Republic
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | - Mohamad Ali Farho
- Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic
| | - Zain A Ibrahim
- Faculty of Medicine, Tishreen University, Lattakia, Syrian Arab Republic
- Cancer Research Center, Tishreen University, Lattakia, Syrian Arab Republic
| | - Haitham Abbassi
- Department of Obstetrics and Gynecology, Damascus University Hospital, Damascus, Syrian Arab Republic
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Mohamad R, Al Laham O, Albrijawy R, Sallom M, Merhij A, Almousa M. A case report of bilateral benign Ovarian Fibrothecoma coincidental with ascites: an unconventional co-occurrence. Ann Med Surg (Lond) 2023; 85:3739-3743. [PMID: 37427164 PMCID: PMC10328581 DOI: 10.1097/ms9.0000000000001016] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/10/2023] [Indexed: 07/11/2023] Open
Abstract
Ovarian fibrothecoma are a mostly benign and profoundly rare type of gonadal stromal cell tumor. It makes up 3-4% of all kinds of ovarian neoplasia. They are predominantly unilateral in origin and mostly present in women during the postmenopausal phase. Our case is especially important because the tumors occurred bilaterally and were associated with ascites. This seldom happens in patients with ovarian fibrothecoma. Early identification and treatment are key components to avoid the subsequent complications of this tumor. Case presentation We present the case of a 54-year-old female who presented complaining only of a slow progressive increase in the abdominal contour associated with vague abdominal pain. Our preoperative radiological imaging revealed multiple ovarian and uterine masses. Clinical discussion Surgical intervention in the form of a hysterectomy with bilateral salpingo-oophorectomy was achieved. Histopathological analysis revealed bilateral benign ovarian fibrothecoma with benign uterine leiomyomas. The patient underwent an uneventful postoperative recovery. Conclusion Ovarian Fibrothecoma is a rare gynecological pathology. The uniqueness of our case stems from the rarity of its bilateral occurrence and in rare occasions, their occurrence is accompanied by ascites. This kind of co-occurrence should be differentiated from other rare presentations, such as Meigs Syndrome. Therefore, documentation is necessary to circumvent misdiagnoses and to abate the resulting patient morbidity. To further highlight the value of our case, it is to the best of our knowledge, the first documented case of this pathology from our country.
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Affiliation(s)
- Raied Mohamad
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Omar Al Laham
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Reham Albrijawy
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Mostafa Sallom
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Alhasan Merhij
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
- Al-Mouwasat University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
| | - Mohammad Almousa
- Faculty of Medicine, Damascus University, Damascus, (The) Syrian Arab Republic
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4
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Hashmi AA, Rashid K, Asif MG, Dowlah TU, Ali AH, Malik UA, Ali SM, Ali SJ, Zia S, Irfan M. Clinicopathological Parameters Associated With Peritoneal Involvement in Epithelial Ovarian Tumors. Cureus 2023; 15:e36666. [PMID: 37102035 PMCID: PMC10124578 DOI: 10.7759/cureus.36666] [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] [Accepted: 03/25/2023] [Indexed: 04/28/2023] Open
Abstract
Introduction Ovarian tumors remain one of the leading malignancies of the female genital tract, with a high mortality rate due to their insidious onset and lack of detection at an earlier stage. These tumors metastasize by direct extension into the neighboring pelvic organs; hence, the detection of peritoneal metastasis is valuable for staging and prognostic purposes. Peritoneal wash cytological analysis is an effective predictor of the involvement of the ovarian surface and peritoneal dissemination even in subclinical involvement of the peritoneum. The study aims to determine the significance of peritoneal wash cytology as a prognostic parameter and correlate it with various clinicohistological features. Methods A retrospective study was conducted at the Department of Histopathology, Liaquat National Hospital, Karachi, Pakistan, between July 2017 and June 2022. During this period, all the cases of ovarian tumors (borderline and malignant) that underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and omental and lymph node sampling were included in the study. After opening the abdominal cavity, the free fluid present was aspirated immediately, the peritoneum was lavaged with 50-100 mL of warm saline, and samples were collected and sent for cytological analysis. Four cytospin smear slides and cell block preparation were prepared. The findings of peritoneal cytology were correlated with various clinicohistological features. Results A total of 118 cases of ovarian tumors were included in the study. Serous carcinoma was the most common sub-type (50.8%), followed by endometrioid carcinoma (14.4%), and the mean age at diagnosis was found to be 49.9±14.9 years. The mean tumor size was 11.2 cm. The majority of the cases of ovarian carcinoma were of high grade (78.8%), with capsular invasion present in 61% of cases. Positive peritoneal cytology was noted in 58.5% of cases, with omental involvement in 52.5% of cases. Serous carcinoma showed the highest frequency of positive cytology (69.6%) and omental metastasis (74.2%). Apart from tumor type, positive peritoneal cytology showed a significantly positive correlation with age, tumor grade, and capsular invasion. Conclusion Based on our study findings, we conclude that peritoneal wash cytology is a sensitive indicator of the peritoneal spread of ovarian carcinoma, with a significant prognostic value. Serous carcinomas, especially high-grade with capsular invasion, were found to be predictors of peritoneal involvement of ovarian tumors. Although we found smaller tumors to be associated with peritoneal disease more compared to larger ones, this most likely is attributed to tumor histology, as larger tumors were most commonly mucinous compared to serous carcinomas.
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Affiliation(s)
- Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Khushbakht Rashid
- Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
| | | | | | - Abrahim H Ali
- Internal Medicine, Bangladesh Medical College, Dhaka, BGD
| | | | - Syed Munqaad Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | | | - Shamail Zia
- Pathology, Jinnah Sindh Medical University, Karachi, PAK
| | - Muhammad Irfan
- Statistics, Liaquat National Hospital and Medical College, Karachi, PAK
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5
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Cemaloğlu M, Kutluk T, Varan A, Orhan D, Tanyel C, Aydın B, Kurucu N, Yalçın B, Akyüz C. Primary ovarian tumors in children: a single center experience of 124 patients. Turk J Pediatr 2023; 65:245-256. [PMID: 37114690 DOI: 10.24953/turkjped.2022.659] [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] [Indexed: 04/29/2023]
Abstract
BACKGROUND Primary ovarian tumors are rare in the pediatric age group. We reviewed our 40-year experience with ovarian tumors to evalute the clinical features and treatment results in a single institution. METHODS Between January 1975 and October 2015, 124 girls with primary ovarian tumor were diagnosed and treated in our center. Tumors were identified with biopsy or total resection and/or serum markers. Seventy four children were included in the treatment analysis. RESULTS Median age for 124 children was 11.0 years (0.73-17.63). The main complaint was abdominal pain in 85 patients (68.5%). One hundred and five patients (84.6%) had total one-sided salpingo-oophorectomy and five patients had bilateral salpingo-oophorectomy. Amongst 124 cases, 29 patients had mature teratoma, which was the most common tumor in this study. Dysgerminoma (n=21) was the most common malignant histopathologic type. Stage I disease was diagnosed in 57.2% and stage IV in 6.6% of the patients. Five year overall survival (OS) and event-free survival (EFS) for 124 children were 82.5% and 76.3% respectively. For 74 children who received treatment, 5-year OS and EFS were 75.2% and 67.1%, respectively. Age (p < 0.017), histopathological subgroup (p < 0.001), stage (p =0.003) and chemotherapy protocols (p =0.049) were significant prognostic factors for OS. CONCLUSIONS The survival rates in children with ovarian tumors were comparable with studies in the literature. Although patients treated with platin based regimens had better survival rates, prognosis was still poor for the patients in advanced stages. This should be the focus for further studies and improvements.
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Affiliation(s)
- Mustafa Cemaloğlu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Diclehan Orhan
- Department of Pediatric Pathology, Hacettepe University Faculty of Medicine, Ankara
| | - Cahit Tanyel
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
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6
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Che H, Jatsenko T, Lenaerts L, Dehaspe L, Vancoillie L, Brison N, Parijs I, Van Den Bogaert K, Fischerova D, Heremans R, Landolfo C, Testa AC, Vanderstichele A, Liekens L, Pomella V, Wozniak A, Dooms C, Wauters E, Hatse S, Punie K, Neven P, Wildiers H, Tejpar S, Lambrechts D, Coosemans A, Timmerman D, Vandenberghe P, Amant F, Vermeesch JR. Pan-Cancer Detection and Typing by Mining Patterns in Large Genome-Wide Cell-Free DNA Sequencing Datasets. Clin Chem 2022; 68:1164-1176. [PMID: 35769009 DOI: 10.1093/clinchem/hvac095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/12/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cell-free DNA (cfDNA) analysis holds great promise for non-invasive cancer screening, diagnosis, and monitoring. We hypothesized that mining the patterns of cfDNA shallow whole-genome sequencing datasets from patients with cancer could improve cancer detection. METHODS By applying unsupervised clustering and supervised machine learning on large cfDNA shallow whole-genome sequencing datasets from healthy individuals (n = 367) and patients with different hematological (n = 238) and solid malignancies (n = 320), we identified cfDNA signatures that enabled cancer detection and typing. RESULTS Unsupervised clustering revealed cancer type-specific sub-grouping. Classification using a supervised machine learning model yielded accuracies of 96% and 65% in discriminating hematological and solid malignancies from healthy controls, respectively. The accuracy of disease type prediction was 85% and 70% for the hematological and solid cancers, respectively. The potential utility of managing a specific cancer was demonstrated by classifying benign from invasive and borderline adnexal masses with an area under the curve of 0.87 and 0.74, respectively. CONCLUSIONS This approach provides a generic analytical strategy for non-invasive pan-cancer detection and cancer type prediction.
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Affiliation(s)
- Huiwen Che
- Department of Human Genetics, Laboratory for Cytogenetics and Genome Research, KU Leuven, Leuven, Belgium
| | - Tatjana Jatsenko
- Department of Human Genetics, Laboratory for Cytogenetics and Genome Research, KU Leuven, Leuven, Belgium
| | - Liesbeth Lenaerts
- Department of Oncology, Laboratory of Gynecological Oncology, KU Leuven, Leuven, Belgium
| | - Luc Dehaspe
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Leen Vancoillie
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Brison
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Ilse Parijs
- Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | | | - Daniela Fischerova
- Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ruben Heremans
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium
| | - Chiara Landolfo
- Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Antonia Carla Testa
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore Roma, Rome, Italy
| | | | - Lore Liekens
- Department of Oncology, Molecular Digestive Oncology, KU Leuven, Leuven, Belgium
| | - Valentina Pomella
- Department of Oncology, Molecular Digestive Oncology, KU Leuven, Leuven, Belgium
| | - Agnieszka Wozniak
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium
| | - Christophe Dooms
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.,Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - Els Wauters
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.,Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
| | - Sigrid Hatse
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium.,Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Kevin Punie
- Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Neven
- Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Hans Wildiers
- Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Tejpar
- Department of Oncology, Molecular Digestive Oncology, KU Leuven, Leuven, Belgium
| | - Diether Lambrechts
- Department of Human Genetics, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - An Coosemans
- Department of Oncology, Laboratory of Tumor Immunology and Immunotherapy, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Dirk Timmerman
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Peter Vandenberghe
- Department of Human Genetics, Laboratory of Genetics of Malignant Diseases, KU Leuven, Leuven, Belgium.,Department of Hematology, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Amant
- Department of Oncology, Laboratory of Gynecological Oncology, KU Leuven, Leuven, Belgium.,Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.,Department of Surgery, Center for Gynecological Oncology Amsterdam, Academic Medical Centre Amsterdam-University of Amsterdam and the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Joris Robert Vermeesch
- Department of Human Genetics, Laboratory for Cytogenetics and Genome Research, KU Leuven, Leuven, Belgium.,Centre for Human Genetics, University Hospitals Leuven, Leuven, Belgium
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Delehaye F, Sarnacki S, Orbach D, Cheikhelard A, Rouger J, Parienti JJ, Faure-Conter C, Hameury F, Dijoud F, Aubry E, Wacrenier A, Habonimana E, Duchesne C, Joseph S, Alliot H, Scalabre A, Chaussy Y, Podevin G, Croue A, Haraux E, Guibal MP, Pommepuy I, Ballouhey Q, Lavrand F, Peycelon M, Irtan S, Guerin F, Dariel A, Borionne C, Galmiche L, Rod J. Lessons from a large nationwide cohort of 350 children with ovarian mature teratoma: A study in favor of ovarian-sparing surgery. Pediatr Blood Cancer 2022; 69:e29421. [PMID: 34842332 DOI: 10.1002/pbc.29421] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ovarian mature teratoma (OMT) is a common ovarian tumor found in the pediatric population. In 10%-20% of cases, OMT occurs as multiple synchronous or metachronous lesions on ipsi- or contralateral ovaries. Ovarian-sparing surgery (OSS) is recommended to preserve fertility, but total oophorectomy (TO) is still performed. DESIGN This study reviews the clinical data of patients with OMT, and analyzes risk factors for second events. A national retrospective review of girls under 18 years of age with OMTs was performed. Data on clinical features, imaging, laboratory studies, surgical reports, second events and their management were retrieved. RESULTS Overall, 350 children were included. Eighteen patients (5%) presented with a synchronous bilateral form at diagnosis. Surgery was performed by laparotomy (85%) and laparoscopy (15%). OSS and TO were performed in 59% and 41% of cases, respectively. Perioperative tumor rupture occurred in 23 cases, independently of the surgical approach. Twenty-nine second events occurred (8.3%) in a median time of 30.5 months from diagnosis (ipsilateral: eight cases including one malignant tumor; contralateral: 18 cases; both ovaries: three cases). A large palpable mass, bilateral forms, at diagnosis and perioperative rupture had a statistical impact on the risk of second event, whereas the type of surgery or approach did not. CONCLUSION This study is a plea in favor of OSS as the first-choice treatment of OMT when possible. Close follow-up during the first 5 years is mandatory considering the risk of 8.3% of second events, especially in cases with risk factors.
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Affiliation(s)
- Fanny Delehaye
- Department of Pediatric Haematology and Oncology, University Hospital of Caen, 14000, Caen, France
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Université de Paris, Hôpital Necker Enfants-Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Daniel Orbach
- SIREDO Oncology Centre (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Alaa Cheikhelard
- Department of Pediatric Surgery, Université de Paris, Hôpital Necker Enfants-Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.,National Reference Centre for Rare Gynecological Diseases (PGR), Paris, France
| | - Jérémie Rouger
- Department of Pediatric Haematology and Oncology, University Hospital of Caen, 14000, Caen, France
| | - Jean-Jacques Parienti
- Department of Biostatistics and Clinical Research, University Hospital of Caen Normandy, Caen, France
| | - Cécile Faure-Conter
- Centre Leon Bernard, Pediatric Hemato-Oncology Institute (IHOPe), Lyon, France
| | - Frédéric Hameury
- Pediatric Surgery Department, Femme-Mère-Enfant University Hospital, 59, boulevard Pinel, 69677, Bron, France
| | - Frédérique Dijoud
- Anatomy-Cytology-Pathology Department, Women-Mother and Child Hospital, Hospices Civils de Lyon, Lyon, France
| | - Estelle Aubry
- CHU Lille, Centre de Référence du Développement Génital DEV GEN, Service de Chirurgie Pédiatrique, Hôpital Jeanne de Flandres, 59000, Lille, France
| | - Agnès Wacrenier
- Anatomy-Cytology-Pathology Department, CHU Lille, Lille, France
| | - Edouard Habonimana
- Department of Pediatric Surgery, Rennes University Hospital, Rennes, France
| | - Camille Duchesne
- Department of Pediatric Surgery, Rennes University Hospital, Rennes, France
| | - Solène Joseph
- Department of Pediatric Surgery, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44000, Nantes, France
| | - Hortense Alliot
- Department of Pediatric Surgery, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44000, Nantes, France
| | - Aurélien Scalabre
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint-Etienne Cedex 2, France
| | - Yann Chaussy
- Paediatric Surgery Department, University Hospital of Besancon, Besancon, France
| | - Guillaume Podevin
- Paediatric Surgery Department, Angers University Hospital, Angers, France
| | - Anne Croue
- Anatomy-Cytology-Pathology Department, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Elodie Haraux
- Paediatric Surgery Department, Amiens University Hospital, Amiens, France
| | - Marie Pierre Guibal
- Department of Pediatric Surgery, University Hospital of Montpellier, Montpellier, France
| | - Isabelle Pommepuy
- Service d'anatomie Pathologique, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87042, Limoges Cedex, France
| | - Quentin Ballouhey
- Department of Pediatric Surgery, Hôpital des Enfants, 8 Avenue Dominique Larrey, 87042, Limoges Cedex, France
| | - Frédéric Lavrand
- Department of Pediatric Surgery, Groupe Hospitalier Pellegrin, Hôpital d'enfants, Bordeaux, France
| | - Matthieu Peycelon
- AP-HP, Hôpital Universitaire Robert-Debré, Pediatric Urology Department, Reference Center for Rare Diseases (CRMR), Malformations Rares des Voies Urinaires (MARVU), Université de Paris, Paris, France
| | - Sabine Irtan
- Paediatric Surgery Department, Trousseau Hospital - Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Florent Guerin
- Paediatric Surgery Department, Groupement Hospitalier Paris Sud (GHUPS), Hôpital Bicêtre, Le Kremlin-Bicetre, France
| | - Anne Dariel
- Pediatric Surgery Department, Hôpital d'enfants de la Timone, Marseille, France
| | - Claude Borionne
- Pediatric Surgery Department, Hôpital d'enfants de la Timone, Marseille, France
| | - Louise Galmiche
- Pathology Department, CHU de Nantes, Hôtel-Dieu, 1, Place Alexis-Ricordeau, 44000, Nantes, France
| | - Julien Rod
- Department of Pediatric Surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14000, Caen, France.,Laboratory INSERM U1086, ANTICIPE, Centre François Baclesse, Caen, France
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Gao B, Zhao X, Gu P, Sun D, Liu X, Li W, Zhang A, Peng E, Xu D. A nomogram model based on clinical markers for predicting malignancy of ovarian tumors. Front Endocrinol (Lausanne) 2022; 13:963559. [PMID: 36506042 PMCID: PMC9729545 DOI: 10.3389/fendo.2022.963559] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to build a nomogram based on clinical markers for predicting the malignancy of ovarian tumors (OTs). METHOD A total of 1,268 patients diagnosed with OTs that were surgically removed between October 2017 and May 2019 were enrolled. Clinical markers such as post-menopausal status, body mass index (BMI), serum human epididymis protein 4 (HE4) value, cancer antigen 125 (CA125) value, Risk of Ovarian Malignancy Algorithm (ROMA) index, course of disease, patient-generated subjective global assessment (PG-SGA) score, ascites, and locations and features of masses were recorded and analyzed (p 0.05). Significant variables were further selected using multivariate logistic regression analysis and were included in the decision curve analysis (DCA) used to assess the value of the nomogram model for predicting OT malignancy. RESULT The significant variables included post-menopausal status, BMI, HE4 value, CA125 value, ROMA index, course of disease, PG-SGA score, ascites, and features and locations of masses (p 0.05). The ROMA index, BMI (≥ 26), unclear/blurred mass boundary (on magnetic resonance imaging [MRI]/computed tomography [CT]), mass detection (on MRI/CT), and mass size and features (on type B ultrasound [BUS]) were screened out for multivariate logistic regression analysis to assess the value of the nomogram model for predicting OT malignant risk (p 0.05). The DCA revealed that the net benefit of the nomogram's calculation model was superior to that of the CA125 value, HE4 value, and ROMA index for predicting OT malignancy. CONCLUSION We successfully tailored a nomogram model based on selected clinical markers which showed superior prognostic predictive accuracy compared with the use of the CA125, HE4, or ROMA index (that combines both HE and CA125 values) for predicting the malignancy of OT patients.
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Affiliation(s)
- Bingsi Gao
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Obstetrics and Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xingping Zhao
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Pan Gu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Dan Sun
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xinyi Liu
- Department of Obstetrics and Gynecology, Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China
| | - Waixing Li
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Aiqian Zhang
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Enuo Peng
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Enuo Peng, ; Dabao Xu,
| | - Dabao Xu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Enuo Peng, ; Dabao Xu,
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Zhang A, Hu Q, Ma Z, Song J, Chen T. Application of enhanced computed tomography-based radiomics nomogram analysis to differentiate metastatic ovarian tumors from epithelial ovarian tumors. J Xray Sci Technol 2022; 30:1185-1199. [PMID: 36189526 DOI: 10.3233/xst-221244] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To investigate the value of nomogram analysis based on conventional features and radiomics features of computed tomography (CT) venous phase to differentiate metastatic ovarian tumors (MOTs) from epithelial ovarian tumors (EOTs). METHODS A dataset involving 286 patients pathologically confirmed with EOTs (training cohort: 133 cases, validation cohort: 68 cases) and MOTs (training cohort: 54 cases, validation cohort: 31 cases) is assembled in this study. Radiomics features are extracted from the venous phase of CT images. Logistic regression is employed to build models based on conventional features (model 1), radiomics features (model 2), and the combination of model 1 and model 2 (model 3). Diagnostic performance is assessed and compared. Additionally, a nomogram is plotted for model 3, and decision curve analysis is applied for clinical use. RESULTS Age, abdominal metastasis, para-aortic lymph node metastasis, location, and septation are chosen to build Model 1. Ten optimal radiomics features are ultimately selected and radiomics score (rad-score) is calculated to build Model 2. Nomogram score is calculated to build model 3 that shows optimal diagnostic performance in both the training (AUC = 0.952) and validation cohorts (AUC = 0.720), followed by model 1 (AUC = 0.872 for training cohort and AUC = 0.709 for validation cohort) and model 2 (AUC = 0.833 for training cohort and AUC = 0.620 for validation cohort). Additionally, Model 3 achieves accuracy, sensitivity, and specificity of 0.893, 0.880, and 0.926 in the training cohort and 0.737, 0.853, and 0.613 in the validation cohort. CONCLUSION Model 3 demonstrates the best diagnostic performance for preoperative differentiation of MOTs from EOTs. Thus, nomogram analysis based on Model 3 may be used as a biomarker to differentiate MOTs from EOTs.
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Affiliation(s)
- Aining Zhang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiming Hu
- Department of Obstetrics & Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhanlong Ma
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiacheng Song
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ting Chen
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Kowsarnia S, Javadi N. Ovarian Cancer With Breast Metastasis and Two Pathogenic Variants of BRCA1 Gene. Cureus 2021; 13:e18691. [PMID: 34790454 PMCID: PMC8583985 DOI: 10.7759/cureus.18691] [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] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/16/2022] Open
Abstract
Ovarian cancer is the second most common gynecologic cancer after uterine cancer in the United States. Ovarian cancer ranks sixth in cancer deaths among women, accounting for more deaths than other female reproductive system cancers. Breast metastasis in ovarian cancer is a rare presentation and predicts a poor prognosis and challenging management. Our case is a 42-year-old Chinese woman with high-grade serous ovarian carcinoma that presents with metastasis to the breast during the course of her illness. Genetic evaluation of the ovarian tumor showed two BRCA1 pathogenic variants. Germline pathogenic variant of c.2110_2111DelAA and a somatic variant of c.4071_4096+14del40. Our patient was offered different treatment regimens but showed progression of her disease. The low survival rate and high recurrence rate in ovarian cancer show that we still need to investigate our current approved treatments. Our report aims to shed light on the genetic evaluation of ovarian tumors and treatment options available in refractory cases of progressive ovarian cancer. Furthermore, we explain our investigational therapy regimen and the reasoning behind it.
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Affiliation(s)
- Saeedeh Kowsarnia
- Research, Olive View-University of California, Los Angeles (UCLA) Education & Research Institute, Sylmar, USA
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11
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Shivange G, Mondal T, Lyerly E, Bhatnagar S, Landen CN, Reddy S, Kim J, Doan B, Riddle P, Tushir-Singh J. A patch of positively charged residues regulates the efficacy of clinical DR5 antibodies in solid tumors. Cell Rep 2021; 37:109953. [PMID: 34731630 PMCID: PMC8720280 DOI: 10.1016/j.celrep.2021.109953] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/19/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022] Open
Abstract
Receptor clustering is the first and critical step to activate apoptosis by death receptor-5 (DR5). The recent discovery of the autoinhibitory DR5 ectodomain has challenged the long-standing view of its mechanistic activation by the natural ligand Apo2L. Because the autoinhibitory residues have remained unknown, here we characterize a crucial patch of positively charged residues (PPCR) in the highly variable domain of DR5. The PPCR electrostatically separates DR5 receptors to autoinhibit their clustering in the absence of ligand and antibody binding. Mutational substitution and antibody-mediated PPCR interference resulted in increased apoptotic cytotoxic function. A dually specific antibody that enables sustained tampering with PPCR function exceptionally enhanced DR5 clustering and apoptotic activation and distinctively improved the survival of animals bearing aggressive metastatic and recurrent tumors, whereas clinically tested DR5 antibodies without PPCR blockade function were largely ineffective. Our study provides mechanistic insights into DR5 activation and a therapeutic analytical design for potential clinical success.
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MESH Headings
- A549 Cells
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/metabolism
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized/immunology
- Antibodies, Monoclonal, Humanized/metabolism
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibody Specificity
- Antineoplastic Agents, Immunological/immunology
- Antineoplastic Agents, Immunological/metabolism
- Antineoplastic Agents, Immunological/pharmacology
- Apoptosis/drug effects
- Epitopes
- Humans
- Mice, Inbred C57BL
- Mice, Inbred NOD
- Mice, SCID
- Neoplasms/drug therapy
- Neoplasms/immunology
- Neoplasms/metabolism
- Receptors, TNF-Related Apoptosis-Inducing Ligand/antagonists & inhibitors
- Receptors, TNF-Related Apoptosis-Inducing Ligand/immunology
- Receptors, TNF-Related Apoptosis-Inducing Ligand/metabolism
- Signal Transduction
- Tumor Burden/drug effects
- Xenograft Model Antitumor Assays
- Mice
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Affiliation(s)
- Gururaj Shivange
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville VA 22908, USA
| | - Tanmoy Mondal
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Department of Medical Microbiology and Immunology, University of California School of Medicine, University of California, Davis, Davis, CA 95616, USA; Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville VA 22908, USA
| | - Evan Lyerly
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Undergraduate Research Program Volunteers, University of Virginia, Charlottesville VA; Blavatnik Institute, Harvard Medical School, Boston MA
| | - Sanchita Bhatnagar
- Department of Medical Microbiology and Immunology, University of California School of Medicine, University of California, Davis, Davis, CA 95616, USA; Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville VA 22908, USA
| | | | - Shivani Reddy
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Undergraduate Research Program Volunteers, University of Virginia, Charlottesville VA
| | - Jonathan Kim
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Undergraduate Research Program Volunteers, University of Virginia, Charlottesville VA
| | - Britney Doan
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Undergraduate Research Program Volunteers, University of Virginia, Charlottesville VA
| | - Paula Riddle
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Undergraduate Research Program Volunteers, University of Virginia, Charlottesville VA
| | - Jogender Tushir-Singh
- Laboratory of Novel Biologics, Medical Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA; Department of Medical Microbiology and Immunology, University of California School of Medicine, University of California, Davis, Davis, CA 95616, USA; Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville VA 22908, USA; University of Virginia Comprehensive Cancer Center, Charlottesville VA; UC Davis Comprehensive Cancer Center, University of California School of Medicine, University of California, Davis, Davis, CA 95616, USA.
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12
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Kostov S, Kornovski Y, Slavchev S, Ivanova Y, Dzhenkov D, Yordanov A, Slavcheva S. Pseudomyxoma peritonei of appendiceal origin mimicking ovarian cancer - a case report with literature review. Prz Menopauzalny 2021; 20:148-53. [PMID: 34703416 DOI: 10.5114/pm.2021.109120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/28/2021] [Indexed: 11/17/2022]
Abstract
Pseudomyxoma peritonei (PMP) is a rare and uncommon condition, characterized by the presence of mucinous ascites in the abdominal cavity. The most common cause of PMP is mucinous adenocarcinoma of the appendix, followed by neoplasms of the ovary, endocervix, fallopian tube, alimentary organs, urachus, urinary bladder, lung, mucinous cyst of the spleen, and breast. Herein, we report a case of a 64-year-old postmenopausal woman (gravida 2, para 2) who presented at the department of gynecology with a short history of nausea and abdominal distention. Abdominal and vaginal ultrasonography showed a large amount of free fluid in the pelvis with hyperechoic echogenicity and right pelvic tumor with mixed echogenicity. Computed tomography demonstrated the presence of a heterogeneous, hypodense mass, without contrast enhancement, located on the right side of the pelvis, near the right ovary. Laparotomy was performed. Revision of the abdominal cavity revealed a large amount of yellow gelatinous mucinous ascites – approximately 1.5 l. A tumor (6 x 7 cm in diameter), arising from the appendix and located in the pouch of Douglas near the right ovary, was observed. Histopathology examination revealed poorly differentiated mucinous appendiceal adenocarcinoma, comprising up to 50% signet ring cells. Gastrointestinal tumors such as appendiceal neoplasms combined with PMP may mimic ovarian carcinomas. Computed tomography, abdominal/vaginal ultrasonography and tumor marker levels (carcino-embryonic antigen, carbohydrate antigen 19.9, carbohydrate antigen Ca-125) may establish the diagnosis. A differential diagnosis with appendiceal tumors should be considered for patients with right pelvic masses.
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Peng XS, Ma Y, Wang LL, Li HX, Zheng XL, Liu Y. Evaluation of the Diagnostic Value of the Ultrasound ADNEX Model for Benign and Malignant Ovarian Tumors. Int J Gen Med 2021; 14:5665-5673. [PMID: 34557021 PMCID: PMC8454417 DOI: 10.2147/ijgm.s328010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/09/2021] [Indexed: 12/23/2022] Open
Abstract
Objective To investigate the diagnostic performance of the ADNEX model in the International Ovarian Tumor Analysis diagnostic models for ovarian tumors and further explore its application value in the staging of ovarian tumors. Methods A total of 224 patients who underwent ultrasound for evaluation of adnexal masses and were treated surgically owing to adnexal masses from January 2018 to June 2020 in our hospital were selected for research on the diagnostic accuracy of the ADNEX model. The clinical information and ultrasonographic findings of the patients were collected, and the pathological diagnosis was taken as the gold standard. According to the ADNEX model, the ovarian tumors were divided into five subtypes: benign and borderline, stage I, stage II–IV, and metastatic cancer. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, and area under the receiver operating characteristics curve (AUC) of the ADNEX model were calculated. Results Of the 224 patients, 119 (53.1%) developed benign tumors and 105 (46.9%) had malignant tumors. When the cut-off value for malignancy risk was 10%, the ADNEX model including CA 125 achieved a sensitivity of 94.3% (95% CI: 88.0–97.9%), specificity of 74.0% (95% CI: 65.1–81.6%), positive predictive value of 76.2% (95% CI: 70.2–81.3%), negative predictive value of 93.6% (95% CI: 87.0–97.0%), diagnostic odds ratio of 45.25, and an AUC of 0.94 (95% CI: 0.90–0.97) for differentiating between benign and malignant ovarian tumors. The AUC in the model excluding CA 125 was 0.93 (95% CI: 0.89–0.96), but the difference was not statistically significant (P=0.20). The accuracy of the ADNEX model for the diagnosis of ovarian tumors of all subtypes exceeds 80% when CA 125 measurements were included in the application, but the sensitivity for diagnosing borderline, stage I, and metastatic ovarian tumors was only 60.0% (95% CI:36.1–80.9%), 28.6% (95% CI:8.4–58.1%) and 45.5% (95% CI:16.7–76.6%). Conclusion The ADNEX model shows good diagnostic performance in differentiating between benign and malignant ovarian tumors. The model has a certain clinical value in the diagnosis of all subtypes of ovarian tumors, but the sensitivity is unsatisfactory for the diagnosis of borderline, stage I, and metastatic ovarian tumors and needs to be verified.
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Affiliation(s)
- Xiao-Shan Peng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150080, People's Republic of China
| | - Yue Ma
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150080, People's Republic of China
| | - Ling-Ling Wang
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150080, People's Republic of China
| | - Hai-Xia Li
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150080, People's Republic of China
| | - Xiu-Lan Zheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150080, People's Republic of China
| | - Ying Liu
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, 150080, People's Republic of China
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Faaborg L, Jakobsen A, Waldstrøm M, Petersen CB, Andersen RF, Steffensen KD. HOXA9-methylated DNA as a diagnostic biomarker of ovarian malignancy. Biomark Med 2021; 15:1309-1317. [PMID: 34514844 DOI: 10.2217/bmm-2021-0144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim: In ovarian cancer, methylated HOXA9 (meth-HOXA9) has been proposed as a relevant biomarker, however, its role in the carcinogenic development remains unknown. This study aimed at evaluating meth-HOXA9 as a diagnostic biomarker in ovarian cancer. Materials & methods: The meth-HOXA9 status was examined in 138 tissue specimens encompassing normal ovaries, benign- and borderline tumors, and ovarian cancer using droplet digital PCR. Results: Meth-HOXA9 was detected in 93% (82/88) and 88% (14/16) of ovarian cancer and borderline tumors, respectively. In patients with benign ovarian tumors meth-HOXA9 was detected in 17% (3/18). Using receiver operating characteristic (ROC) analysis meth-HOXA9 had a diagnostic accuracy of 98%. Conclusion: Meth-HOXA9 is highly cancer specific and could serve as a general diagnostic marker of ovarian malignancy.
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Affiliation(s)
- Louise Faaborg
- Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, 5000, Denmark
| | - Anders Jakobsen
- Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, 5000, Denmark
| | - Marianne Waldstrøm
- Institute of Regional Health Research, University of Southern Denmark, Odense, 5000, Denmark.,Department of Pathology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark
| | - Christina B Petersen
- Department of Pathology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark
| | - Rikke F Andersen
- Department of Clinical Biochemistry, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark
| | - Karina D Steffensen
- Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, 5000, Denmark.,Center for Shared Decision Making, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, 7100, Denmark
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15
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Otani S, Kido A, Himoto Y, Sakata A, Otani T, Kuwahara R, Moribata Y, Nishio N, Yajima R, Nakao K, Kurata Y, Minamiguchi S, Mandai M, Nakamoto Y. Diagnostic Value of DCE-MRI for Differentiating Malignant Adnexal Masses Compared with Contrast-enhanced-T1WI. Magn Reson Med Sci 2021; 21:599-607. [PMID: 34483226 DOI: 10.2463/mrms.mp.2021-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/09/2022] Open
Abstract
PURPOSE To compare the diagnostic performance of dynamic contrast-enhanced-MR (DCE-MR) and delayed contrast-enhanced (CE)-MRI added to unenhanced MRI, including diffusion weighted image (DWI) for differentiating malignant adnexal tumors, conducting a retrospective blinded image interpretation study. METHODS Data of 80 patients suspected of having adnexal tumors by ultrasonography between April 2008 and August 2018 were used for the study. All patients had undergone preoperative MRI and surgical resection at our institution. Four radiologists (two specialized in gynecological radiology and two non-specialized) were enrolled for blinded review of the MR images. A 3-point scale was used: 0 = benign, 1 = indeterminate, and 2 = malignant. Three imaging sets were reviewed: Set A, unenhanced MRI including DWI; Set B, Set A and delayed CE-T1WI; and Set C, Set A and DCE-MRI. Imaging criteria for benign and malignant tumors were given in earlier reports. The diagnostic performance of the three imaging sets of the four readers was calculated. Their areas under the curve (AUCs) were compared using the DeLong method. RESULTS Accuracies of Set B were 81%-88%. Those of Set C were 81%-85%. The AUCs of Set B were 0.83 and 0.89. Those of Set C were 0.81-0.86. For two readers, Set A showed lower accuracy and AUC than Set B/Set C (less than 0.80), although those were equivalent in other readers. No significant difference in AUCs was found among the three sequence sets. Intrareader agreement was moderate to almost perfect in Sets A and B, and substantial to almost perfect in Set C. CONCLUSION DCE-MR showed no superiority for differentiating malignant adnexal tumors from benign tumors compared to delayed CE-T1WI with conventional MR and DWI.
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Affiliation(s)
- Satoshi Otani
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Yuki Himoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Tomoaki Otani
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Ryo Kuwahara
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Yusaku Moribata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Naoko Nishio
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Ryo Yajima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Kyoko Nakao
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Yasuhisa Kurata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine
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Alayed AM, Almawi AS, Alghamdi EG, Alfaleh HS, Kadasah NS. Ovarian Collision Tumor, Massive Mucinous Cystadenoma, and Benign Mature Cystic Teratoma. Cureus 2021; 13:e16221. [PMID: 34367821 PMCID: PMC8342314 DOI: 10.7759/cureus.16221] [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] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 11/26/2022] Open
Abstract
Collision tumors are rare neoplasms defined by the presence of two distant tumors in the same organ without any histological intermixing. Ovarian tumors are often asymptomatic during the early stages and become symptomatic when increased in size causing vague abdominal pain, abdominal distention, vomiting, and frequent urination. We report here a case of a 28-year-old female who presented with a history of worsening abdominal pain and distension. An abdominopelvic ultrasound scan showed a huge complex mass occupying the pelvic area with non-visualization of the left ovary suggesting an ovarian origin; further characterization by cross-sectional imaging by both CT and MRI were performed confirming a left ovarian complex mass containing multiseptated cystic and fat component at the same time along with massive ascites. After surgical resection of the mass, histopathology revealed mucinous cystadenoma coexisting with cystic teratoma.
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Affiliation(s)
| | | | - Ebtehaj G Alghamdi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | | | - Nouf S Kadasah
- Radiology, Prince Sultan Military Medical City, Riyadh, SAU
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Yu XP, Wang L, Yu HY, Zou YW, Wang C, Jiao JW, Hong H, Zhang S. MDCT-Based Radiomics Features for the Differentiation of Serous Borderline Ovarian Tumors and Serous Malignant Ovarian Tumors. Cancer Manag Res 2021; 13:329-336. [PMID: 33488120 PMCID: PMC7814232 DOI: 10.2147/cmar.s284220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/27/2020] [Accepted: 12/16/2020] [Indexed: 01/03/2023] Open
Abstract
Objective To investigate whether multidetector computed tomography (MDCT)-based radiomics features can discriminate between serous borderline ovarian tumors (SBOTs) and serous malignant ovarian tumors (SMOTs). Patients and Methods Eighty patients with SBOTs and 102 patients with SMOTs, confirmed by pathology (training set: n = 127; validation set: n = 55) from December 2017 to June 2020, were enrolled in this study. The interclass correlation coefficient (ICC) and least absolute shrinkage and selection operator (LASSO) regression were applied to select radiomics parameters derived from MDCT images on the arterial phase (AP), venous phase (VP), and equilibrium phase (EP). Receiver operating characteristic (ROC) analysis of each selected parameter was carried out. Heat maps were created to illustrate the distribution of the radiomics parameters. Three models incorporating selected radiomics parameters generated by support vector machine (SVM) classifiers in each phase were analyzed by ROC and compared using the DeLong test. Results The most predictive features selected by ICC and LASSO regression between SBOTs and SMOTs included 9 radiomics parameters on AP, VP, and EP each. Three models on AP, VP, and EP incorporating the selected features generated by SVM classifiers produced AUCs of 0.80 (accuracy, 0.75; sensitivity, 0.74; specificity, 0.75), 0.86 (accuracy, 0.78; sensitivity, 0.80; specificity, 0.75), and 0.73 (accuracy, 0.69; sensitivity, 0.71; specificity, 0.67), respectively. There were no significant differences in the AUCs among the three models (AP vs. VP, P = 0.199; AP vs. EP, P = 0.260; VP vs. EP, P = 0.793). Conclusion MDCT-based radiomics features could be used as biomarkers for the differentiation of SBOTs and SMOTs.
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Affiliation(s)
- Xin-Ping Yu
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Lei Wang
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Hai-Yang Yu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Yu-Wei Zou
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Chang Wang
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Jin-Wen Jiao
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
| | - Hao Hong
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing, People's Republic of China
| | - Shuai Zhang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People's Republic of China
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Burla L, Kalaitzopoulos DR, Eberhard M, Samartzis N. [Endosalpingiosis - an Irrelevant Incidental Finding During Laparoscopy?]. Praxis (Bern 1994) 2021; 110:804-811. [PMID: 34702059 DOI: 10.1024/1661-8157/a003728] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Endosalpingiosis - an Irrelevant Incidental Finding During Laparoscopy? Abstract. Endosalpingiosis refers to the ectopic presence of tubal epithelium. However, this incidental finding received little attention, although it is the second most common benign peritoneal pathology in women following endometriosis. In contrast to endometriosis, endosalpingiosis shows an increase in prevalence with age beyond the menopause. Furthermore, it does not appear to be chronically inflammatory and, according to research to this date, does not cause chronic pain or infertility. Recent epidemiological and molecular pathological studies show a significantly higher incidence of ovarian and endometrial tumors in women with endosalpingiosis. These correlations have not been conclusively clarified. Generally accepted clinical recommendations for the detection of endosalpingiosis do not yet exist. In order to better understand the disease value of endosalpingiosis and its oncological correlations, this entity should be brought to the attention of surgical gynecology and involved pathology.
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Affiliation(s)
- Laurin Burla
- Frauenklinik, Kantonsspital Schaffhausen, Schaffhausen
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Elsharoud A, Brakta S, Elhusseini H, Al-Hendy A. A presentation of ovarian fibrothecoma in a middle-aged female with recurrent massive ascites and postmenopausal bleeding: A case report. SAGE Open Med Case Rep 2020; 8:2050313X20974222. [PMID: 33425356 PMCID: PMC7758649 DOI: 10.1177/2050313x20974222] [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] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 10/26/2020] [Indexed: 11/19/2022] Open
Abstract
Fibrothecomas are mostly benign ovarian tumors. We describe a rare case of fibrothecoma in a 59-year-old woman with a history of recurrent massive ascites and postmenopausal bleeding. Over 2 years she has undergone more than 50 paracenteses with 8–11 L withdrawn each time. She presented with a newly diagnosed pelvic mass and bilateral hydrosalpinges demonstrated on ultrasound and were confirmed with computed tomography. The pelvic magnetic resonance imaging showed a large complex cystic mass arising from the left ovary measuring 16.6 × 12.1 × 8.6 cm3 with an area of irregular mural enhancement. The patient underwent left salpingo-oophorectomy with benign frozen section results. The final pathology was consistent with cystic degeneration of fibrothecoma
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Affiliation(s)
- Amro Elsharoud
- Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Soumia Brakta
- Department of Obstetrics and Gynecology, Section of Reproductive Endocrine, Infertility & Genetics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Heba Elhusseini
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
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20
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Panoutsopoulou K, Avgeris M, Magkou P, Mavridis K, Dreyer T, Dorn J, Obermayr E, Reinthaller A, Michaelidou K, Mahner S, Vergote I, Loverix L, Braicu I, Sehouli J, Zeillinger R, Magdolen V, Scorilas A. miR-181a overexpression predicts the poor treatment response and early-progression of serous ovarian cancer patients. Int J Cancer 2020; 147:3560-3573. [PMID: 32621752 DOI: 10.1002/ijc.33182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/27/2020] [Revised: 05/13/2020] [Accepted: 06/02/2020] [Indexed: 01/10/2023]
Abstract
Ovarian cancer (OC) remains a leading cause of gynecological cancer-related death worldwide, characterized by poor 5-year survival. Molecular markers could serve as crucial tools of personalized prognosis and therapy. Herein, we present miR-181a as novel predictor of OC prognosis, using five independent OC cohorts. In particular, a screening (n = 81) and an institutionally independent validation (n = 100, OVCAD multicenter study) serous OC (SOC) cohorts were analyzed. Bagnoli et al (2016) OC179 (n = 124) to OC133 (n = 100) and TCGA (n = 489) served as external validation cohorts. Patients' survival and disease progression were assessed as clinical endpoint events. Bootstrap analysis was performed for internal validation and decision curve analysis was utilized to evaluate clinical benefit. miR-181a overexpression was unveiled as powerful and independent molecular predictor of patients' poor survival and higher risk for disease progression after debulking surgery and platinum-based chemotherapy. Analysis of the OVCAD institutionally independent cohort, as well as of Bagnoli et al. and TCGA external cohorts further confirmed the unfavorable prognostic nature of miR-181a overexpression in SOC. Strikingly, multivariate prognostic models incorporating miR-181a with established disease markers clearly improved patients' risk-stratification and offered superior clinical benefit in OC prognostication. Conclusively, miR-181a evaluation could augment prognostic accuracy and support precision medicine decisions in OC.
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Affiliation(s)
- Konstantina Panoutsopoulou
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Margaritis Avgeris
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Magkou
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Mavridis
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Tobias Dreyer
- Clinical Research Unit, Department of Obstetrics and Gynecology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Julia Dorn
- Clinical Research Unit, Department of Obstetrics and Gynecology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Eva Obermayr
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Alexander Reinthaller
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Kleita Michaelidou
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sven Mahner
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ignace Vergote
- Department of Gynecologic Oncology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Liselore Loverix
- Department of Gynecologic Oncology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Ioana Braicu
- Department of Gynecology, Charité University Medicine, Campus Virchow, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, Charité University Medicine, Campus Virchow, Berlin, Germany
| | - Robert Zeillinger
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Viktor Magdolen
- Clinical Research Unit, Department of Obstetrics and Gynecology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Scorilas
- Department of Biochemistry and Molecular Biology, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
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Liu X, Liu G, Chen L, Liu F, Zhang X, Liu D, Liu X, Cheng X, Liu L. Untargeted Metabolomic Characterization of Ovarian Tumors. Cancers (Basel) 2020; 12:cancers12123642. [PMID: 33291756 PMCID: PMC7761955 DOI: 10.3390/cancers12123642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/20/2020] [Revised: 11/27/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
Simple Summary This study utilized untargeted metabolomic techniques to detect urine and plasma metabolites. Using support vector machine algorithm, three models for ovarian tumors diagnosis, benign-malignant distinguishing, early diagnosis and borderline-malignant distinguishing were developed. These models have good classification performance and provided a novel insight for non-invasive diagnosis of ovarian cancer. Abstract Diagnosis of ovarian cancer is difficult due to the lack of clinical symptoms and effective screening algorithms. In this study, we aim to develop models for ovarian cancer diagnosis by detecting metabolites in urine and plasma samples. Ultra-high-performance liquid chromatography and quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) in positive ion mode was used for metabolome quantification in 235 urine samples and 331 plasma samples. Then, Urine and plasma metabolomic profiles were analyzed by univariate and multivariate statistics. Four groups of samples: normal control, benign, borderline and malignant ovarian tumors were enrolled in this study. A total of 1330 features and 1302 features were detected from urine and plasma samples respectively. Based on two urine putative metabolites, five plasma putative metabolites and five urine putative metabolites, three models for distinguishing normal-ovarian tumors, benign-malignant (borderline + malignant) and borderline-malignant ovarian tumors were developed respectively. The AUC (Area Under Curve) values were 0.987, 0876 and 0.943 in discovery set and 0.984, 0.896 and 0.836 in validation set for three models. Specially, the diagnostic model based on 5 plasma putative metabolites had better early-stage diagnosis performance than CA125 alone. The AUC values of the model were 0.847 and 0.988 in discovery and validation set respectively. Our results showed that normal and ovarian tumors have unique metabolic signature in urine and plasma samples, which shed light on the ovarian cancer diagnosis and classification.
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Affiliation(s)
- Xiaona Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; (X.L.); (G.L.)
| | - Gang Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; (X.L.); (G.L.)
| | - Lihua Chen
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (L.C.); (F.L.)
| | - Fei Liu
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (L.C.); (F.L.)
| | - Xiaozhe Zhang
- CAS Key Laboratory of Separation of Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; (X.Z.); (D.L.); (X.L.)
| | - Dan Liu
- CAS Key Laboratory of Separation of Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; (X.Z.); (D.L.); (X.L.)
| | - Xinxin Liu
- CAS Key Laboratory of Separation of Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; (X.Z.); (D.L.); (X.L.)
| | - Xi Cheng
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (L.C.); (F.L.)
- Correspondence: (X.C.); (L.L.); Tel.: +86-021-64174774 (X.C.)
| | - Lei Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China; (X.L.); (G.L.)
- Data Science, School of (Institute for Big Data), Fudan University, Shanghai 200032, China
- Academy for Engineering and Technology, Fudan University, Shanghai 200032, China
- Faculty of Medical Instrumentation, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
- Correspondence: (X.C.); (L.L.); Tel.: +86-021-64174774 (X.C.)
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Pietkiewicz D, Horała A, Plewa S, Jasiński P, Nowak-Markwitz E, Kokot ZJ, Matysiak J. MALDI-MSI-A Step Forward in Overcoming the Diagnostic Challenges in Ovarian Tumors. Int J Environ Res Public Health 2020; 17:ijerph17207564. [PMID: 33080944 PMCID: PMC7589662 DOI: 10.3390/ijerph17207564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
This study presents the use of matrix-assisted laser desorption and ionization mass spectrometry imaging (MALDI-MSI) directly on the tissue of two ovarian tumors that often present a diagnostic challenge, a low-grade serous borderline ovarian tumor and ovarian fibrothecoma. Different spatial distribution of m/z values within the tissue samples was observed, and regiospecific peaks were identified. Among the 106 peaks in the borderline ovarian tumor five, regiospecific peaks (m/z: 2861.35; 2775.79; 3368.34; 3438.43; 4936.37) were selected using FlexImaging software. Subsequently, the distribution of those selected peaks was visualized on the fibrothecoma tissue section, which demonstrated the differences in the tissue homo-/heterogeneous structure of both tumors. The comparison with the histopathological staining of the ovarian borderline tumor tissue section, obtained during serial sectioning, showed a close correlation of the molecular map with the morphological and histopathological features of the tissue and allowed the identification of different tissue types within the sample. This study highlights the potential significance of MSI in enabling morphological characterization of ovarian tumors as well as correct diagnosis and further prognosis than thus far seen in the literature. Osteopontin, tropomyosin and orosomucoid are only a couple of the molecules investigated using MALDI-MSI in ovarian cancer research. This study, in line with the available literature, proves the potential of MALDI-MSI to overcome the current limitations of classic histopathological examination giving a more in-depth insight into the tissue structure and thus lead to the more accurate differential diagnosis of ovarian tumors, especially in the most challenging cases.
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Affiliation(s)
- Dagmara Pietkiewicz
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland; (D.P.); (S.P.)
| | - Agnieszka Horała
- Gynecologic Oncology Department, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland; (A.H.); (E.N.-M.)
| | - Szymon Plewa
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland; (D.P.); (S.P.)
| | - Piotr Jasiński
- Department of Pathology Gynecological and Obstetric Clinical Hospital, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland;
| | - Ewa Nowak-Markwitz
- Gynecologic Oncology Department, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland; (A.H.); (E.N.-M.)
| | - Zenon J. Kokot
- Faculty of Health Sciences, Calisia University, 13 Kaszubska Street, 62-800 Kalisz, Poland;
| | - Jan Matysiak
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland; (D.P.); (S.P.)
- Correspondence:
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Ansardamavandi A, Tafazzoli-Shadpour M, Omidvar R, Nili F. An AFM-Based Nanomechanical Study of Ovarian Tissues with Pathological Conditions. Int J Nanomedicine 2020; 15:4333-4350. [PMID: 32606681 PMCID: PMC7311358 DOI: 10.2147/ijn.s254342] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Different diseases affect both mechanical and chemical features of the involved tissue, enhancing the symptoms. METHODS In this study, using atomic force microscopy, we mechanically characterized human ovarian tissues with four distinct pathological conditions: mucinous, serous, and mature teratoma tumors, and non-tumorous endometriosis. Mechanical elasticity profiles were quantified and the resultant data were categorized using K-means clustering method, as well as fuzzy C-means, to evaluate elastic moduli of cellular and non-cellular parts of diseased tissues and compare them among four disease conditions. Samples were stained by hematoxylin-eosin staining to further study the content of different locations of tissues. RESULTS Pathological state vastly influenced the mechanical properties of the ovarian tissues. Significant alterations among elastic moduli of both cellular and non-cellular parts were observed. Mature teratoma tumors commonly composed of multiple cell types and heterogeneous ECM structure showed the widest range of elasticity profile and the stiffest average elastic modulus of 14 kPa. Samples of serous tumors were the softest tissues with elastic modulus of only 400 Pa for the cellular part and 5 kPa for the ECM. Tissues of other two diseases were closer in mechanical properties as mucinous tumors were insignificantly stiffer than endometriosis in cellular part, 1300 Pa compared to 1000 Pa, with the ECM average elastic modulus of 8 kPa for both. CONCLUSION The higher incidence of carcinoma out of teratoma and serous tumors may be related to the intense alteration of mechanical features of the cellular and the ECM, serving as a potential risk factor which necessitates further investigation.
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Affiliation(s)
- Arian Ansardamavandi
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | | | - Ramin Omidvar
- Faculty of Biology, Centre for Biological Signalling Studies (BIOSS), Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Fatemeh Nili
- Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
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Novak CM, Horst EN, Lin E, Mehta G. Compressive Stimulation Enhances Ovarian Cancer Proliferation, Invasion, Chemoresistance, and Mechanotransduction via CDC42 in a 3D Bioreactor. Cancers (Basel) 2020; 12:cancers12061521. [PMID: 32532057 PMCID: PMC7352213 DOI: 10.3390/cancers12061521] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 02/08/2023] Open
Abstract
This report investigates the role of compressive stress on ovarian cancer in a 3D custom built bioreactor. Cells within the ovarian tumor microenvironment experience a range of compressive stimuli that contribute to mechanotransduction. As the ovarian tumor expands, cells are exposed to chronic load from hydrostatic pressure, displacement of surrounding cells, and growth induced stress. External dynamic stimuli have been correlated with an increase in metastasis, cancer stem cell marker expression, chemoresistance, and proliferation in a variety of cancers. However, how these compressive stimuli contribute to ovarian cancer progression is not fully understood. In this report, high grade serous ovarian cancer cell lines were encapsulated within an ECM mimicking hydrogel comprising of agarose and collagen type I, and stimulated with confined cyclic or static compressive stresses for 24 and 72 h. Compression stimulation resulted in a significant increase in proliferation, invasive morphology, and chemoresistance. Additionally, CDC42 was upregulated in compression stimulated conditions, and was necessary to drive increased proliferation and chemoresistance. Inhibition of CDC42 lead to significant decrease in proliferation, survival, and increased chemosensitivity. In summary, the dynamic in vitro 3D platform developed in this report, is ideal for understanding the influence of compressive stimuli, and can be widely applicable to any epithelial cancers. This work reinforces the critical need to consider compressive stimulation in basic cancer biology and therapeutic developments.
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Affiliation(s)
- Caymen M. Novak
- Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (C.M.N.); (E.N.H.); (E.L.)
| | - Eric N. Horst
- Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (C.M.N.); (E.N.H.); (E.L.)
| | - Emily Lin
- Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (C.M.N.); (E.N.H.); (E.L.)
| | - Geeta Mehta
- Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (C.M.N.); (E.N.H.); (E.L.)
- Materials Science and Engineering, University of Michigan, Ann Arbor, MI 48109, USA
- Macromolecular Science and Engineering, University of Michigan, Ann Arbor, MI 48109, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
- Precision Health, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +1-734-763-3957
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Gaur JH, Hassan MJ, Elahi AA, Khetrapal S, Khan S, Jetley S. Synchronous benign Brenner's tumor of ovary with leiomyoma and endometrial adenocarcinoma in a postmenopausal female. J Cancer Res Ther 2020; 15:1418-1420. [PMID: 31898686 DOI: 10.4103/jcrt.jcrt_109_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/04/2022]
Abstract
Brenner tumors of ovary are usually an incidental finding. It is an uncommon tumor which is seen affecting women of fifth to sixth decade. It is classified under transitional cell tumors of ovary, which includes benign, borderline, and malignant Brenner tumors and transitional cell carcinoma. These tumors have been associated with synchronous and metachronous neoplasia, most commonly other ovarian epithelial tumors such as mucinous cystadenoma. Occasionally, these tumors may be associated with endometrial hyperplasia or carcinomas which are due to hormones elaborated by the stromal component of Brenner tumor. The hormone produced is estrogen and less commonly androgens, which alters the estrogen and progesterone levels, causing hyperstimulation of endometrium. We present a case of 50-year-old postmenopausal women who presented with coexisting incidental Brenner tumor with leiomyoma and Endometrial adenocarcinoma. Only few authors have reported similar tumor occurrence in the past.
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Affiliation(s)
- Jyotsana Harit Gaur
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Mohammad Jaseem Hassan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Arifa Anwar Elahi
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Shaan Khetrapal
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sabina Khan
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sujata Jetley
- Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
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Wang C, de Ávila BEF, Mundaca-Uribe R, Lopez-Ramirez MA, Ramírez-Herrera DE, Shukla S, Steinmetz NF, Wang J. Active Delivery of VLPs Promotes Anti-Tumor Activity in a Mouse Ovarian Tumor Model. Small 2020; 16:e1907150. [PMID: 32329580 PMCID: PMC7507763 DOI: 10.1002/smll.201907150] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/01/2020] [Accepted: 03/17/2020] [Indexed: 05/23/2023]
Abstract
Virus-like nanoparticles (VLPs) have been used as an attractive means in cancer immunotherapy because of their unique intrinsic immunostimulatory properties. However, for treating metastatic tumors in the peritoneal cavity, such as ovarian cancer, multiple injections of therapy are needed due to the large peritoneal space and fast excretion of therapy. Here, it is reported on the development of active VLP delivery vehicles for the treatment of peritoneal ovarian tumors using biocompatible Qβ VLPs-loaded Mg-based micromotors. The autonomous propulsion of such Qβ VLPs-loaded Mg-micromotors in the peritoneal fluid enables active delivery of intact immunostimulatory Qβ VLPs to the peritoneal space of ovarian tumor bearing mice, greatly enhancing the local distribution and retention of Qβ VLPs. Such improved distribution and longer retention time of Qβ in the peritoneal cavity leads to enhanced immunostimulation and therefore increased survival rate of tumor-bearing mice compared to a passive Qβ treatment. For clinical translation, the active delivery of VLPs holds great promise for tumor immunotherapy toward the treatment of different types of primary and metastatic tumors in the peritoneal cavity.
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Affiliation(s)
- Chao Wang
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
| | | | - Rodolfo Mundaca-Uribe
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
| | | | | | - Sourabh Shukla
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Nicole F. Steinmetz
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
- Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
- Radiology, University of California San Diego, La Jolla, CA 92093, USA
- Moores Cancer Center, University of California San Diego, La Jolla, CA 92093, USA
- Center for Nano-Immunoengineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Joseph Wang
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
- Center for Nano-Immunoengineering, University of California San Diego, La Jolla, CA 92093, USA
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Dong F, Xie X, Wei X, Jiao MM, Duan J, Pan L, Bi L, Fan Z, Yang M. Metastatic serous borderline tumor with micro-invasive ovarian carcinoma presenting as a breast lump: A case report. Medicine (Baltimore) 2020; 99:e19383. [PMID: 32118786 PMCID: PMC7478492 DOI: 10.1097/md.0000000000019383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RATIONALE Breast metastasis from serous borderline tumor with micro-invasive carcinoma of ovary is a very rare condition. The breast lump as the only clinical presentation is rarely seen in ovarian carcinoma, which may lead to be misdiagnosed, and the mechanism of breast metastasis from ovarian tumors in early stage still needs to be explored. Differentiation from primary breast cancer and extramammary malignancy is crucial because the treatment and prognosis are significantly different. PATIENT CONCERNS A 33-year-old female presented with a painless, movable, 1.0 × 1.0 cm lump in the upper outer quadrant of the right breast for a month. DIAGNOSES Breast metastasis of serous borderline tumor with micro-invasive ovarian carcinoma confirmed by pathology and immunohistochemistry. INTERVENTIONS The patient underwent lumpectomy, bilateral ovarian tumor stripping operation and prophylactic chemotherapy. OUTCOMES No signs of recurrence have been detected in 1.5 years of follow-up. LESSONS Distant metastasis may occur in early stage of ovarian carcinoma. It is important to determine the origin of the primary tumor and develop an effective treatment strategy for patients. Imaging findings and pathological diagnostic criteria are important to accurately differentiate between metastasis and primary breast lesions, which may improve the patient's outcomes.
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Affiliation(s)
| | | | - Xue Wei
- Department of Breast Surgery
| | | | | | | | - Lirong Bi
- Department of Pathology, First Hospital of Jilin University, Changchun, People's Republic of China
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Palakkan S, Augestine T, Valsan MK, Vahab KPA, Nair LK. Role of Frozen Section in Surgical Management of Ovarian Neoplasm. Gynecol Minim Invasive Ther 2020; 9:13-17. [PMID: 32090007 PMCID: PMC7008647 DOI: 10.4103/gmit.gmit_2_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 10/03/2019] [Accepted: 11/12/2019] [Indexed: 11/17/2022] Open
Abstract
Objective: Cancers of the adnexae, including ovarian and fallopian tube, constitute the eighth most common cancers among women worldwide. Surgery remains the cornerstone in the management of ovarian cancer. Intraoperative frozen section diagnosis of ovarian tumors is widely used in making this distinction and to decide the course of surgery. Therefore, the accuracy of this technique is very important. The aim was to determine the overall accuracy, sensitivity, specificity, and predictive values of frozen section for ovarian tumors and to evaluate the role of frozen section in the surgical management of ovarian tumors. Materials and Methods: This was a descriptive longitudinal study conducted in the gynecology department of a tertiary care hospital. During the 1 ½ year period of data collection, frozen section was performed among 60 cases of ovarian neoplasms. The overall accuracy, sensitivity, specificity and predictive values of frozen section for benign, borderline and malignant categories of ovarian tumors were studied. Results: Out of the 60 patients of ovarian tumors, frozen section diagnosis showed that 43 (71.7%) tumors were benign, 11 (18.3%) were malignant and 6 (10%) were of borderline nature. Final histopathological diagnosis showed that 45 (75%) tumors were benign, 11 (18.3%) were malignant and 4 (6.7%) were borderline. Frozen section for benign tumors had 95% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 88% negative predictive value (NPV). Malignant tumors had 90% sensitivity, 97% specificity, 90% PPV and 97% NPV with frozen section. However, frozen section had low sensitivity (75%) and PPV (50%) for borderline tumors. Specificity was 94% and NPV 98% in this group of tumors. Conclusion: Frozen section was found to be an accurate and useful modality in the intraoperative evaluation of patients with ovarian neoplasm. The results can help to decide the type and extent of surgery.
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Affiliation(s)
- Saphina Palakkan
- Department of Obstetrics and Gynecology, MES Medical College, Malappuram, Kerala, India
| | - Tony Augestine
- Department of Obstetrics and Gynecology, MES Medical College, Malappuram, Kerala, India
| | - M K Valsan
- Department of Obstetrics and Gynecology, MES Medical College, Malappuram, Kerala, India
| | - K P Abdul Vahab
- Department of Obstetrics and Gynecology, MES Medical College, Malappuram, Kerala, India
| | - Lekha K Nair
- Department of Pathology, MES Medical College, Malappuram, Kerala, India
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Elgendy A, Lakshminarayanan B, Elrouby A, Mostafa M, Salem MA, Turner K, Khairi A, Squire R, K Shehata SM, Shehata S, Powis M. Management of pediatric benign ovarian tumors in England and Egypt: A comparative study. Afr J Paediatr Surg 2020; 17:33-38. [PMID: 33106451 PMCID: PMC7818669 DOI: 10.4103/ajps.ajps_64_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/18/2022] Open
Abstract
AIM OF THE STUDY We aimed to compare the management of pediatric benign ovarian tumors between an English center and three Egyptian institutions. MATERIALS AND METHODS This was a retrospective review of all children presenting with benign ovarian tumors between January 2014 and January 2019. A standardized dataset was used to compare between both sides. RESULTS Eighty-nine patients were included (54 English and 35 Egyptians). Median age at diagnosis in England was 13 years (2-16y), while in Egypt it was 7 years (9m-16y) with P =0.001. Mature teratomas or dermoid cysts were the most common findings in England and Egypt; 75.9% and 82.8% of cases, respectively. The presentation with an acute abdomen represented 27.8% of English and 28.6% of Egyptian patients. Incidentally diagnosed lesions constituted 15% of English patients, whereas none of the Egyptian cases were discovered incidentally. There were variations in diagnostic imaging; England: Ultrasound (USS) (54), magnetic resonance imaging (MRI) (37), and computed tomography (CT) (only one)-Egypt: USS (35), CT (17), and MRI (only one). Minimally invasive surgery (MIS) was performed in 15% of English and 23% of Egyptian patients (P = 0.334). Ovarian-sparing surgery (OSS) was performed in: England 35%, Egypt 37%; P = 0.851. OSS was performed using MIS in 87.5% (7/8) of English patients and 100% (8/8) of Egyptians. Patients presented as emergencies generally had open oophorectomies: England; 86.7% open and 80% oophorectomy-Egypt; 100% open and 90% oophorectomy. Recurrences or metachronous disease occurred in 5.6% of English and 5.7% of Egyptian patients. CONCLUSIONS There were no significant differences regarding surgical management, tumor pathology, and recurrence or metachronous disease. However, age, incidental diagnosis, and imaging modalities showed notable differences. MIS was correlated with ovarian preservation, whereas emergency surgery generally resulted in open oophorectomy.
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Affiliation(s)
- Ahmed Elgendy
- Surgical Oncology Unit, Department of Surgery, Tanta University, Tanta, Egypt
| | | | - Ahmed Elrouby
- Department of Pediatric Surgery, Alexandria University, Alexandria, Egypt
| | - Mahmoud Mostafa
- Department of Pediatric Surgery, Assiut University, Assiut, Egypt
| | | | - Kerry Turner
- Department of Pathology, Leeds Teaching Hospitals NHS Trust, Leeds, England, UK
| | - Ahmed Khairi
- Department of Pediatric Surgery, Alexandria University, Alexandria, Egypt
| | - Roly Squire
- Department of Pediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, England, UK
| | | | - Sameh Shehata
- Department of Pediatric Surgery, Alexandria University, Alexandria, Egypt
| | - Mark Powis
- Department of Pediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, England, UK
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Sahin S, Cakmakcı S, Bayhan T, Aksel B, Bulut ZM, Sari N, İlhan İE. A Rare Malignity of Childhood: Krukenberg Tumor-Case Report and Review of Literature. J Adolesc Young Adult Oncol 2019; 9:303-306. [PMID: 31660771 DOI: 10.1089/jayao.2019.0082] [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] [Indexed: 11/13/2022] Open
Abstract
Krukenberg tumor (KT) is a rare ovarian carcinoma containing mucin-filled signet ring cells. It accounts for 1%-2% of all ovarian tumors. It is seen at an average age of 40 years. Reported pediatric cases of KT in the literature are very limited. Herein, we present an adolescent with a KT that was compatible with metastatic ring cell colon carcinoma.
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Affiliation(s)
- Seda Sahin
- Department of Pediatric Hematology and Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Selma Cakmakcı
- Department of Pediatric Hematology and Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Turan Bayhan
- Department of Pediatric Hematology and Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Bülent Aksel
- Department of General Surgery, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Zarife Melda Bulut
- Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Neriman Sari
- Department of Pediatric Hematology and Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - İnci Ergürhan İlhan
- Department of Pediatric Hematology and Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Cimic A, Mironova M, Khoury-Collado F, Salih Z. Cytologic smears improve accuracy of frozen sections of ovarian tumors in the community practice settings. Cytojournal 2019; 16:10. [PMID: 31367218 PMCID: PMC6628726 DOI: 10.4103/cytojournal.cytojournal_20_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 11/28/2018] [Indexed: 11/23/2022] Open
Abstract
Background: The ovaries can be the site for various primary tumors and also the presenting site of metastatic disease. Quick and correct intraoperative diagnosis is crucial for the patient's further management. The aim of this study was to demonstrate the advantages of the combined diagnostic method – ovarian frozen sections in conjunction with cytologic smears. Methods: From June 2016 to June 2017, we prospectively prepared additional two cytologic smears with Diff-Quik stain on ovarian frozen sections comprised of two hematoxylin and eosin sections. For quality assurance purposes, we compared the results of frozen section discrepancies and deferrals with those that of the previous year from June 2015 to June 2016. Results: With the introduction of cytologic smears to ovarian frozen sections, the number of discrepancies and deferrals combined decreased from 13.75% to 7.85%. The most benefit of smears was observed in primary ovarian malignancies. Conclusions: In the setting where all the members of the pathology group render cytologic evaluations routinely, smears play an important complementary role.
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Affiliation(s)
- Adela Cimic
- Address: Department of Pathology, Maimonides Medical Center, Brooklyn, NY, USA
| | | | | | - Ziyan Salih
- Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
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Abstract
Influence of obesity on surgical complications and survival of patients with ovarian tumors were investigated. In total, 362 patients who were diagnosed with ovarian cancer by biopsy in the Department of Pathology of Shanxi Dayi Hospital Affiliated to Shanxi Medical University from April 2012 to July 2017 were selected as research subjects for retrospective analysis. The patients were divided into the obesity group [body mass index (BMI) ≥28] (n=64), the overweight group (≥24 BMI <28) (n=124), the normal body weight group (≥18.5 BMI <24) (n=108) and the low body weight group (BMI <18.5) (n=66). The surgical conditions and postoperative complications of patients in the 4 groups were compared, and the patients were followed up for prognosis for one year, and their mortality rates were recorded. The surgical time, intraoperative blood loss amount and blood transfusion amount of the patients in the obesity group were the highest, followed by the overweight group (P<0.05). Among the 4 groups, the prognosis of patients in the obesity group was also the worst. The incidence rates of complications among all groups were compared, and the incidence rate of complications in the obesity group was the highest (50.00%), followed by the overweight group (30.65%), the low body weight group (13.64%) and the normal body weight group (4.63%), (P<0.05). The prognosis follow-up results showed that the 1-year mortality rate in the obesity group was the highest (35.94%), followed by the overweight group (28.23%). For patients with ovarian cancer, obesity raises the risks of postoperative complications and worsens their prognosis. Therefore, indexes of patients with tumors associated with high BMI should be monitored more strictly after surgeries.
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Affiliation(s)
- Huimin Lv
- Department of Gynaecology and Obstetrics, Shanxi Dayi Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030000, P.R. China
| | - Suhui Wu
- Department of Gynaecology and Obstetrics, Shanxi Dayi Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030000, P.R. China
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Mărginean CO, Mărginean C, Chinceşan M, Mărginean MO, Meliţ LE, Săsăran V, Mărginean CD. Pediatric ovarian tumors, a challenge for pediatrician and gynecologist: Three case reports (CARE compliant). Medicine (Baltimore) 2019; 98:e15242. [PMID: 31008957 PMCID: PMC6494269 DOI: 10.1097/md.0000000000015242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Ovarian or adnexal tumors are very rare in patients below the age of 18 years, most of them being functional cysts, only 10% being malignant. We report 3 cases of ovarian tumors with the aim of revealing the particularities regarding the diagnosis and management of benign and malignant ovarian tumors in pediatric patients. PATIENT CONCERNS The 1st case, a 9-year-old girl presented for diffuse abdominal pain, distended abdomen and rapid increase in abdominal volume. The 2nd case describes a 13-year-old female patient admitted for acute abdominal pain and nausea, and the 3rd one was an 18-year-old female teenager who presented for distended abdomen, intermittent diffuse abdominal pain and rapid increase in abdomen volume. DIAGNOSES The abdominal ultrasound revealed in all 3 patients suggestive signs for ovarian tumors. INTERVENTIONS The 1st patient underwent laparotomy with adnexectomy, and the histopathological exam showed the diagnosis of dysgerminoma. The 2nd patient underwent laparoscopy with adnexectomy, and the histopathological exam revealed a borderline tumor. The 3rd patient benefited by a laparotomy with left ovariectomy, and the histopathological exam pointed out a mature teratoma. OUTCOMES The outcome was favorable in all 3 cases, but the patients with dysgerminoma and mature teratoma were further referred to the oncologist for proper assessment. LESSONS Laparoscopy may represent the first choice for uncomplicated ovarian masses. The diagnosis and the therapeutic plan must be based on symptoms, pelvic ultrasound, the time of menarche and the potential serum markers.
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Abstract
The diagnosis of ovarian cancer in adolescents and young adults is always challenging. Many issues exist, and most important of these may be access to care with an appropriate provider. A range of histologies occur in the ovaries, and their frequency changes markedly as patients progress from adolescence to young adulthood. The very curable germ cell tumors of adolescence slowly give way to aggressive carcinomas, which require a different treatment approach. Special consideration is needed for treatment of toxicity. In an ideal world, centers consisting of pediatric, medical, and gynecological oncologists may be the most appropriate to care for these complex and diverse patients.
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Affiliation(s)
- Michelle Lockley
- Barts Cancer Institute, Queen Mary University of London, London, UK
- Department of Oncology, University College London Hospital, London, UK
| | - Sara J Stoneham
- Department of Oncology, University College London Hospital, London, UK
| | - Thomas A Olson
- Department of Paediatrics and Child Health, University College London Hospital, London, UK
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
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Shenoy GN, Loyall J, Berenson CS, Kelleher RJ, Iyer V, Balu-Iyer SV, Odunsi K, Bankert RB. Sialic Acid-Dependent Inhibition of T Cells by Exosomal Ganglioside GD3 in Ovarian Tumor Microenvironments. J Immunol 2018; 201:3750-3758. [PMID: 30446565 PMCID: PMC6289713 DOI: 10.4049/jimmunol.1801041] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/15/2018] [Indexed: 01/07/2023]
Abstract
The tumor microenvironment is rendered immunosuppressive by a variety of cellular and acellular factors that represent potential cancer therapeutic targets. Although exosomes isolated from ovarian tumor ascites fluids have been previously reported to induce a rapid and reversible T cell arrest, the factors present on or within exosomes that contribute to immunosuppression have not been fully defined. In this study, we establish that GD3, a ganglioside expressed on the surface of exosomes isolated from human ovarian tumor ascites fluids, is causally linked to the functional arrest of T cells activated through their TCR. This arrest is inhibited by Ab blockade of exosomal GD3 or by the removal of GD3+ exosomes. Empty liposomes expressing GD3 on the surface also inhibit the activation of T cells, establishing that GD3 contributes to the functional arrest of T cells independent of factors present in exosomes. Finally, we demonstrate that the GD3-mediated arrest of the TCR activation is dependent upon sialic acid groups, because their enzymatic removal from exosomes or liposomes results in a loss of inhibitory capacity. Collectively, these data define GD3 as a potential immunotherapeutic target.
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Affiliation(s)
- Gautam N. Shenoy
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Jenni Loyall
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Charles S. Berenson
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, Infectious Disease Division, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, and Department of Veteran Affairs, Western New York Health Care System, Buffalo, New York
| | - Raymond J. Kelleher
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Vandana Iyer
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, New York
| | - Sathy V. Balu-Iyer
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, New York
| | - Kunle Odunsi
- Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, New York
| | - Richard B. Bankert
- Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
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Abstract
Background Diffusion-weighted imaging (DWI) and quantitative apparent diffusion coefficient (ADC) values are widely used in the differential diagnosis of ovarian tumors. Purpose To assess the diagnostic performance of quantitative ADC values in ovarian tumors. Material and Methods PubMed, Embase, the Cochrane Library, and local databases were searched for studies assessing ovarian tumors using quantitative ADC values. We quantitatively analyzed the diagnostic performances for two clinical problems: benign vs. malignant tumors and borderline vs. malignant tumors. We evaluated diagnostic performances by the pooled sensitivity and specificity values and by summary receiver operating characteristic (SROC) curves. Subgroup analyses were used to analyze study heterogeneity. Results From the 742 studies identified in the search results, 16 studies met our inclusion criteria. A total of ten studies evaluated malignant vs. benign ovarian tumors and six studies assessed malignant vs. borderline ovarian tumors. Regarding the diagnostic accuracy of quantitative ADC values for distinguishing between malignant and benign ovarian tumors, the pooled sensitivity and specificity values were 0.91 and 0.91, respectively. The area under the SROC curve (AUC) was 0.96. For differentiating borderline from malignant tumors, the pooled sensitivity and specificity values were 0.89 and 0.79, and the AUC was 0.91. The methodological quality of the included studies was moderate. Conclusion Quantitative ADC values could serve as useful preoperative markers for predicting the nature of ovarian tumors. Nevertheless, prospective trials focused on standardized imaging parameters are needed to evaluate the clinical value of quantitative ADC values in ovarian tumors.
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Affiliation(s)
- Shan Pi
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Rong Cao
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Jin Wei Qiang
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
| | - Yan Hui Guo
- Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China
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Phillips LN, Krishnamurti L, Rytting H, Olson TA. Ovarian Sertoli-Leydig tumor after bone marrow transplant for sickle cell disease. Pediatr Blood Cancer 2018; 65:e27367. [PMID: 30039911 DOI: 10.1002/pbc.27367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/31/2018] [Accepted: 06/21/2018] [Indexed: 11/12/2022]
Abstract
As bone marrow transplant for sickle cell disease becomes increasingly common, long-term outcomes including secondary malignancies are beginning to be described. Here, we report a case of ovarian Sertoli-Leydig tumor that occurred after allogeneic bone marrow transplant for sickle cell disease.
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Affiliation(s)
- Lia Neu Phillips
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Lakshmanan Krishnamurti
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Heather Rytting
- Department of Pathology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Thomas A Olson
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
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Md Arshad NZ, Ng BK, Md Paiman NA, Abdullah Mahdy Z, Mohd Noor R. Intra-Operative Frozen Sections for Ovarian Tumors – A Tertiary Center Experience. Asian Pac J Cancer Prev 2018; 19:213-218. [PMID: 29373916 PMCID: PMC5844621 DOI: 10.22034/apjcp.2018.19.1.213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Accuracy of diagnosis with intra-operative frozen sections is extremely important in the evaluation
of ovarian tumors so that appropriate surgical procedures can be selected. Study design: All patients who with
intra-operative frozen sections for ovarian masses in a tertiary center over nine years from June 2008 until April 2017
were reviewed. Frozen section diagnosis and final histopathological reports were compared. Main outcome measures:
Sensitivity, specificity, positive and negative predictive values of intra-operative frozen section as compared to final
histopathological results for ovarian tumors. Results: A total of 92 cases were recruited for final evaluation. The frozen
section diagnoses were comparable with the final histopathological reports in 83.7% of cases. The sensitivity, specificity,
positive predictive value and negative predictive value for benign and malignant ovarian tumors were 95.6%, 85.1%,
86.0% and 95.2% and 69.2%, 100%, 100% and 89.2% respectively. For borderline ovarian tumors, the sensitivity and
specificity were 76.2% and 88.7%, respectively; the positive predictive value was 66.7% and the negative predictive
value was 92.7%. Conclusion: The accuracy of intra-operative frozen section diagnoses for ovarian tumors is high
and this approach remains a reliable option in assessing ovarian masses intra-operatively.
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Affiliation(s)
- Nur Zaiti Md Arshad
- Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia.
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Azami S, Aoki Y, Iino M, Sakaguchi A, Ogura K, Ogishima D, Matsumoto T. Useful aspects of diagnosis of imprint cytology in intraoperative consultation of ovarian tumors: comparison between imprint cytology and frozen sections. Diagn Cytopathol 2017; 46:28-34. [PMID: 29034605 PMCID: PMC5765498 DOI: 10.1002/dc.23844] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/02/2017] [Accepted: 10/06/2017] [Indexed: 11/14/2022]
Abstract
Background In the intraoperative consultation of ovarian tumors, the histological diagnosis of frozen sections (FS) of large tumors is frequently difficult because of the limited number of tumor samples. The application of imprint cytology (IC), in which samples are obtained from wide areas of the tumors, is useful for intraoperative consultation. However, the useful aspects of IC have not been clearly defined. The present study is a detailed comparison of IC and FS that clearly defines the useful aspects of IC. Methods Fifty‐five cases of ovarian tumors that were examined using both IC and FS were evaluated. The histological diagnoses consisted of benign (16), borderline (6), and malignancy (33). All of the malignant tumors consisted of various types of carcinoma. Results Benignity and malignancy were accurately diagnosed by both IC and FS. In the borderline group, the diagnostic accuracy of IC was very low (1/6: 16.6%) compared with FS (4/6: 66.6%). The diagnostic accuracy including benign, borderline, and malignant groups was 90.9% (50/55) for IC and 96.3% (53/55) for FS. Concerning the diagnosis of the types of carcinoma, the overall diagnostic accuracy of IC (25/31: 80.6%) was greater than that of FS (21/31: 67.7%), especially for the diagnosis of clear cell carcinoma (IC, 100%; FS, 80%) and mixed carcinoma (IC, 66.6%; FS, 16.6%). Conclusion The useful aspects of IC in the intraoperative consultation are the diagnosis of benignity or malignancy and the accuracy of diagnosing clear cell carcinoma and mixed carcinoma.
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Affiliation(s)
- Shiho Azami
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Yuuji Aoki
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Mizuki Iino
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Asumi Sakaguchi
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Kanako Ogura
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Daiki Ogishima
- Department of Gynecology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Toshiharu Matsumoto
- Department of Diagnostic Pathology, Juntendo University Nerima Hospital, Tokyo, Japan
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Mørch LS, Dehlendorff C, Baandrup L, Friis S, Kjaer SK. Use of antidepressants and risk of epithelial ovarian cancer. Int J Cancer 2017; 141:2197-2203. [PMID: 28791695 DOI: 10.1002/ijc.30919] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 03/06/2017] [Revised: 06/27/2017] [Accepted: 07/14/2017] [Indexed: 11/06/2022]
Abstract
Antidepressants are widely prescribed among women to treat depression and anxiety disorders, but studies of their effects on gynecological cancer risk are sparse. We assessed associations between various antidepressants and risk of epithelial ovarian cancer. By using Danish nationwide registers, we identified all women (cases) aged 30-84 years with incident epithelial (serous, endometrioid, clear cell or mucinous) ovarian cancer during 2000-2011 (n = 4,103) and matched each case to 20 population controls (n = 58,706) by risk-set matching. Data on drug use (including tricyclic and related antidepressants, selective serotonin reuptake inhibitors, other antidepressants, and potential confounder drugs), medical and reproductive history and socioeconomic parameters, were obtained from nationwide registries. We used conditional logistic regression models to estimate adjusted odds ratios (ORs) and two-sided 95% confidence intervals (CIs) for epithelial ovarian cancer associated with antidepressive drug use. Compared with non-use, use of selective serotonin reuptake inhibitors was associated with a decreased risk of ovarian cancer (OR, 0.85; 95% CI, 0.74-0.96), whereas the associations for other antidepressants were close to unity [tricyclic and related antidepressants: OR, 0.99 (95% CI, 0.78-1.26); other antidepressants: OR, 1.05 (95% CI, 0.76-1.46)]. For individual types of SSRI, reduced ORs were observed for citalopram OR, 0.78 (95% CI, 0.66-0.93), paroxetine 0.79 (95% CI, 0.56-1.12) and sertraline 0.80 (95% CI, 0.60-1.08). Among postmenopausal women, the inverse association was restricted to users of menopausal hormone therapy. In conclusion, use of selective serotonin reuptake inhibitors was associated with a decreased risk of epithelial ovarian cancer; thereby implying potential chemopreventive properties of these drugs.
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Affiliation(s)
- Lina S Mørch
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, DK-2100, Copenhagen, Denmark
| | - Christian Dehlendorff
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark
| | - Louise Baandrup
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark
| | - Søren Friis
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, DK-2100, Copenhagen, Denmark
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Levanat S, Sabol M, Musani V, Ozretic P, Trnski D. Hedgehog Signaling Pathway as Genetic and Epigenetic Target in Ovarian Tumors. Curr Pharm Des 2017; 23:73-94. [PMID: 27719639 DOI: 10.2174/1381612822666161006154705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 08/04/2016] [Accepted: 09/29/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hedgehog signaling pathway is a developmental pathway mostly inactive in adult tissues, with the exception of stem cells. It is often found upregulated in various tumors, and associated with cancer stem cell maintenance. METHODS This review focuses on different aspects of Hedgehog activation in tumors, with special emphasis on ovarian tumors and their treatment. RESULTS Mutations in pathway components lead to a series of developmental malformations and syndromes. Aberrant activation of the pathway can be caused by mutations, noncanonical transcriptional regulation, or epigenetic changes. CONCLUSION This pathway is an interesting target in cancer therapy, especially when combined with therapies targeting other signaling pathways. Combination therapy can be used to bypass resistance or to target cancer stem cells in a more efficient way.
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Affiliation(s)
- Sonja Levanat
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruder Boskovic Institute, Bijenicka cesta 54, 10002 Zagreb, Croatia
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Ayhan A, Ozler A, Dursun P, Haberal AN. Potential role of increasing number of sections in frozen section diagnosis of ovarian tumors. J Exp Ther Oncol 2016; 11:245-250. [PMID: 27849334] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/29/2016] [Accepted: 05/06/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess the accuracy of intraoperative frozen section of ovarian tumours at our institution and to identify the possible reasons for misdiagnosis. STUDY DESIGN Between January 2002 and August 2013, a total of 684 patients were included in the study. Frozen section diagnosis was compared with the final paraffin section diagnosis as the gold standard. The sensitivity, specificity, and positive and negative predictive values of frozen-section diagnosis were calculated for benign, borderline and malignant tumours. Clinicopathological parameters influenced by misdiagnosis were evaluated performing multivariate logistic regression analysis. RESULTS The overall accuracy was detected as 96.1%. Frozen-section diagnoses of 26 patients (3.8%) showed discordance. The specificity (99.7%) and PPV (99.4%) of frozen-section diagnosis was highest in the malignant category. In BOTs, diagnostic agreement was observed in 57 of 70 (81.4%) cases. The PPV (81.4%) was lowest for these patients. Tumour diameter of ≥10 cm (OR [95% CI]= 3.0 [1.1 to 8.2]; P=0.030) and mucinous histology (OR [95% CI]= 2.5 [1.0 to 6.2]; P=0.042) were significant predictors of misdiagnosis. With the increase in the number of sections, the accuracy rate of frozen section diagnosis was decreased. While not statistically significant (p=0.361). CONCLUSION The number of sections is increased parallel to increase in tumor diameters. On the contrary, the diagnostic accuracy was no significantly increased with an increase in the number of sections. This discrepancy may be associated with falling tumor size per frozen section. A prospective study based on a certain tumour diameter per frozen section may better demonstrate the positive effect of the number of sections.
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Affiliation(s)
- Ali Ayhan
- Departments of Obstetrics and Gynecology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Ali Ozler
- Departments of Obstetrics and Gynecology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Polat Dursun
- Departments of Obstetrics and Gynecology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - A Nihan Haberal
- Departments of Pathology, Baskent University, Faculty of Medicine, Ankara, Turkey
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Agostini A, Panagopoulos I, Davidson B, Trope CG, Heim S, Micci F. A novel truncated form of HMGA2 in tumors of the ovaries. Oncol Lett 2016; 12:1559-1563. [PMID: 27446471 DOI: 10.3892/ol.2016.4805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 07/27/2015] [Accepted: 05/10/2016] [Indexed: 12/18/2022] Open
Abstract
Neoplasms of the ovary are the second most common tumor of the female reproductive system, and the most lethal of the gynecological malignancies. Ovarian tumors are divided into a copious number of different groups reflecting their different features. The present study analyzed 187 ovarian tumors (39 sex-cord stromal tumors, 22 borderline tumors and 126 carcinomas) for the expression of the high-mobility group AT-hook 2 (HMGA2) gene, for mutations in the isocitrate dehydrogenase (NADP(+)) 1, cytosolic (IDH1), isocitrate dehydrogenase (NADP(+)) 2, mitochondrial (IDH2) and telomerase reverse transcriptase (TERT) genes, and for methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter. Reverse transcription-polymerase chain reaction analysis showed that HMGA2 was expressed in 74.5% of the samples (120/161). A truncated transcript of HMGA2 was identified in 11 cases. A novel truncated form of HMGA2 was found in 4 serous high-grade carcinomas. Only 4 tumors (4/185) showed the TERT C228T mutation. No IDH1 or IDH2 mutations were found. Methylation of the promoter of MGMT was found in 2 borderline tumors (2/185). HMGA2 was expressed, in its truncated and native form, in different ovarian tumors, even the less aggressive types, underscoring the general importance of this gene in ovarian tumorigenesis. Mutations involving TERT, as well as MGMT promoter methylation, are rare events in ovarian tumors.
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Affiliation(s)
- Antonio Agostini
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, 0310 Oslo, Norway; Centre for Cancer Biomedicine, University of Oslo, 0310 Oslo, Norway
| | - Ioannis Panagopoulos
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, 0310 Oslo, Norway; Centre for Cancer Biomedicine, University of Oslo, 0310 Oslo, Norway
| | - Ben Davidson
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, 0310 Oslo, Norway; Faculty of Medicine, University of Oslo, 0310 Oslo, Norway
| | - Claes Goran Trope
- Department of Gynecology, The Norwegian Radium Hospital, Oslo University Hospital, 0310 Oslo, Norway
| | - Sverre Heim
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, 0310 Oslo, Norway; Centre for Cancer Biomedicine, University of Oslo, 0310 Oslo, Norway; Faculty of Medicine, University of Oslo, 0310 Oslo, Norway
| | - Francesca Micci
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, 0310 Oslo, Norway; Centre for Cancer Biomedicine, University of Oslo, 0310 Oslo, Norway
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Kovač JD, Terzić M, Mirković M, Banko B, Đikić-Rom A, Maksimović R. Endometrioid adenocarcinoma of the ovary: MRI findings with emphasis on diffusion-weighted imaging for the differentiation of ovarian tumors. Acta Radiol 2016; 57:758-66. [PMID: 26307063 DOI: 10.1177/0284185115599805] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 03/07/2015] [Accepted: 07/15/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Preoperative differentiation of ovarian malignant tumors still remains a challenge. Diffusion-weighted imaging (DWI) provides information about cellularity of the lesion and might facilitate discrimination between different malignant ovarian lesions. PURPOSE To evaluate magnetic resonance imaging (MRI) findings of endometrioid adenocarcinoma of the ovary and to determine the value of DWI in the differential diagnosis of malignant and benign adnexal tumors. MATERIAL AND METHODS The following MRI findings were reviewed in 162 patients (21 endometrioid adenocarcinoma, 103 other malignant tumors, 38 benign tumors): lesion size, morphological appearance, T2-weighted (T2W) signal intensity, T1-weighted (T1W) signal intensity, contrast-enhancement pattern, DWI signals with apparent diffusion coefficient (ADC) calculated for b = 800 s/mm(2) in solid tumor components. RESULTS The most common morphological appearance was predominantly cystic lesion, found in 90.3% of patients with endometriod adenocarcinoma. The solid parts were slightly hyperintense on T2W images in 19 patients with marked enhancement after contrast administration. No significant difference (P = 0.13) in conventional MRI features was found between endometrioid adenocarcinoma and other malignant ovarian tumors. Hyperintensity on DWI was more frequently observed in malignant tumors than in benign lesions (P < 0.001). ADC values were significantly lower in endometrioid adenocarcinoma than other malignant tumors (0.79 ± 0.21 vs. 0.90 ± 0.19; P = 0.04) and in all malignant lesions compared with benign tumors (0.88 ± 0.31 vs. 1.33 ± 0.17; P < 0.001). CONCLUSION DWI with ADC measurement could indicate the presence of endometrioid adenocarcinomas due to a slightly but significantly lower ADC values compared to other malignant ovarian lesions. Thus, DWI is beneficial and should be part of a standard protocol for the evaluation of indeterminate adnexal lesions.
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Affiliation(s)
- Jelena Djokić Kovač
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Terzić
- Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Mirković
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Banko
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Đikić-Rom
- Pathology Department, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Ružica Maksimović
- Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Forae GD, Aligbe JU. Ovarian tumors among Nigerian females: A private practice experience in Benin-City, Nigeria. Adv Biomed Res 2016; 5:61. [PMID: 27135030 PMCID: PMC4832882 DOI: 10.4103/2277-9175.179183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/20/2012] [Accepted: 05/26/2015] [Indexed: 01/10/2023] Open
Abstract
Background: Ovarian tumors ranked high among gynecological tumor globally. Reports have it that ovarian tumors cut across all age groups, but more common in adult females. Currently, ovarian cancer is the 4th most common cancer in terms of incidence and mortality patterns in women globally. To highlight the frequency and histological types of ovarian tumors in a private practice establishment in Benin-City, Southern Nigeria. Materials and Methods: Hematoxylin and eosin stained-slides of ovarian biopsies diagnosed at the Ashamas Foundation Diagnostic Centre, Benin-City for 10 years were archived and studied. Request forms were analyzed for clinical bio-data, diagnosis and nature of biopsies. Ovarian tumors were classified according to the World Health Organization manual series. Results: A total of 236 of all ovarian lesions were encountered in this study. Of these, 200 (84.7%) were benign lesions while malignant lesions accounted for 36 (15.3%). Of this, 200 benign lesions 79 accounting for (39.5%) were a benign neoplastic tumor. The ratio of benign to malignant tumors was 5.6:1.0. The mean age of benign neoplastic tumor was 31.6 years ± 10.4 standard deviation (SD). Out of the 79 benign neoplastic tumors; germ cell tumors was the most common accounting for 49 (62%). The mean age of the 36 malignant ovarian tumors was 40.1 years ± 16.2 SD with the majority as malignant surface epithelial tumors accounting for (n = 16; 44.4%). The malignant germ cell tumor was the most common constituting 10 (27.7%). Conclusion: Germ cell tumor was the most common with the majority occurring in reproductive age. Our finding is a reversal of what obtains in the western countries where surface epithelial tumor was the most common with the majority occurring in elderly females.
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Affiliation(s)
- Gerald Dafe Forae
- Department of Pathology, University of Benin Teaching Hospital, Benin-City, Nigeria; Ashama Foundation Diagnostic Centre, Benin-City, Nigeria
| | - Jonathan Umezulike Aligbe
- Department of Pathology, University of Benin Teaching Hospital, Benin-City, Nigeria; Ashama Foundation Diagnostic Centre, Benin-City, Nigeria
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Sanverdi I, Vural F, Temizkan O, Temel O, Ayvaci H, Gunes P. Primary ovarian leiomyoma in a postmenopausal woman: A case report. North Clin Istanb 2016; 3:222-4. [PMID: 28275755 DOI: 10.14744/nci.2015.07379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 11/11/2015] [Indexed: 12/04/2022] Open
Abstract
Leiomyomas are benign neoplasms that can develop wherever smooth muscle is present. Primary leiomyomas of the ovary originate from smooth muscle cells of ovarian tissue and are rare, solitary tumors. Approximately 70 cases have been reported. They usually present in premenopausal women. The present case is a report of left ovarian leiomyoma in a postmenopausal woman.
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Lavrut PM, Le Loarer F, Normand C, Grosos C, Dubois R, Buenerd A, Conter C, Dijoud F, Blay JY, Collardeau-Frachon S. Small Cell Carcinoma of the Ovary, Hypercalcemic Type: Report of a Bilateral Case in a Teenager Associated with SMARCA4 Germline Mutation. Pediatr Dev Pathol 2016; 19:56-60. [PMID: 26230154 DOI: 10.2350/15-04-1624-cr.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a highly aggressive neoplasm that typically occurs in young females. Paraneoplastic hypercalcemia is associated in two thirds of the cases. Recent studies demonstrated that this rare tumor harbors the same molecular features of malignant rhabdoid tumor secondary to SMARCA4/BRG1 mutations. We illustrate herein a typical bilateral case of SCCOHT with comprehensive molecular characterization in a 14-year-old girl. We also discuss the value of SMARCA4 immunostaining in the diagnostic approach of undifferentiated ovarian and pelvic malignancies.
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Affiliation(s)
| | - François Le Loarer
- 2 Department of Biopathology, Centre Léon Bérard, Lyon, France.,3 Université Claude Bernard Lyon, Lyon, France.,4 Cancer Research Center of Lyon, INSERM U1052, Lyon, France
| | - Charline Normand
- 5 Department of Pediatric Oncology, Centre Léon Bérard, Lyon, France
| | - Céline Grosos
- 6 Department of Surgery, Hôpital Femme Mère Enfant, CHU de Lyon, France
| | - Rémi Dubois
- 6 Department of Surgery, Hôpital Femme Mère Enfant, CHU de Lyon, France
| | - Annie Buenerd
- 1 Department of Pathology, Hôpital Femme Mère Enfant, CHU de Lyon, France
| | - Cécile Conter
- 5 Department of Pediatric Oncology, Centre Léon Bérard, Lyon, France
| | - Frédérique Dijoud
- 1 Department of Pathology, Hôpital Femme Mère Enfant, CHU de Lyon, France.,3 Université Claude Bernard Lyon, Lyon, France
| | - Jean-Yves Blay
- 3 Université Claude Bernard Lyon, Lyon, France.,4 Cancer Research Center of Lyon, INSERM U1052, Lyon, France.,7 Department of Oncology, Centre Leon Bérard, Lyon, France
| | - Sophie Collardeau-Frachon
- 1 Department of Pathology, Hôpital Femme Mère Enfant, CHU de Lyon, France.,3 Université Claude Bernard Lyon, Lyon, France
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Fresneau B, Orbach D, Faure-Conter C, Verité C, Castex MP, Kalfa N, Martelli H, Patte C. Sex-Cord Stromal Tumors in Children and Teenagers: Results of the TGM-95 Study. Pediatr Blood Cancer 2015. [PMID: 26206391 DOI: 10.1002/pbc.25614] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We present the results of the TGM-95 study for gonadal sex-cord stromal tumors (SCT). METHODS Between 1995 and 2005, children (<18 years) with gonadal SCT were prospectively registered. Primary gonadal resection was recommended whenever feasible. Patients with disseminated disease or an incomplete resection received neoadjuvant or adjuvant VIP chemotherapy (etoposide, ifosfamide, cisplatinum). RESULTS Thirty-eight children with ovarian SCT were registered. Median age was 10.7y. Endocrine symptoms were present in 21 cases. The histological diagnoses were as follows: juvenile (23) and adult (3) granulosa cell tumors, Sertoli-Leydig cell tumors (11), and mixed germ cell SCT (1). An initial oophorectomy ± salpingectomy led to complete resection in 23 patients who did not receive adjuvant treatment; two of them relapsed: one achieved second complete remission whereas the other one died of disease. Fifteen patients had tumor rupture and/or malignant ascites: 11 received chemotherapy and did not relapse, four did not receive chemotherapy and relapsed with a fatal outcome in two cases. With a median follow-up of 5.9y, the 5-y EFS and OS rates were respectively 85% and 94%. Eleven patients had localized testicular tumors (median age 0.83y): juvenile granulosa cell tumors (4), Sertoli or Leydig cell tumors (5) and not otherwise specified SCT (2). Treatment was surgery alone with an inguinal orchiectomy. None have relapsed (median follow-up: 5.4y). CONCLUSIONS Childhood SCT carry favorable prognosis. In ovarian SCT, surgery should be complete and non-mutilating. Adjuvant chemotherapy efficiently prevents recurrences in cases of tumor rupture. In childhood testicular SCT, the prognosis is excellent with an inguinal orchiectomy, prompting the debate on testis-sparing surgery.
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Affiliation(s)
- Brice Fresneau
- Gustave Roussy, Department of Pediatric Oncology, Villejuif, France
| | - Daniel Orbach
- Institut Curie, Pediatric Adolescent Young Adult Department, Paris, France
| | - Cécile Faure-Conter
- Institut d'Hemato-Oncologie Pediatrique, Department of Pediatric Oncology, Lyon, France
| | - Cécile Verité
- Hôpital Pellegrin, Department of Pediatric Oncology, Bordeaux, France
| | - Marie Pierre Castex
- Centre hospitalier universitaire, Department of Pediatric Oncology, Toulouse, France
| | - Nicolas Kalfa
- Centre hospitalier universitaire, Department of Pediatric Surgery, Montpellier, France
| | - Hélène Martelli
- Centre hospitalier universitaire, Department of Pediatric Surgery, Le Kremlin-Bicêtre, France
| | - Catherine Patte
- Gustave Roussy, Department of Pediatric Oncology, Villejuif, France
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Hall MJ, Innocent J, Rybak C, Veloski C, Scott WJ, Wu H, Ridge JA, Hoffman JP, Borghaei H, Turaka A, Daly MB. Bilateral granulosa cell tumors: a novel malignant manifestation of multiple endocrine neoplasia 1 syndrome found in a patient with a rare menin in-frame deletion. Appl Clin Genet 2015; 8:69-73. [PMID: 25733923 PMCID: PMC4337709 DOI: 10.2147/tacg.s72223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Introduction Multiple endocrine neoplasia 1 (MEN1) is a cancer syndrome resulting from mutations of the MEN1 gene. The syndrome is characterized by neoplasia of the parathyroid and pituitary glands, and malignant tumors of the endocrine pancreas. Other manifestations include benign lipomas, angiofibromas, and carcinoid tumors commonly originating in the colon, thymus, and lung. This is the first report of MEN1 syndrome manifesting as bilateral granulosa cell ovarian tumors, and which is associated with a rare intronic mutation of the MEN1 gene. Case report A 41-year-old woman presented with abdominal pain, increasing abdominal girth, and dysmenorrhea. Ultrasound demonstrated enlarged ovaries and uterine fibroids. After an exploratory laparotomy, she subsequently underwent bilateral salpingo–oophorectomy with hysterectomy where the pathology revealed bilateral cystic granulosa cell tumors of the ovaries. Additional workup including computed tomography imaging discovered a thymic mass, which the pathology showed was malignant, along with a pancreatic mass suspicious for a neuroendocrine tumor. Hyperparathyroidism was also discovered and was found to be secondary to a parathyroid adenoma. Genetic testing revealed an exceedingly rare mutation in the MEN1 gene (c.654 + 1 G>A). Discussion Mutations of the menin gene leading to MEN1 syndrome are classically nonsense or missense mutations producing a dysfunctional protein product. Recently, researchers described a novel mutation of MEN1 (c.654 + 1 G>A) in a male proband meeting the criteria for clinical MEN1 syndrome. Functional analysis performed on the stable mutant protein showed selective disruption of the transforming growth factor beta signaling pathway, yet it maintained its wild-type ability to inhibit nuclear factor kappa B and to suppress JunD transcriptional activity. Conclusion To our knowledge, this is the first report of MEN1 syndrome associated with bilateral granulosa cell malignancy. We postulate that this presentation may be due to the novel menin gene mutation recently described.
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Affiliation(s)
- Michael J Hall
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Julie Innocent
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Christina Rybak
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Colleen Veloski
- Department of Internal Medicine, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Walter J Scott
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Hong Wu
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - John A Ridge
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - John P Hoffman
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Hossein Borghaei
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Aruna Turaka
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
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50
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Nunes N, Ambler G, Foo X, Naftalin J, Widschwendter M, Jurkovic D. Use of IOTA simple rules for diagnosis of ovarian cancer: meta-analysis. Ultrasound Obstet Gynecol 2014; 44:503-514. [PMID: 24920435 DOI: 10.1002/uog.13437] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/21/2014] [Accepted: 05/30/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To present data on prospective evaluation of the International Ovarian Tumor Analysis (IOTA) 'simple-rules' tool for the diagnosis of ovarian cancer and to perform a meta-analysis of studies that utilized the same diagnostic method. METHODS In the present study a level-II ultrasound operator systematically assessed the tumors of women with an ultrasound diagnosis of adnexal tumor(s) according to the IOTA simple-rules protocol to determine the risk of the tumor being malignant. The results of simple rules were compared with the 'pattern recognition' method and with histological findings. This validation study was included in the subsequent meta-analysis, for which we searched MEDLINE, EMBASE and Cochrane from the publication of the first study in 2008. The terms used were 'simple rules', 'simple rules ovarian', 'ovar tumor' and 'ultrasound'. Quality assessment was performed using the modified Quality Assessment of the Diagnostic Accuracy of Studies (QUADAS-2) checklist. Random effects meta-analysis was used to calculate pooled estimates of sensitivity and specificity for the simple-rules tool, and meta-regression was used to investigate heterogeneity across the studies. RESULTS Three hundred and three women were included in the validation study with 168 (55.4%) benign, 19 (6.3%) borderline and 116 (38.3%) malignant tumors on histological examination. The rules were applicable in 237 (78.2%) of the tumors and for these tumors, sensitivity was 96.2% (95% CI, 90.5-99.0%) and specificity was 88.6% (95% CI, 82.0-93.5%). Six of the 88 discovered studies were included in the meta-analysis along with the current validation study, which resulted in inclusion of a total of 3568 patients. When the meta-analysis was performed the pooled sensitivity (when the rules were applicable) was 93% (95% CI, 90-96%) (I(2) = 32.1%) and the pooled specificity was 95% (95% CI, 93-97%) (I(2) = 78.1%). Heterogeneity was observed across the studies. Sensitivity was higher and specificity lower in the study populations in which the prevalence of malignant tumors was greatest. CONCLUSION The simple rules protocol could be used in 76-89% of tumors and is an accurate test for the diagnosis of ovarian cancer. Assessment by an ultrasound expert is required when the protocol cannot be applied.
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Affiliation(s)
- N Nunes
- Gynaecological Diagnostic Outpatient Treatment Unit, University College Hospital, London, UK
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