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1
Anand, Santhosh, Sandip Chandrasekar, Kalayarasan Raja, and Biju Pottakkat. "Mucinous cystic neoplasm of the liver with biliary communication: an exception to the current classification." BMJ Case Reports 12, no. 1 (January 2019): bcr—2018–227063. http://dx.doi.org/10.1136/bcr-2018-227063.
Full textAbstract:
Cystic neoplasms of the liver are rare tumours. According to the recent WHO classification, they are classified into mucinous cystic neoplasm and intraductal papillary neoplasm based on the presence of ovarian-like stroma and biliary communication. We report two rare cases of mucinous cystadenoma of the liver with biliary communication and discuss the shortcomings of current classification.
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P., Swarnalatha, Rajasekhar Reddy S., and Chaitanya B. "Study of histomorphological spectrum of ovarian neoplasms: an institutional perspective." International Journal of Advances in Medicine 6, no. 5 (September 23, 2019): 1563. http://dx.doi.org/10.18203/2349-3933.ijam20194197.
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Background: Ovarian tumours account for one of the top five gynaecological malignancies in Indian women. The prime objective of the current study is to document the frequency, age distribution and diverse histomorphological spectrum of ovarian tumours in a peripheral institute in South India catering rural population.Methods: The study comprises of retrospective clinico pathological evaluation of 77 cases of ovarian neoplasms in Indian Red Cross Cancer Hospital, Nellore, India during a 4 year period ( January 2015 to December 2018 ). Non neoplastic ovarian lesions were excluded. Gross and microscopic histopathological examination was done for ovarian neoplasms. These were classified according to the WHO classification of ovarian tumours (2003).Results: Out of 77 cases studied, majority were malignant tumours (72.72%), followed by benign (23.38%) and borderline tumours (3.9%). Age ranged from 11-80 years. Epithelial tumours were the most common (75.32%), followed by sex cord stromal tumours (12.98%), germ cell tumours (9.09%) and metastatic ovarian tumours (1.3%). Serous cystadenoma was the commonest benign tumour and serous papillary carcinoma was the commonest malignant ovarian tumour.Conclusions: It is concluded from this study that on morphological grounds, tumours originating from surface epithelium are the most common. Higher incidence of malignant tumours supports the metaphor often used for ovarian malignancy “ the silent killer ”.
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Sharma, Manupriya, Anjali Soni, and Rashmi Kaul. "Histopathological pattern of ovarian neoplasms in Sub-Himalayan belt of rural India: a four-year study from a tertiary care teaching hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 12 (November 23, 2017): 5448. http://dx.doi.org/10.18203/2320-1770.ijrcog20175258.
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Background: Ovarian tumors are one of the ubiquitous and common forms of neoplasms in women. The aim of the study was to understand the pattern of benign and malignant ovarian neoplasms and their distribution in different age groups in rural population of India.Methods: A retrospective study conducted in the Department of Pathology in close collaboration with Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda (HP), India. All the patients irrespective of age group who were operated for ovarian neoplasms (benign or malignant) were included in this retrospective analysis over duration of four years (2013 to 2016). “WHO classification system” was used, for classification of all these ovarian tumors. The incidence of these tumors with respect to age group was also studied.Results: During the study period (2013-2016), there were a total of 242 surgeries for ovarian neoplasms. Of these, majority of the tumours were benign 184 (76%), but an alarming number of women had malignant ovarian tumours 51 (21%), remaining 7 (3%) cases were borderline. Age wise distribution was 7% (16/242) in less than 20 years age, 19% (46/242) in 20-30 years age, 29% (69/242) in 30-40 years age group, 24% (59/242) in 40-50 years and remaining 21% (52/242) in more than 50 years age group. Pre-dominantly benign tumors were surface epithelial tumors (serous/ mucinous cystadenoma), germ cell tumors (mature cystic teratoma) and endometrioma. Major malignant tumors were surface epithelial tumors (serous/mucinous cystadeno-carcinoma), and germ cell tumors (dysgerminoma, immature teratoma).Conclusions: In this sub-Himalayan belt of rural India, the incidence of benign ovarian tumors was 76%. Borderline ovarian tumors were seen in 3% cases and the remaining 21% cases were malignant ones. Even though benign tumors were the commonest for each age group, however as the age of women increased the proportion of malignant tumors in them increased. Surface epithelial tumors are the most common class of tumors in both benign and malignant tumors. Serous cystadenoma is the most common ovarian tumor overall as well as most common benign tumor whereas serous cystadeno-carcinoma is most common malignancy. Stromal ovarian tumor (one case) is a rarity. Only one woman had bilateral ovarian tumor.
4
Misdraji, Joseph. "Appendiceal Mucinous Neoplasms: Controversial Issues." Archives of Pathology & Laboratory Medicine 134, no. 6 (June 1, 2010): 864–70. http://dx.doi.org/10.5858/134.6.864.
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Abstract Low grade appendiceal mucinous neoplasms can spread to the peritoneum as pseudomyxoma peritonei even though they are not obviously invasive in the appendix. During the past several decades, several problematic issues surrounding this enigmatic tumor have been debated in the literature, including appropriate nomenclature for the appendiceal tumors and their peritoneal metastases. In this article, the most contentious issues in the area of appendiceal mucinous tumors are examined. First, the classification systems that have been proposed for these tumors are compared in the context of whether the appendiceal mucinous tumors are ruptured adenomas or invasive carcinomas. The controversy about the nature of pseudomyxoma peritonei and its classification systems is discussed in the following section. A brief discussion follows that examines the issue of localized pseudomyxoma peritonei and its clinical significance. Next reviewed is the largely resolved controversy about whether ovarian mucinous tumors in this setting are separate primaries or are metastases from the appendiceal tumor. Finally, the controversy about the most effective treatment of patients with pseudomyxoma peritonei is discussed.
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Turashvili, Gulisa, and Ricardo Lastra. "What’s new in gynecologic pathology 2021: ovary and fallopian tube." Journal of Pathology and Translational Medicine 55, no. 5 (September 15, 2021): 366–67. http://dx.doi.org/10.4132/jptm.2021.07.28.
Full textAbstract:
The 5th edition of the World Health Organization (WHO) Classification of Female Genital Tumors was published in 2020. Although the classification of ovarian and fallopian tube neoplasms is largely unchanged from the prior (4th) edition, this newsletter compiles the most important refinements in these organ sites, including serous and non-serous epithelial tumors, and sex cord-stromal tumors.
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Fatima, Rasheed, Sandhya M., and Sowmya T. S. "Study of histomorphological pattern of ovarian neoplastic and non-neoplastic lesions." International Journal of Research in Medical Sciences 5, no. 5 (April 26, 2017): 2095. http://dx.doi.org/10.18203/2320-6012.ijrms20171849.
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Background: The ovary is a striking exception to the Virchow’s dictum that organs that are frequently the site of primary cancer are rarely involved in secondary malignancy, and vice versa. Both primary and secondary carcinomas of the ovary are relatively frequent and show an astounding variety of pathologic patterns. The objectives were to study the histomorphological diversity of various neoplasms and non neoplastic lesions of ovary. To provide a specific diagnosis based upon the histomorphological study which is of paramount clinical significance in further management of the patient.Methods: The present study is based on histomorphological evaluation of 100 cases of ovarian neoplastic and non neoplastic lesions received at the department of Pathology, tertiary care hospital from June 2008 to Aug 2010.Results: A wide variation of age was noted. Among neoplastic lesions, majority of the cases were seen in age group of 20-39 years i.e., 50.6%. Non neoplastic lesion occurred in all age group, but majority of the incidences were seen in the age group of 20 to 40 years of age, accounting for 60% of total occurrence. the commonest ovarian tumor was serous cyst adenoma constituting 54.1% (46 cases) of all ovarian neoplasm. Mucinous cyst adenoma was the second most common tumor. There were 72 cases (85%) of benign, 2 cases (2%) of borderline and 11 cases (13%) of malignant tumors in the present study.Conclusions: The diversity of neoplasms makes it mandatory to classify the tumors accurately by histopathological features following universally accepted classification.
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Cho, Kathleen R. "Ovarian Cancer Update: Lessons From Morphology, Molecules, and Mice." Archives of Pathology & Laboratory Medicine 133, no. 11 (November 1, 2009): 1775–81. http://dx.doi.org/10.5858/133.11.1775.
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Abstract Ovarian carcinomas are a heterogeneous group of neoplasms. Pathologists currently employ a morphology-based classification system to divide ovarian carcinomas into major subgroups based on degree (tumor grade) and type of differentiation (eg, serous, endometrioid, clear cell, or mucinous). Molecular studies have shown that specific genetic defects are likely to be present in certain histologic types of ovarian carcinomas and unlikely to be present in others. Within the serous and endometrioid carcinomas, the molecular defects in low-grade versus high-grade tumors also appear to be largely distinct. Recently, mouse models of ovarian carcinoma have been developed that recapitulate many of the morphologic features and biologic behavior of selected subtypes of ovarian cancer. It is expected that these mouse models will yield new insights into ovarian cancer pathogenesis and prove useful for preclinical testing of novel strategies for ovarian cancer treatment.
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Nagamine and Mikami. "Ovarian Seromucinous Tumors: Pathogenesis, Morphologic Spectrum, and Clinical Issues." Diagnostics 10, no. 2 (January 31, 2020): 77. http://dx.doi.org/10.3390/diagnostics10020077.
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Ovarian seromucinous tumors were introduced in the 2014 World Health Organization (WHO) classification as one of the seven types of ovarian epithelial tumors. They are characterized by frequent association with endometriosis and bilaterality, microscopic appearance of papillary architecture, and admixture of a variety of müllerian-type epithelium. They are considered to be endometriosis-related ovarian neoplasms, along with endometrioid and clear cell tumors; recent molecular studies suggest this particular tumor is a variant of endometrioid tumor. Discrepancies in nomenclature, definition, and morphology of seromucinous tumors appear to be a source of confusion, for both clinicians and general surgicalpathologists. This review summarizes the clinicopathological features of benign, borderline, and malignant seromucinous tumors, as well as controversies regarding these tumors.
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Santandrea, Giacomo, Simonetta Piana, Riccardo Valli, Magda Zanelli, Elisa Gasparini, Antonio De Leo, Vincenzo Dario Mandato, and Andrea Palicelli. "Immunohistochemical Biomarkers as a Surrogate of Molecular Analysis in Ovarian Carcinomas: A Review of the Literature." Diagnostics 11, no. 2 (January 29, 2021): 199. http://dx.doi.org/10.3390/diagnostics11020199.
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The term “ovarian carcinoma” encompasses at least five different malignant neoplasms: high-grade serous carcinoma, low-grade serous carcinoma, endometrioid carcinoma, mucinous carcinoma, and clear cell carcinoma. These five histotypes demonstrated distinctive histological, molecular, and clinical features. The rise of novel target therapies and of a tailored oncological approach has demanded an integrated multidisciplinary approach in the setting of ovarian carcinoma. The need to implement a molecular-based classification in the worldwide diagnostic and therapeutic setting of ovarian cancer demanded a search for easy-to-use and cost-effective molecular-surrogate biomarkers, relying particularly on immunohistochemical analysis. The present review focuses on the role of immunohistochemistry as a surrogate of molecular analysis in the everyday diagnostic approach to ovarian carcinomas.
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Pillarisetty, Karishma, and Savithri Ravindra. "Immunohistochemical Study of CA 125 in Surface Epithelial Tumors of Ovary in Correlation with Serum Levels." Annals of Pathology and Laboratory Medicine 7, no. 7 (July 30, 2020): A355–360. http://dx.doi.org/10.21276/apalm.2798.
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Background:
Ovarian carcinoma is the 4th leading cancer among women in India. Primary ovarian neoplasms exhibit a wide range of histopathological patterns and tumors with epithelial differentiation are most frequent. Among malignant tumors, most common histological type is serous adenocarcinoma whose diagnosis is established in advanced stages of disease in approximately 75% of patients.
The most widely used tumor marker in ovarian cancer, often considered “gold standard” is Cancer Antigen125. Cancer Antigen 125 is a high molecular weight glycoprotein which is raised in approximately 90% of patients with advanced epithelial ovarian cancer.
Methods:
A 2 year prospective study included 81 cases of ovarian neoplasms with surface epithelial differentiation. The specimens were fixed in 10% formalin, routinely processed. Sections of 4-5 microns thickness were obtained from the paraffin block and stained with Hematoxylin & Eosin. The tumors were categorised according to WHO classification. Immunohistochemical analysis of Cancer Antigen 125 was done in all malignant & borderline tumors.
Result:
A total of 81 cases were studied. There were 15 cases with elevated serum Cancer Antigen 125 levels. Of these 8 showed positive tissue expression. The sensitivity of serum Cancer Antigen 125 was 68.75% & its specificity was 93.8%.
Conclusion:
Serum Cancer Antigen 125 is elevated in ovarian tumors especially in malignant surface epithelial tumors & more commonly in serous cystadenocarcinoma. There was a good correlation between serum levels & tissue expression of Cancer Antigen 125.
11
Sahin, Hilal, Asli Irmak Akdogan, Janette Smith, Jeries Paolo Zawaideh, and Helen Addley. "Serous borderline ovarian tumours: an extensive review on MR imaging features." British Journal of Radiology 94, no. 1125 (September 1, 2021): 20210116. http://dx.doi.org/10.1259/bjr.20210116.
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Serous borderline ovarian tumours (SBOTs) are an intermediate group of neoplasms, which have features between benign and malignant ovarian tumours and for which, fertility-sparing surgery can be offered. MRI in imaging of SBOTs is, therefore, crucial in raising the possibility of the diagnosis, in order to present the patient with the most appropriate treatment options. There are characteristic MRI features that SBOTs demonstrate. In addition, recent advanced techniques, and further classification into subtypes within the borderline group have been developed. The aim of this article is to review the MRI features of SBOT and provide the reporter with an awareness of the imaging tips and tricks in the differential diagnosis of SBOT.
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Malenkovic, Goran, Tihomir Dugandzija, Aljosa Mandic, Marija Velaga, Olivera Tesic, and Marina Popovic. "Linear trend in patients with ovarian cancer in period 2001-2008 at Oncology Institute of Vojvodina." Medical review 63, no. 9-10 (2010): 607–10. http://dx.doi.org/10.2298/mpns1010607m.
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Introduction. Ovarian cancer is one of the leading health problems, as it is the underlying cause of disease and deaths of a large number of women around the world. Postmenopausal female population, in whom ovarian carcinoma is most often diagnosed in advanced stages of the disease, is primarily affected. Material and methods. We used data from Hospital Registry for Malignant Neoplasms at Oncology Institute of Vojvodina, for the period from 2001 to 2008, according to which 422 cases of ovarian carcinoma were reported. The obtained data were classified into three groups according to FIGO classification of ovarian malignant neoplasms. The statistical assessment of data employed the method of linear trend and tests of statistical significance (t-test). Results. The results of our study showed that most cases of diagnosed disease were advanced forms of ovarian cancer, FIGO stages II and IV. The linear trend of the reported cases in stage I for the period 2001/2008 showed a descending trend. According to the processed data, in the same period of time, stage II showed an ascending trend, while stages III and IV described together showed a moderate ascending linear trend. Conclusion. A vast majority of cases of ovarian cancer are detected in advanced stages of the disease, which is at the same time the group with the worst prognosis. Special attention should be paid to the group of patients with positive family history, as well as the presence of BRCA1 and BRCA 2 genetic mutations. Currently existing diagnostic procedures have not given good results individually in terms of high sensitivity for diagnosis of early stages.
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De Paolis, Elisa, Rosa Maria Paragliola, and Paola Concolino. "Spectrum of DICER1 Germline Pathogenic Variants in Ovarian Sertoli–Leydig Cell Tumor." Journal of Clinical Medicine 10, no. 9 (April 23, 2021): 1845. http://dx.doi.org/10.3390/jcm10091845.
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Sertoli–Leydig Cell Tumors (SLCTs) are rare ovarian sex cord-stromal neoplasms, which predominantly affect adolescents and young female adults. The SLCTs clinical diagnosis and treatment remains challenging due to the rarity and the varied presentation. A large majority of SLCTs are unilateral, but also bilateral neoplasms have been reported, sometimes in the context of DICER1 syndrome. In fact, the most significant discovery regarding the molecular genetics basis of SLCTs was the finding of somatic and germline pathogenic variants in the DICER1 gene. The DICER1 protein is a key component of the micro-RNA processing pathway. Germline DICER1 pathogenic variants are typically inherited in an autosomal dominant pattern and are most often loss-of-function variants dispersed along the length of the gene. Contrarily, DICER1-related tumors harbor a characteristic missense “RNase IIIb hotspot” mutation occurring in trans, or, less frequently, loss of heterozygosity (LOH) event involving the wild-type allele. While DICER1 mutations have been identified in approximately 60% of SLCTs, especially in the moderately or poorly differentiated types, there are only a few case reports of ovarian SLCT with underlying germline DICER1 mutations. In this review, we focus on the molecular genetic features of SLCT, performing an extensive survey of all germline pathogenic variants modifying the whole sequence of the DICER1 gene. We point out that DICER1 genetic testing, coupled with an accurate variants classification and timely counseling, is of crucial importance in the clinical management of ovarian SLCT-affected patients.
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De Leo, Antonio, Donatella Santini, Claudio Ceccarelli, Giacomo Santandrea, Andrea Palicelli, Giorgia Acquaviva, Federico Chiarucci, et al. "What Is New on Ovarian Carcinoma: Integrated Morphologic and Molecular Analysis Following the New 2020 World Health Organization Classification of Female Genital Tumors." Diagnostics 11, no. 4 (April 14, 2021): 697. http://dx.doi.org/10.3390/diagnostics11040697.
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Ovarian carcinomas represent a heterogeneous group of neoplasms consisting of separate entities with distinct risk factors, precursor lesions, pathogenesis, patterns of spread, molecular profiles, clinical course, response to chemotherapy, and outcomes. The histologic subtype and the related molecular features are essential for individualized clinical decision-making. The fifth edition of the World Health Organization classification of tumors of the female genital tract divides ovarian carcinomas into at least five main and distinct types of ovarian carcinomas: high-grade serous carcinoma, low-grade serous carcinoma, endometrioid carcinoma, clear cell carcinoma, and mucinous carcinoma. Molecular pathology has improved the knowledge of genomic landscape of ovarian carcinomas identifying peculiar alterations for every histologic subtype. It is well-known that high-grade and low-grade serous carcinomas are separate entities with entirely different morphologic and molecular characteristics. TP53 and BRCA mutations are typical of high-grade serous carcinoma, whereas BRAF and KRAS mutations frequently occur in low-grade serous carcinoma. Endometrioid and clear cell carcinomas are frequently associated with endometriosis. Endometrioid tumors are characterized by β-catenin alterations, microsatellite instability, and PTEN and POLE mutations, while ARID1A mutations occur in both endometrioid and clear cell carcinomas. Mucinous carcinomas are uncommon tumors associated with copy-number loss of CDKN2A and KRAS alterations and metastasis from other sites should always be considered in the differential diagnosis.
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V., Anitha Pallikkara, and Shameem K. Ummer Ali. "Histopathological profile of ovarian tumors in a tertiary care center- a descriptive study." International Journal of Research in Medical Sciences 9, no. 4 (March 26, 2021): 1010. http://dx.doi.org/10.18203/2320-6012.ijrms20211342.
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Background: Ovarian neoplasms are a heterogeneous group of tumors with varied clinical, morphological and histological features. Ovarian cancer accounts for about 3% of all cancer in females and is the 5th most common cause of death due to cancer because most ovarian tumors spread beyond ovary by the time of diagnosis. The objective of the study was to document the histological pattern and prevalence of ovarian tumors in specimens received at department of pathology government medical college Alappuzha.Methods: This was a prospective study of 18 months duration which comprised of 245 cases of ovariectomy and ovariotomy specimens received in the department of pathology, govt. T.D medical college Alappuzha, Kerala. After detailed and thorough gross examination of the specimens, bits from representative areas were routinely processed and stained with H and E. Tumors were classified as per WHO classification. Appropriate immunohistochemical studies were performed wherever required.Results: Out of 245 cases studied, majority were benign tumors (78.36%), followed by malignant tumors (15. 11%). Borderline tumors comprised (6.53%) of the total cases. Age groups studied ranged from 11-70 years. Epithelial tumors were the most common (76.32%) followed by germ cell tumors (17.55%), sex cord stromal tumors (5.03%) and carcinoma arising in germ cell tumors (0.81%). Serous cystadenoma was found to be the commonest benign tumor and serous cystadenocarcinoma was the commonest malignant ovarian neoplasm.Conclusions: Surface epithelial tumors were the most common ovarian tumors. The maximum number of tumors were noted in the age group 21-40 years. Malignant tumors were common above 40 years.
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Spiridonova, N. V., and A. A. Demura. "Features of laboratory data in the early diagnosis of tumors and ovarian tumours." Meditsinskiy sovet = Medical Council, no. 9 (July 30, 2020): 206–12. http://dx.doi.org/10.21518/2079-701x-2020-9-206-212.
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At the moment, there are a huge number of risk factors for the development of a tumor process in the ovaries. One of the fundamental niches that allow us to suspect the presence of an imbalance in the body, and the presence of neoplasms is laboratory diagnostics. The purpose of our work was to evaluate changes in laboratory blood tests as a predictor of the development of oncological tumor process in the ovaries in patients of reproductive age (18-40 years). The collection and processing of laboratory data of 168 outpatient and inpatient medical histories of patients of reproductive age, operated on the basis of the Department of oncogynecology of the sbuz SOKOD for tumors and ovarian tumours from 2012 to 2015. Statistical analysis was performed using the statistical package SPSS21, license number 20130626-3 (An IBM Company; USA) and Microsoft Excel (Microsoft; USA). To achieve this goal, the patients were divided into groups according to the who morphological classification of 2013. A study of clinical blood analysis and biochemical blood analysis at the preoperative and early postoperative stages of treatment was conducted. The CA-125 titer was evaluated in two stages: as a qualitative and quantitative indicator. A study was also conducted for the presence of a genetic mutation in the BRCA 1 and 2 genes by taking a blood sample. In conclusion, we can conclude that on the basis of laboratory data it is impossible to conduct a differential diagnosis between tumors and tumor-like formations of the ovaries. When evaluating changes in General clinical blood tests, no significant changes were detected. Our work in a group of patients of reproductive age revealed the absence of mutations in the BRCA 1 and 2 genes. There was a significant increase in the tumor marker of the CA-125 titer (p = 0.015) in a group of patients with tumors and ovarian tumours aged 18–40 years.
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Davydova, Irina I., Marina A. Chekalova, Apollon I. Karseladze, Viktor V. Kuznetsov, Liudmila A. Meshcheriakova, Tatiana V. Dedy, Evgenii I. Cherkasov, and Alena S. Zharova. "Serous borderline ovarian tumors: modern possibilities of ultrasound diagnostics in monitoring the course of the disease after organ-preserving operations." Journal of Modern Oncology 23, no. 1 (May 19, 2021): 106–11. http://dx.doi.org/10.26442/18151434.2021.1.200578.
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Relevance. Borderline ovarian tumors (BOT) occur mainly in women of reproductive age and account for 20% of all neoplasms of the female genital organs. Currently, there is an increase in the incidence of ВОТ. One of the reasons for the increase in morbidity is the improvement of knowledge and experience in relation to the morphological diagnosis of tumors of low malignancy potential. Nevertheless, the results of a preliminary instrumental assessment of the nature of the disease and the final diagnosis formed by histological examination are not always satisfactory, since borderline tumors are a thin layer that occupies an intermediate position between benign and malignant tumors. And, in spite of the fact that ВОТ is an independent nosological form in the histological classification, nevertheless, they have signs of both benign and malignant neoplasms. In this regard, the complexity of both instrumental and morphological diagnostics of ВOT becomes understandable, and, therefore, difficulties arise in determining the tactics of treatment, choosing the optimal operation, and the need for drug therapy. All these issues are directly related to the patients quality of life, and, most importantly, to survival. Because an incorrectly established diagnosis entails incorrect treatment and unsatisfactory results. Thus, the study of the peculiarities of ВOT diagnostics is extremely important. The ultrasound computed tomography method is simple, relatively cheap and affordable. Considering that almost all patients with ovarian neoplasms undergo this type of examination, it is extremely important and interesting to assess the role of the ultrasound method in the diagnosis of ВОТ. Moreover, at present more and more gynecological oncologists are resorting to organ-preserving surgical interventions for ВOТ. Therefore, it is especially important to study the possibility of ultrasound diagnostics in monitoring the course of the disease after breast-conserving operations, identifying recurrences of the disease in the ovary, differentiating recurrence and cystic formations of the ovaries.
Aim. To determine the effectiveness of computer-assisted ultrasound diagnostics in monitoring the course of BOT after breast-conserving operations.
Materials and methods. At Blokhin National Medical Research Center of Oncology carried out a retrospective and prospective analysis of 405 patients with serous BOT for the period 19702013. The age of the patients varied in a wide range, the minimum was 15, the maximum was 78 years, the median corresponded to 38 years. Before the start of treatment, the patients underwent an ultrasound examination (ultrasound) of the abdominal organs, the pelvic organs and the retroperitoneal space. The studies were carried out on expert ultrasonic systems Siemens ACUSON S2000, Hitachi ARIETTA V70 and Philips EPIQ 5.
Results. We studied the capabilities of the ultrasound method for diagnosing serous BOT based on the analysis of morpho-ultrasound comparisons in patients after conservative and ultra-conservative operations.
Conclusion. It has been established that ultrasound diagnostics is of decisive importance both in the initial diagnosis and in the dynamic observation of patients with conservative and ultra-conservative surgery for serous BOT. Echography makes it possible to diagnose a tumor in the ovary in 83.3% of cases and to reject the diagnosis in 86.7% of cases.
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Postlewait, Lauren McLendon, Cecilia G. Ethun, Nipun B. Merchant, Alexander A. Parikh, Kamran Idrees, William G. Hawkins, Ryan C. Fields, et al. "A multi-center study of 349 pancreatic mucinous cystic neoplasms: Preoperative risk factors for adenocarcinoma." Journal of Clinical Oncology 34, no. 4_suppl (February 1, 2016): 231. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.231.
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231 Background: Pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma per WHO 2000 classification. Given their malignant potential, current guidelines recommend resection. However, there are limited data on preoperative risk factors for adenocarcinoma (AC) and high grade dysplasia (HGD) occurring in an MCN. Methods: MCN resections from 2000-2014 at the 8 institutions of the Central Pancreas Consortium were included. Patients with and without AC/HGD were compared. Primary aims were to determine preoperative risk factors for AC/HGD in an MCN and to assess outcomes of MCN-associated AC. Results: Of 1667 resections for pancreatic cystic lesions, 349 pts (21%) had an MCN with 52 (15%) having MCN-associated AC/HGD. Male gender (29 vs 8%; p<0.001), head/neck location (39 vs 13%; p<0.001), increased MCN size (7.2 vs 4.6 cm; p=0.004), radiographic presence of a solid component/mural nodule (54 vs 20%; p<0.001), and duct dilation (43 vs 12%; p<0.001) were associated with AC/HGD compared to benign MCN. All persisted as independent predictors of MCN-associated AC/HGD (Table). AC/HGD was not associated with presence of radiographic septations or preoperative cyst fluid analysis (CEA, amylase, or mucin). Median CA19-9 for patients with AC/HGD was 210 vs 15 U/ml for those without (p=0.001). In the 44 pts with AC, 41 (93%) had lymph nodes harvested with nodal metastases in only 14 (34%). Median FU for pts with AC was 27 mos. AC recurred in 12 pts (27%) with a 3-yr RFS of 59%. OS for pts with MCN-associated AC was 64% at 3 yrs. Conclusions: Adenocarcinoma or high grade dysplasia is present in 15% of resected pancreatic mucinous cystic neoplasms. Pre-operative factors associated with AC/HGD in an MCN include male gender, head/neck location, larger MCN, solid component/mural nodule, and duct dilation on imaging. MCN-associated AC appears to have decreased LN involvement and increased RFS and OS compared to typical pancreatic ductal adenocarcinoma. [Table: see text]
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Melgaard, Daniel Taasti, Trine Stokbro Korsgaard, Martin Soendergaard Thoefner, Morten Roenn Petersen, and Hanne Gervi Pedersen. "Moody Mares—Is Ovariectomy a Solution?" Animals 10, no. 7 (July 16, 2020): 1210. http://dx.doi.org/10.3390/ani10071210.
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Unwanted behaviour in mares is a commonly presenting problem to the veterinarian. This behaviour may range from the mare being uncooperative or aggressive when handled on the ground, kicking, bucking or rearing when ridden or being aggressive towards other horses. This purpose of the study was to evaluate whether bilateral ovariectomy in mares with unwanted behaviour improved the mare’s behaviour and/or rideability from the owner’s perspective. The mares were grouped and compared statistically based on their histological classification as having either “normal” or neoplastic ovaries. This study is a retrospective case series report of twenty-eight ovariectomized mares. A semi-quantitative value (1–10) pre- and post-ovariectomy for A) behaviour on ground/in stable and B) rideability was given, based on the owner’s observations. The horses were grouped based on their histopathologic diagnosis as “Normal ovaries” or “Neoplasia”. Following ovariectomy, rideability improved, with a score of ≥5 in 80% (8/10) of mares with normal ovaries and in 57% (8/14) of mares with ovarian neoplasm. A behavioural improvement of ≥5 was observed in 40% (4/10) of mares with normal ovaries, and in 43% (6/14) of mares with ovarian neoplasm. A significant difference was observed between the semi-quantitative value pre- and post-ovariectomy in both groups. No difference was observed in change in behaviour and rideability score between the group with normal ovaries and neoplastic ovaries. Mares with unwanted behaviour not obviously related to the oestrus cycle and to painful conditions may benefit from ovariectomy to alter their behaviour and rideability.
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Vavinskaya, Vera, Joel M. Baumgartner, Albert Ko, Cheryl C. Saenz, and Mark A. Valasek. "Low-Grade Appendiceal Mucinous Neoplasm Involving the Endometrium and Presenting with Mucinous Vaginal Discharge." Case Reports in Obstetrics and Gynecology 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/6841989.
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Primary appendiceal mucinous lesions are uncommon and represent a spectrum from nonneoplastic mucous retention cysts to invasive adenocarcinoma. Low-grade appendiceal mucinous neoplasms (LAMNs) represent an intermediate category on this spectrum and can be classified according to whether or not they are confined to the appendix. Although LAMNs are frequently confined to the appendix, they can also spread to the peritoneum and clinically progress as pseudomyxoma peritonei (i.e., mucinous ascites). Thus, the appropriate classification of appendiceal primary neoplasia is essential for prognosis and influences clinical management. In addition, the precise classification, management, and clinical outcome of patients with disseminated peritoneal disease remain controversial. Here, we report an unusual case of LAMN with pseudomyxoma peritonei that initially presented with mucinous and bloody vaginal discharge. Pathological evaluation revealed low-grade appendiceal mucinous neoplasm with secondary involvement of the peritoneum, ovaries, and endometrial surface. Therefore, LAMN should be considered in the differential diagnosis of mucinous vaginal discharge.
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Shakuntala, P. N., K. Uma Devi, K. Shobha, U. D. Bafna, and M. Geetashree. "Pure Large Cell Neuroendocrine Carcinoma of Ovary: A Rare Clinical Entity and Review of Literature." Case Reports in Oncological Medicine 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/120727.
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Large cell neuroendocrine carcinoma (LCNEC) of the ovary is a rare tumor and is now included in the World Health Organization tumor classification. Its prognosis is generally very poor even when the diagnosis is made at an early stage. We report a case of pure large cell neuroendocrine tumour of ovary, appearing 9 months following laparoscopic type I hysterectomy, bilateral pelvic lymph node dissection with ovarian preservation of anatomically normal looking ovaries performed for a cervical biopsy diagnosis of cervical intraepithelial neoplasia grade III with foci of invasion. The rarity lies in the rapid onset (9 months) of a large tumor following conservation of an anatomically normal ovaries. Surgical debulking and five cycles of chemotherapy (Etoposide and Cisplatin) were administered to the woman. She is on followup with no clinical or radiological evidence of disease recurrence for 6 months.
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Mishra, Bagmi, Madhusmita Rout, Ritu Pradhan, Subhalaxmi Mahapatra, and Sashibhusan Dash. "Histopathological classification of ovarian neoplasm: a retrospective study of 612 cases from a regional cancer centre, Odisha, India." International Journal of Research in Medical Sciences 8, no. 4 (March 26, 2020): 1266. http://dx.doi.org/10.18203/2320-6012.ijrms20201307.
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Background: Ovarian cancer is the leading cause of cancer related death amongst women in India. Identification of histological types helps to predict tumor behaviour and further appropriate management. Aims and objectives is to study the histopathological parameters of ovarian tumor.Methods: This retrospective study was done on patients who presented ovarian mass and subsequently underwent surgery in a Regional Cancer Centre, Odisha, over a period of three years from January 2016 to December 2018. All datas such as age, site, gross findings and histological tumor types were retrieved from pathology and analyzed using MS Excel worksheet.Results: A total 612 cases of ovarian tumor were included for study. Non-neoplastic to neoplastic tumor ratio was 1:7.74. Surface epithelial tumors comprised the majority of tumors, accounting for 452 cases (83.39%). Malignant lesions were predominant in this series 416 cases (76%). Majority of borderline tumors were of mucinous subtype 20 (76.92%). The Mean±SD ages of all benign comprising, borderline and malignant tumors were 47.4±11.9, 44.9±14.3 and 46.9±13, respectively. On the basis of two tired grading system, high grade malignant serous tumors were maximum, 226 (74.34%). Ovarian surface involvement, omental invasion, uterine invasion, LVSI, capsular invasion and pelvic lymph node involvement was observed in 146 (35.26%), 106 (25.6%), 12 (2.89%), 70 (16.9%), 6 (1.44%) and 12 (2.89%) respectively. According to the FIGO staging system, among primary malignant tumor, 58% patients were presented in late stage (III and IV).Conclusions: The high incidence of malignant ovarian tumor with late presentation was observed in our study. So, further study is warranted to elucidate the major factors in our population.
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Das, Manish Kumar, and Sita Ghimire. "Histopathological Study of Ovarian Lump and Serum Tumor Marker Ca 125 estimation as a Screening Tool." Journal of Nobel Medical College 7, no. 1 (August 22, 2018): 30–36. http://dx.doi.org/10.3126/jonmc.v7i1.20844.
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Background: Ovarian tumor is the fourth commonest cancer in female in Nepal. About 80% is benign and 20% of these tumors are malignant. Due to its complex nature, vagueness and non-specificity of the symptoms it produces, the ovarian neoplasm can mislead both the doctor and patients. Hence this study was undertaken with aims & objectives to study the morphology of ovarian specimens as well as estimate serum CA125 as screening tool. Material and Methods: A study of over one year comprised of 75 specimens of ovary diagnosed in the Department of Pathology, Nobel medical college and teaching hospital, Biratnagar. After thorough gross examination and preparation of H&E stained slides the lesion of ovary were classified as per WHO classification. Also, preoperative blood samples were obtained from patients for estimation of serum CA125 level. Blood samples was also drawn from 20 healthy females in reproductive age group who acted as controls. Results: Of the 75 cases of ovarian mass, based on histology 75% were benign, and 25% were malignant. Surface epithelial tumors were the commonest (68%) of all ovarian tumor, followed by germ cell tumors (13%), sex cord–stromal tumors (6%). Serous Cystadenoma (29%) was the commonest benign tumor and serous cystadenocarcinoma (9%) commonest malignant neoplasm. CA125 levels was raised in epithelial ovarian cancers. Maximum rise was seen in serous cystadenocarcinoma. Exceptionally a small percentage of epithelial cancer showed normal level (false negative). Also, few benign tumors, non-epithelial tumors and even non-neoplastic lesions showed false positive rise in CA125 (false positive). Conclusion: Accurate histopathological evaluation of ovarian specimen is necessary both in terms of therapeutic intervention as well as prognosis. CA125 is an important screening tool for detection of epithelial ovarian cancers. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 30-36
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Kaspar, Hanna G., and Christopher P. Crum. "The Utility of Immunohistochemistry in the Differential Diagnosis of Gynecologic Disorders." Archives of Pathology & Laboratory Medicine 139, no. 1 (January 1, 2015): 39–54. http://dx.doi.org/10.5858/arpa.2014-0057-ra.
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Context Immunohistochemistry has assumed an increasing role in the identification and characterization of gynecologic disorders including lesions with deceptively bland morphology, uncommon and underdiagnosed neoplasms, and neoplasms with specific genetic alterations associated with overexpression or loss of expression of specific proteins. The diagnostic accuracy has been significantly improved owing to the discovery and increasing experience with the tumor-associated biomarkers, and the increasing demand for precise tumor classification to assess suitability for the expanding therapeutic modalities including clinical trials. Objective To differentiate lesions of the gynecologic tract through the use of effective immunohistochemical panels. Data Sources Literature review and authors' personal practice experience. Conclusions The application of diagnostic and prognostic immunohistochemical panels has enabled pathologists to better guide therapeutic decisions and to better predict the clinical outcome. It is now well established that the use of ancillary testing, including immunohistochemistry, has a significant power in the identification, differentiation, and classification of reactive, premalignant, and malignant gynecologic disorders. This article discusses the utilities and pitfalls of the commonly used immunohistochemical markers in the context of overlapping morphologic features encountered in the uterus, ovaries, and fallopian tubes.
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Saha, Joysree, Sohana Siddique, Sumaya Akter, Md Abdul Quader, Indrajit Prasad, Sharmina Siddique, Saleha Alam, and Shafinaz Mehzabin. "A Retrospective Clinicopathological Study of Malignant Ovarian Tumors: A 3 Year Experience in a Tertiary Health Care Center of Dhaka, Bangladesh." Journal of Dhaka Medical College 29, no. 2 (January 5, 2021): 100–105. http://dx.doi.org/10.3329/jdmc.v29i2.51182.
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Background: Ovarian tumors are a heterogeneous group of neoplasm that have become increasingly important now-a-days because of their large variety of neoplastic entities and gradually increased rate of mortality due to female genital cancers.
Objectives: The aim of this study was to analyze the histopathological pattern and clinical presentation of malignant ovarian tumors according to the WHO classification of ovarian tumors [2003] in a tertiary care center of Dhaka, Bangladesh.
Materials and Methods: This retrospective study included and studied a total of 54 cases of malignant ovarian tumors at the Department of Obstetrics and Gynecology, Popular Medical College Hospital, Dhaka, Bangladesh over a period of 3 years from Jan 2015 to Dec 2017.
Results: The mean age was 47.44±14.24 years old (age ranged from 20-70 years). Of the 54 malignant ovarian tumors studied, the commonest histological pattern observed in the study was serous cyst adenocarcinoma constituting 26 cases (48.15%) followed by adenocarcinoma of ovary (25.9%), mucinous cyst adenocarcinoma (14.8%), endometriod adenocarcinoma (3.7%), dysgerminoma (3.7%) and ovarian choriocarcinoma (3.7%). High level of serum CA125 was found in most of the cases (n=48; 88.89%). The chief complaints were abdominal pain (n=38; 70.37%) and abdominal distension (n=29; 53.70%). Majority were admitted with less than one month duration of symptoms. The size of the tumor varied from 2.2 to 20 cm. All the patients were admitted in III and IV stage.
Conclusions: Serous cyst adenocarcinoma was the common finding of this study. The prognosis and varying therapeutic strategies of malignant ovarian tumors necessitate an accurate histopathological evaluation.
J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 100-105
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Stukan, Maciej, Juan Luis Alcazar, Jacek Gębicki, Elizabeth Epstein, Marcin Liro, Alexandra Sufliarska, Sebastian Szubert, et al. "Ultrasound and Clinical Preoperative Characteristics for Discrimination Between Ovarian Metastatic Colorectal Cancer and Primary Ovarian Cancer: A Case-Control Study." Diagnostics 9, no. 4 (December 1, 2019): 210. http://dx.doi.org/10.3390/diagnostics9040210.
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The aim of this study was to describe the clinical and sonographic features of ovarian metastases originating from colorectal cancer (mCRC), and to discriminate mCRC from primary ovarian cancer (OC). We conducted a multi-institutional, retrospective study of consecutive patients with ovarian mCRC who had undergone ultrasound examination using the International Ovarian Tumor Analysis (IOTA) terminology, with the addition of evaluating signs of necrosis and abdominal staging. A control group included patients with primary OC. Clinical and ultrasound data, subjective assessment (SA), and an assessment of different neoplasias in the adnexa (ADNEX) model were evaluated. Fisher’s exact and Student’s t-tests, the area under the receiver–operating characteristic curve (AUC), and classification and regression trees (CART) were used to conduct statistical analyses. In total, 162 patients (81 with OC and 81 with ovarian mCRC) were included. None of the patients with OC had undergone chemotherapy for CRC in the past, compared with 40% of patients with ovarian mCRC (p < 0.001). The ovarian mCRC tumors were significantly larger, a necrosis sign was more frequently present, and tumors had an irregular wall or were fixed less frequently; ascites, omental cake, and carcinomatosis were less common in mCRC than in primary OC. In a subgroup of patients with ovarian mCRC who had not undergone treatment for CRC in anamnesis, tumors were larger, and had fewer papillations and more locules compared with primary OC. The highest AUC for the discrimination of ovarian mCRC from primary OC was for CART (0.768), followed by SA (0.735) and ADNEX calculated with CA-125 (0.680). Ovarian mCRC and primary OC can be distinguished based on patient anamnesis, ultrasound pattern recognition, a proposed decision tree model, and an ADNEX model with CA-125 levels.
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Porcu, Eleonora, Giulia Maria Cillo, Linda Cipriani, Federica Sacilotto, Leonardo Notarangelo, Giuseppe Damiano, Maria Dirodi, and Ilaria Roncarati. "Impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcomes in young women with breast cancer." Journal of Assisted Reproduction and Genetics 37, no. 3 (December 24, 2019): 709–15. http://dx.doi.org/10.1007/s10815-019-01658-9.
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Abstract Purpose To determine the impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcome. The main purpose and research question of the study is to determine the impact of BRCA1 and BRCA2 mutations on ovarian reserve and fertility preservation outcomes. Methods Prospective study: 67 breast cancer patients between 18 and 40 years old, undergoing a fertility preservation by means of oocyte storage were considered. Inclusions criteria for the study were age between 18 and 40 years old, BMI between 18 and 28, breast cancer neoplasm stage I and II according to American Joint Committee on Cancer classification (2017) and no metastasis. Exclusion criteria: age over 40 years old, BMI < 18 and > 28, breast cancer neoplasm stage III and IV and do not performed the BRCA test. A total of 21 patients had not performed the test and were excluded. Patients were divided into four groups: Group A was composed by 11 breast cancer patients with BRCA 1 mutations, Group B was composed by 11 breast cancer patients with BRCA 2 mutations, Group C was composed by 24 women with breast cancer without BRCA mutations, and Group D (control) was composed by 181 normal women. Results Group A showed significant lower AMH levels compared to Group C and D (1.2 ± 1.1 vs 4.5 ± 4.1 p < 0.05 and 1.2 ± 1.1 vs 3.8 ± 2.5 p < 0.05). BRCA1 mutated patients showed a significant lower rate of mature oocytes (MII) compared to Group C (3.1 ± 2.3 vs 7.2 ± 4.4 p < 0,05) and Group D (3.1 ± 2.3 vs 7.3 ± 3.4; p < 0,05). Breast cancer patients needed a higher dose of gonadotropins compared to controls (Group A 2206 ± 1392 Group B2047.5 ± 829.9 Group C 2106 ± 1336 Group D 1597 ± 709 p < 0,05). No significant differences were found among the groups considering basal FSH levels, duration of stimulation, number of developed follicles, and number of total retrieved oocytes. Regarding BRCA2 mutation, no effect on fertility was shown in this study. Conclusions The study showed that BRCA1 patients had a higher risk of premature ovarian insufficiency (POI) confirmed by a diminished ovarian reserve and a lower number of mature oocytes suitable for cryopreservation.
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Kai, Keita, Mariko Hashiguchi, Makiko Kurihara, Yuya Tanaka, Sho Kitamura, Mitsuo Nakamura, Chika Shichijo, et al. "Cytological Appearances of Ovarian Seromucinous Borderline Tumor in Ascites: Presentation of 2 Cases." Acta Cytologica 65, no. 5 (2021): 440–47. http://dx.doi.org/10.1159/000517313.
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<b><i>Background:</i></b> Seromucinous borderline tumor (SMBT) is a rare neoplasm which was newly defined in the 2014 WHO classification. Although the clinical and histopathological characteristics of SMBT have been well described, its cytological characteristics have not. We recently experienced 2 cases of SMBT which were defined by cytological findings of ascites. <b><i>Case Presentation:</i></b> Case 1 was a 65-year-old Japanese woman. Preoperative imaging studies revealed abundant ascites and a cystic tumor, with a solid component measuring 13 cm on the left ovary. Radical surgery was performed during the intraoperative diagnosis of ovarian borderline tumor, made by histological examinations of frozen tumor sections. The cytological smears of preoperatively and intraoperatively collected ascites showed many atypical cells resembling reactive mesothelial cells. Alcian-blue staining of cell block sections revealed intracytoplasmic mucin, and the results of immunohistochemistry were consistent with SMBT. The final pathological diagnosis of tumor was SMBT. Case 2 was a 28-year-old Japanese woman. Preoperative imaging studies revealed a small amount of ascites and cystic tumors with solid components in the bilateral ovaries. She initially underwent fertility preservation surgery. SMBT was suspected by cytological examination of smears of intraoperatively collected ascites and the findings of cell block. She underwent additional radical surgery based on a final pathological diagnosis of SMBT. <b><i>Conclusion:</i></b> In our experience, the tumor cells of SMBT in ascites mimicked reactive mesothelial cells. The nuclear atypia of SMBTs was intermediate between that of reactive mesothelial cells and serous carcinoma. The immunohistochemistry and mucin staining using cell block were very helpful for facilitating the cytodiagnosis of SMBT.
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Giovannini, Elisabetta, Giampiero Giovacchini, Elisa Borsò, Patrizia Lazzeri, Mattia Riondato, Rossella Leoncini, Valerio Duce, and Andrea Ciarmiello. "[68Ga]-Dota Peptide PET/CT in Neuroendocrine Tumors: Main Clinical Applications." Current Radiopharmaceuticals 12, no. 1 (March 4, 2019): 11–22. http://dx.doi.org/10.2174/1874471012666181212101244.
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Objective: Neuroendocrine Neoplasms (NENs) are generally defined as rare and heterogeneous tumors. The gastrointestinal system is the most frequent site of NENs localization, however they can be found in other anatomical regions, such as pancreas, lungs, ovaries, thyroid, pituitary, and adrenal glands. Neuroendocrine neoplasms have significant clinical manifestations depending on the production of active peptide. Methods: Imaging modalities play a fundamental role in initial diagnosis as well as in staging and treatment monitoring of NENs, in particular they vastly enhance the understanding of the physiopathology and diagnosis of NENs through the use of somatostatin analogue tracers labeled with appropriate radioisotopes. Additionally, the use of somatostatin analogues provides the ability to in-vivo measure the expression of somatostatin receptors on NEN cells, a process that might have important therapeutic implications. Results: A large body of evidences showed improved accuracy of molecular imaging based on PET/CT radiotracer with SST analogues (e.g. [68Ga]-DOTA peptide) for the detection of NEN lesions in comparison to morphological imaging modalities. So far, the role of imaging technologies in assessing treatment response is still under debate. Conclusion: This review offers the systems of classification and grading of NENs and summarizes the more useful recommendations based on data recently published for the management of patients with NENs, with special focus on the role of imaging modalities based on SST targeting with PET / CT radiotracers.
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Zhong, Lihua, Jianchao Wang, Yanping Chen, Weiqing Lin, Xiaoyan Liu, Ying Dou, Lihua Sun, et al. "Comprehensive Genomic Profiling of Angioimmunoblastic T-Cell Lymphoma (AITL) in Chinese Patients." Blood 132, Supplement 1 (November 29, 2018): 5293. http://dx.doi.org/10.1182/blood-2018-99-119891.
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Abstract Background: Angioimmunoblastic T-cell lymphoma (AITL) is an age-related malignant lymphoma, classified as a subtype of mature peripheral T-cell lymphoma. The 2016 revised WHO classification of lymphoid neoplasms proposed AITL as a nodal lymphoma derived from the T follicular helper cell. Extensive genomic analyses of AITL have discovered recurrent mutations in RHOA, TET2, DNMT3A, IDH2, and within genes of the T-cell receptor signaling pathway, with most studies being performed on patients in the Western hemisphere. We sought to define the mutational profile of AITL in Chinese patients. Methods: We collected 10 AITL biopsies from one center in China with confirmed pathologic diagnosis and treatment information. Diagnoses were independently confirmed by OrigiMed pathologists in all 10 AITL cases. Median cohort age at diagnosis was 61.1 years, and 60% (6/10) of the patients were older than 60 years. The male/female ratio was 8/2. In situ hybridization indicated Epstein-Barr virus positivity in 8/10 of AITL cases. DNA was extracted from formalin-fixed paraffin embedded samples, and targeted deep next generation sequencing (NGS) analyses were performed using the 450+ cancer genes panel. Results: Common and novel mutation features were revealed in this Chinese AITL analysis. As previously reported, TET2 mutations were found in 80% (8/10) of AITL patients (pts) with the highest mutation frequency, of which all the 8 pts harbored NMD/truncation and 6 pts harbored more than one mutation. RHOA mutations were seen in 60% (6/10) of cases, 4 cases were RHOA G17V while the other two were C16F and G17E/S26R, respectively. IDH2 R172 mutations were seen in 40% (4/10) of AITL cases. Co-occurring mutations of TET2 and RHOA were detected in the half of the cases (5/10), and 3 cases had concurrent TET2/RHOA/IDH2 mutations. DNMT3A mutations were seen in 30% (3/10) of AITLs cases, one case harbored two mutations including R882C. We also revealed novel mutation features. Recurrent mutations at histone modification genes included TIPARP (2 cases), KMT2C (2 cases), KMT2D (1 case). CRLF2 gene amplification was seen in a female patient. An intergenic PAX5 rearrangement was seen in 1 case along with MET and CFTR gene amplification. Tumor mutational burden (TMB) assessment indicated high TMB (>10 mutations/Mb) in the PAX5 rearrangement case while low TMB in the other nine cases. Discussion: The aim of our study was to reveal the genomic landscape of Chinese AITL. The cohort collection was unbiased, the patients' features were in concordance with previous reports that the disease of AITL is mostly found in the elderly (>60) and shows male predominance. Most cases were EBV-positive. Similar to prior studies, somatic mutations in TET2, RHOA, IDH2, and DNMT3A were found at varying frequencies sequentially of 80%, 60%, 40% and 30% in AITL. Co-occurring mutations of TET2/RHOA were found in 50%. RHOA G17V mutations were predominant mutations while we detected three rare sites in AITL including RHOA C16F, G17E and S26R, in which C16F and G17E were previously reported in other cancers. NGS studies have identified epigenetic modifiers mutations as a hallmark of AITL, highlighting an attractive therapeutic target in this disease. Notably, we also detected substitution mutations of histone modification genes including TIPARP, the mouse ortholog of which catalyzes histone poly(ADP-ribosyl)ation in 2 pts with one mutation previously reported in ovarian cancer; KMT2C in 2 pts with the mutations reported in other cancers. This is the first report TIPARP mutation in AITL. Another novel mutation feature was CRLF2 gene amplification and intergenic PAX5 rearrangement. These two genes are more often involved in B-cell related lymphoma/ leukemia, but our study discovered the gene abnormalities in AITL. The general low TMB is also consistent with other reports. In summary, this effort has identified novel mutation features in Chinese AITLs that can potentially lead to more effective treatments in Chinese population. Disclosures No relevant conflicts of interest to declare.
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Zhang, Qin, Can Tian, Kun Wang, Qi Xin, Yan Shen, Chuan-shan Zhang, and Zhe Ma. "A case of a vaginal Brenner tumor without a gland mimicking a borderline tumor: unusual morphology and diagnostic pitfalls." Journal of International Medical Research 48, no. 8 (August 2020): 030006052094653. http://dx.doi.org/10.1177/0300060520946536.
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Brenner tumor is a rare neoplasm of the vagina. This tumor is diagnosed according to the criteria of ovarian tumors. We report here a 64-year-old postmenopausal woman with a 2.0-cm sessile vaginal polyp for 9 years. Microscopic examination showed unusual features of no gland appearing in the tumor, but the other two characteristic components of transitional islands and dense fibrous stroma were observed. The tumor was diagnosed as a vaginal Brenner tumor on the basis of the definition proposed by the World Health Organization classification of female reproductive organ tumors. In our case, part of the epithelial nests of the Brenner tumor showed basaloid cell differentiation with peripheral palisading, and irregular papillary hyperplasia was observed around the epithelial nests similar to a borderline tumor. However, no mitotic activity or nuclear atypia was present in either the epithelial or stromal components. The presence of epithelial nests requires attention in the medical history of the patient. Our patient did not have a history of primary urothelial carcinoma. Our patient’s benign vaginal Brenner tumor with different morphological characteristics supports the current notion that Walthard nests might act as possible precursor lesions.
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Bing, Zhanyong, and Patrick A. Adegboyega. "Metastasis of Small Cell Carcinoma of Lung Into an Ovarian Mucinous Neoplasm: Immunohistochemistry as a Useful Ancillary Technique for Diagnosis and Classification of Rare Tumors." Applied Immunohistochemistry & Molecular Morphology 13, no. 1 (March 2005): 104–7. http://dx.doi.org/10.1097/00129039-200503000-00017.
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Saleh, Khalil, Christophe Willekens, Jean Edouard Martin, Myriam Kossai, Nadine Khalifé-Saleh, Véronique Saada, Nathalie Auger, et al. "Survival Improvement in Therapy Related Myeloid Neosplasm ? a Single Center Analysis of 428 Patients." Blood 128, no. 22 (December 2, 2016): 4006. http://dx.doi.org/10.1182/blood.v128.22.4006.4006.
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Abstract Therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) arise after cytotoxic chemotherapy and/or radiotherapy administered for a prior neoplasm and have a dismal outcome (median survival of 8 months in the largest series published including 306 patients (pts), Smith, Blood 2003). Recent registry data suggested a continued increase in survival in AML (Derolf, Blood 2009) and we wondered whether this was also observed in the setting of t-AML/ MDS. All pts with a t-AML/MDS diagnosed and/or treated for their prior neoplasm at Gustave Roussy Cancer Center between July 1986 and 2016 were included in this retrospective study. Data regarding pts' demographics, primary diagnosis and treatment, latency time, cytogenetic, treatment and outcome were collected. The diagnosis of t-AML/MDS was based on the WHO 2016 classification. t-AML were classified based on cytogenetic results as favorable, intermediate and adverse according to international classification, t-MDS based on IPSS score as favorable (Low, Int-1) and adverse (Int-2 and High). 428 pts were analyzed. The median age at diagnosis of t-AML/MDS was 56.4 years with a female predominance (60%). 224/428 (52.3%) pts had t-AML, 204/428 (47.7%) t-MDS. The most common primary malignancies were breast cancer (24%), non-Hodgkin lymphoma (15%), Hodgkin lymphoma (HL) (9%) and ovarian cancer (9%). Occurrence of t-AML/MDS following HL represented 26.6% of t-AML/MDS cases between 1986-96 comparing to 4 % between 2006-16 whereas breast cancer rose from 16% to 45%. Prior treatments included chemotherapy alone in 137/428 pts (32%), radiotherapy alone in 61 pts (14%) and both in 230 pts (54%). At diagnosis of t-AML/MDS, 295 pts (69%) were in complete remission (CR) of their prior neoplasm, 29 (7%) had a stable and 104 (24%) a progressive disease. Median interval between primary cancer and t-AML/MDS was 5 years (4.3 and 5.7 years for t-AML and t-MDS respectively, (p=0.03)). Furthermore, delay to develop t-AML/MDS after radiotherapy alone was longer compare to chemotherapy or both (6.1, 5.1 and 4.3 years, respectively (p=0.0087)). In the t-AML subgroup, 47% of pts presented unfavorable cytogenetic (including complex karyotype (20%) and 11q23 abnormalities (16.9%)), 26% intermediate and 26% favorable cytogenetic (core binding factor mutations (12.7%), t(15;17) (13.3%)). In the t-MDS subgroup, 78% of pts were considered adverse; complex karyotype, chromosome 7 and 5 abnormalities were found in 40.8%, 46.7% and 28.9% respectively. Pts received intensive chemotherapy (including 41 allografts), low dose chemotherapy (including 74 treatments with hypomethylating agents) and best supportive care in 42%, 24% and 34% respectively. The median overall survival (OS) was 10.6 months and the 5-year survival was 19.1% (Figure 1A). The 5-year OS of patients in CR of their prior neoplasm was 25.5% compared to 3.65 and 0% for pts with progressive and stable disease, respectively (p<0.001). 5-year OS was not statistically different between t-AML and t-MDS subgroups (23.3% vs 13.5%) and between hematologic or oncologic malignancies as primary diagnosis (12.6% vs 21.1%). Pts with favorable risk t-AML had better 5-year survival compared with patients with intermediate or unfavorable risk disease (55.5% vs 20% vs 12.1% respectively, p<0.001). In addition, favorable t-MDS was associated with better 5-year OS compared to adverse t-MDS (34.9% vs 6.6%, p<0.001). We next compared OS of pts diagnosed for their t-AML/MDS after or before July 2001. A trend for better OS for pts diagnosed in the last 15 years was observed (21.5% vs 15.1%, p=0.39). Interestingly outcome of t-AML patients with favorable subtype significantly improved over the last 15 years (68.8% vs 25%, p=0.03, Figure 1B) which was not the case for other cytogenetic subgroups and for t-MDS, especially pts with adverse prognosis (4.6% vs 3.9%, p=0.92). Pts who received allograft had a trend for better OS in the last 15 years (52.8% vs 21.5% p=0.2). t-AML/MDS are still associated with a low 5-year OS (19.1%) but our results are upper than previous publications. However, a significant improvement of survival in favorable t-AML was observed during the past 30-years, with a trend for pts who benefit from allograft. In addition to improve treatment for t-MDS pts, detection of the disease at the earliest stage is a real challenge to improve their survival. Disclosures No relevant conflicts of interest to declare.
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Khan, Muhammad Arif, Saira Afzal, Hassan Saeed, Hnia Usman, Rooqash Ali, Manaquibb Zain Ali Shaheer Khan, Aqsa Mumtaz, et al. "Frequency of Ovarian Tumors According to WHO Histological Classification and Their Association to Age at Diagnosis." Annals of King Edward Medical University 23, no. 2 (June 10, 2017). http://dx.doi.org/10.21649/akemu.v23i2.1579.
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Ovarian tumors, or ovarian neoplasms, are benign or malignant tumors arising from the ovaries. They may arise from any of the three components of ovary i.e. surface epithelium, germ cells and the stroma of the ovary including sex cords. Tumors in the ovary can also be secondary or metastatic tumors.Objective: To determine the frequency of Ovarian Tumors according to WHO Histological classification and their relation to age at diagnosis in almost one year.Methods: A cross-sectional study was carried out, that included all the consecutive cases of ovarian neoplasms diagnosed at the Pathology department of a public sector university in Lahore from 1 January 2015 to 13 February 2016.Results: In 95 female patients diagnosed with ovarian tumors, the mean age was found to be 29.58 ±11.493 with a range of 3-65 years. Tumors were most common between the ages of 15 to 30 years. The highest rates of malignancy were in the 0-15 and 45-60 age groups (Figure 1). About 78.9% of the tumors (75/95) were benign, 1.1% (1/95) were borderline and 20% (19/95) were malignant (Figure 3), 72.6% (69/95) were epithelial tumors, 23.2% (22/95) were germ cell and 4.2% (4/95) were sex cord stromal tumors (Figure 4). Among the 95 cases, serous tumors were the most common (49.5%), followed by mucinous (16.8%) and teratomas (15.8%).Conclusion: According to our study, ovarian tumors were common between the age of 15 to 29 years. Benign neoplastic lesions were more common than malignant neoplastic lesions. The frequency of malignant and benign ovarian neoplasms found in our research differed from other studies conducted in Pakistan. There is a significant association of ovarian tumors in age less than 30 year as compared to older age groups (P < 0.001).
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"Modern principles of diagnosis and treatment of benign ovarian neoplasms in juveniles." Voprosy ginekologii, akušerstva i perinatologii 20, no. 3 (2021): 100–116. http://dx.doi.org/10.20953/1726-1678-2021-3-100-116.
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This review is devoted to current issues of diagnosis and the choice of management tactics for juvenile girls with benign ovarian tumors. The updated data on age-related epidemiology, classification and terminology of true tumors and ovarian tumor-like formations are presented. Differential manifestation of benign tumors and ovarian tumor-like formations are described. The diagnostic value of genetic tumor markers is analyzed. The recommended management tactics for juvenile girls with benign ovarian tumors depending on the clinical situation are described. The results of the use of hormonal therapy in juveniles are presented. The importance of organ-sparing strategy to treat juvenile girls in order to preserve the ovarian reserve is indicated. Key words: girls, juvenile girls, true ovarian tumors, ovarian reserve, tumor markers, tumor-like ovarian formations, organ-sparing surgery, reproductive health
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Li, Shiyun, Jiaqi Liu, Yuanhuan Xiong, Peipei Pang, Pinggui Lei, Huachun Zou, Mei Zhang, Bing Fan, and Puying Luo. "A radiomics approach for automated diagnosis of ovarian neoplasm malignancy in computed tomography." Scientific Reports 11, no. 1 (April 22, 2021). http://dx.doi.org/10.1038/s41598-021-87775-x.
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AbstractThis paper develops a two-dimensional (2D) radiomics approach with computed tomography (CT) to differentiate between benign and malignant ovarian neoplasms. A retrospective study was conducted from July 2017 to June 2019 for 134 patients with surgically-verified benign or malignant ovarian tumors. The patients were randomly divided in a ratio of 7:3 into two sets, namely a training set (of n = 95) and a test set (of n = 39). The ITK-SNAP software was used to delineate the regions of interest (ROI) associated with lesions of the largest diameters in plain CT image slices. Texture features were extracted by the Analysis Kit (AK) software. The training set was used to select the best features according to the maximum-relevance minimum-redundancy (mRMR) criterion, in addition to the algorithm of the least absolute shrinkage and selection operator (LASSO). Then, we employed a radiomics model for classification via multivariate logistic regression. Finally, we evaluated the overall performance of our method using the receiver operating characteristics (ROC), the DeLong test. and tested in an external validation test sample of patients of ovarian neoplasm. We created a radiomics prediction model from 14 selected features. The radiomic signature was found to be highly discriminative according to the area under the ROC curve (AUC) for both the training set (AUC = 0.88), and the test set (AUC = 0.87). The radiomics nomogram also demonstrated good calibration and differentiation for both the training (AUC = 0.95) and test (AUC = 0.96) samples. External validation tests gave a good performance in radiomic signature (AUC = 0.83) and radiomics nomogram (AUC = 0.95). The decision curve explicitly indicated the clinical usefulness of our nomogram method in the sense that it can influence major clinical events such as the ordering or abortion of other tests, treatments or invasive procedures. Our radiomics model based on plain CT images has a high diagnostic efficiency, which is helpful for the identification and prediction of benign and malignant ovarian neoplasms.
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"Morphology and Classification of Ovarian Neoplasms in F344 Rats and (C57BL/6 × C3H)F1 Mice." JNCI: Journal of the National Cancer Institute, June 1987. http://dx.doi.org/10.1093/jnci/78.6.1229.
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Idrees, Romana, Nasir Ud Din, Sabeehudin Siddique, Saira Fatima, Jamshid Abdul-Ghafar, and Zubair Ahmad. "Ovarian seromucinous tumors: clinicopathological features of 10 cases with a detailed review of the literature." Journal of Ovarian Research 14, no. 1 (March 18, 2021). http://dx.doi.org/10.1186/s13048-021-00796-y.
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Abstract Background The 2014 WHO Classification of ovarian neoplasms introduced a new entity of seromucinous tumors associated with endometriosis. These tumors encompassed a spectrum from benign to malignant and included seromucinous cystadenoma/ cystadenofibroma, seromucinous borderline tumor/atypical proliferative seromucinous tumor and seromucinous carcinoma. However, the 2020 WHO Classification of Female Genital Tumours removed seromucinous carcinomas as a distinct entity and recategorized them as Endometrioid carcinomas with mucinous differentiation. Here we describe clinico-morphologic features of seromucinous tumors recategorizing cases originally diagnosed as seromucinous carcinoma in light of 2020 WHO classification and present detailed review of literature. Methods Slides of seromucinous tumors were reviewed. Special emphasis was given to evaluation of stromal invasion. Follow-up was obtained. Results Ten cases were diagnosed. Mean age was 40 years. Four cases were bilateral. Mean size was 19 cm. Grossly; luminal papillary projections were seen in 6 cases. Tumors demonstrated a papillary architecture with papillae lined by stratified seromucinous epithelium showing nuclear atypia. Stromal invasion was seen in 4 cases. Six cases were reported as borderline seromucinous tumors and 4 cases originally diagnosed as seromucinous carcinoma were recategorized as endometrioid carcinoma with mucinous differentiation on review. Endometriosis was seen in 4 cases. CK7, PAX8 and ER were positive in 7/7 cases. Two cases showed extra-ovarian involvement. Follow up was available in 7 cases. Six patients were alive and well at follow up ranging from 8 to 46 months. Six patients received chemotherapy postoperatively. One patient with carcinoma died of disease 18 months postoperatively. Conclusion In our series, 4 cases were originally diagnosed as seromucinous carcinomas. However, these were recategorized in light of the 2020 WHO Classification of Female Genital tumors as endometrioid carcinomas with mucinous differentiation. Six cases were diagnosed as seromucinous borderline tumors. Thus, majority of cases were borderline in agreement with published literature.
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Kai, Kentaro, Kaei Nasu, Haruto Nishida, Tsutomu Daa, Ayumi Shikama, Takaya Shiozaki, Masamitsu Kurakazu, et al. "Correlation of World Health Organization 2010 classification for gastroenteropancreatic neuroendocrine neoplasms with the prognosis of ovarian neuroendocrine neoplasms: Kansai Clinical Oncology Group-Protocol Review Committee/Intergroup Study." Neuroendocrinology, February 25, 2020. http://dx.doi.org/10.1159/000506743.
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Yoshida, Hiroshi, Hiroki Tanaka, Takafumi Tsukada, Naoko Abeto, Mayumi Kobayashi-Kato, Yasuhito Tanase, Masaya Uno, Mitsuya Ishikawa, and Tomoyasu Kato. "Diagnostic Discordance in Intraoperative Frozen Section Diagnosis of Ovarian Tumors: A Literature Review and Analysis of 871 Cases Treated at a Japanese Cancer Center." International Journal of Surgical Pathology, September 21, 2020, 106689692096051. http://dx.doi.org/10.1177/1066896920960518.
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Background This study examined the accuracy and pitfalls associated with frozen section diagnosis of primary ovarian tumors and ovarian metastases based on the 2014 World Health Organization classification (WHO) criteria and proposed improvements from a pathologist’s perspective. Methods We microscopically reviewed 871 cases of primary ovarian tumor (N = 802) and ovarian metastasis (N = 69) and compared the results of frozen sections with the final diagnosis. Malignant potential concordance (benign, borderline, or malignant) and specific discordant diagnosis rates were analyzed. Finally, we conducted a unique literature review of specific diagnostic errors in the frozen section diagnosis of primary ovarian tumors. Results Of 802 primary ovarian tumors, 50 (6.2%) cases showed discordant diagnoses in which mucinous carcinoma (40.5%), low-grade serous carcinoma (LGSC; 31.3%), and mucinous borderline tumor (18.4%) were frequently misinterpreted. Of 69 ovarian metastases, all 4 cases of low-grade appendiceal mucinous neoplasm (LAMN) were misdiagnosed as primary ovarian mucinous tumor. A literature review revealed that mucinous/serous borderline tumor or carcinoma accounted for approximately 70% of 217 reported discordant diagnoses. Conclusion In the present study, the concordance rate of malignant potential of the tumor was comparable to that previously reported. Even in the 2014 WHO classification, primary ovarian mucinous borderline tumor/carcinoma and LGSC still comprised the majority of discordant cases. Grossing methods that reduce sampling error are required. LAMN was frequently misinterpreted as a benign or borderline ovarian mucinous tumor. To prevent this error, a differential algorithm integrating clinical information and gross findings should be developed.
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Jha, Durga Nand, Ajit Kumar Chaudhary, and Debarshi Jana. "HISTOPATHOLOGICAL STUDY OF OVARIAN LUMPAND SERUM TUMOR MARKER CA 125 ESTIMATION AS A SCREENING TOOL." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, December 1, 2020, 38–40. http://dx.doi.org/10.36106/ijsr/7324427.
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Background Ovarian tumor is commonest cancer in female in India. About 80% is benign and 20% of these tumors are malignant. Due to its complex nature, vagueness and non-specificity of the symptoms it produces, the ovarian neoplasm can mislead both the doctor and patients. Hence this study was undertaken with aims & objectives to study the morphology of ovarian specimens as well as estimate serum CA125 as screening tool. Material and Methods: A study of over one year comprised of 75 specimens of ovary diagnosed in the Department of Pathology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar. After thorough gross examination and preparation of H&E stained slides the lesion of ovary were classified as per WHO classification. Also, preoperative blood samples were obtained from patients for estimation of serum CA125 level. Blood samples was also drawn from 20 healthy females in reproductive age group who acted as controls. Results: Of the 75 cases of ovarian mass, based on histology 75% were benign, and 25% were malignant. Surface epithelial tumors were the commonest (68%) of all ovarian tumor, followed by germ cell tumors (13%), sex cord–stromal tumors (6%). Serous Cystadenoma (29%) was the commonest benign tumor and serous cystadenocarcinoma (9%) commonest malignant neoplasm. CA125 levels was raised in epithelial ovarian cancers. Maximum rise was seen in serous cystadenocarcinoma. Exceptionally a small percentage of epithelial cancer showed normal level (false negative). Also, few benign tumors, non-epithelial tumors and even non-neoplastic lesions showed false positive rise in CA125 (false positive). Conclusion: Accurate histopathological evaluation of ovarian specimen is necessary both in terms of therapeutic intervention as well as prognosis. CA125 is an important screening tool for detection of epithelial ovarian cancers.
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Flores, Ana R., João Lobo, Francisco Nunes, Alexandra Rêma, Paula Lopes, Luís Carvalho, Carla Bartosch, Irina Amorim, and Fátima Gärtner. "Canine ovarian gonadoblastoma with dysgerminoma overgrowth: a case study and literature review." Journal of Ovarian Research 12, no. 1 (September 23, 2019). http://dx.doi.org/10.1186/s13048-019-0561-x.
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Abstract Background Gonadoblastoma (GB) is a rare mixed germ cell-sex cord-stromal tumour, first described in humans, commonly found in dysgenetic gonads of intersex patients that have a Y chromosome. However, this entity in not recognized in the WHO classification of tumours of genital system of domestic animals. Herein, we describe a case of ovarian gonadoblastoma with proliferation of dysgerminoma and sex cord-stromal tumour components, in a phenotypically and cytogenetically normal bitch. Case presentation A 17-year-old cross-breed bitch had a firm, grey-white multinodular mass in the left ovary. The tumour was submitted to histopathological examination and Y chromosome detected through karyotype analysis and PCR studies. Microscopically, the ovary was almost replaced by an irregular neoplasm composed of three distinct, intermixed elements: dysgerminoma, mixed germ cell-sex cord-stromal tumour resembling human GB and a proliferative sex cord-stromal tumour component. The germ cells of gonadoblastoma and dysgerminoma components were immunoreactive for c-KIT. Sex cord-stromal cells of gonadoblastoma were immunoreactive for α-inhibin. The sex cord-stromal tumour was immunoreactive for AE1/AE3, occasionally for α-inhibin and negative for epithelial membrane antigen (EMA). The karyotype was 78, XX and PCR analysis confirmed the absence of the Y chromosome. Conclusion Based on these findings, a diagnosis of gonadoblastoma with proliferation of dysgerminoma and sex cord-stromal tumour was made. This is the first case of ovarian gonadoblastoma in a female dog.
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Steurer, Stefan, Claudia Riemann, Franziska Büscheck, Andreas M. Luebke, Martina Kluth, Claudia Hube-Magg, Andrea Hinsch, et al. "p63 expression in human tumors and normal tissues: a tissue microarray study on 10,200 tumors." Biomarker Research 9, no. 1 (January 25, 2021). http://dx.doi.org/10.1186/s40364-021-00260-5.
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AbstractBackgroundTumor protein 63 (p63) is a transcription factor of the p53 gene family involved in differentiation of several tissues including squamous epithelium. p63 immunohistochemistry is broadly used for tumor classification but published data on its expression in cancer is conflicting.MethodsTo comprehensively catalogue p63 expression, tissue microarrays (TMAs) containing 12,620 tissue samples from 115 tumor entities and 76 normal tissue types were analyzed.Resultsp63 expression was seen in various normal tissues including squamous epithelium and urothelium. At least occasional weak p63 positivity could be detected in 61 (53%) of 115 different tumor types. The frequencies of p63 positivity was highest in squamous cell carcinomas irrespective of their origin (96–100%), thymic tumors (100%), urothelial carcinomas (81–100%), basal type tumors such as basal cell carcinomas (100%), and various salivary gland neoplasias (81–100%). As a rule, p63 was mostly expressed in cancers derived from p63 positive normal tissues and mostly not detectable in tumors derived from p63 negative cancers. However, exceptions from this rule occurred. A positive p63 immunostaining in cancers derived from p63 negative tissues was unrelated to aggressive phenotype in 422 pancreatic cancers, 160 endometrium cancers and 374 ovarian cancers and might be caused by aberrant squamous differentiation or represent stem cell properties. In 355 gastric cancers, aberrant p63 expression occurred in 4% and was linked to lymph node metastasis (p = 0.0208). Loss of p63 in urothelial carcinomas - derived from p63 positive urothelium - was significantly linked to advanced stage, high grade (p < 0.0001 each) and poor survival (p < 0.0001) and might reflect clinically relevant tumor dedifferentiation.ConclusionThe high prevalence of p63 expression in specific tumor types makes p63 immunohistochemistry a suitable diagnostic tool. Loss of p63 expression might constitute a feature of aggressive cancers.
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Rondón-Ayala, José A. "Cáncer hereditario de colon no polipósico asociado a adenocarcinoma de endometrio, piel actínica y consanguinidad. A propósito de un caso." Bionatura 3, no. 4 (November 15, 2018). http://dx.doi.org/10.21931/rb/2018.03.04.10.
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