scholarly journals Borderline Ovarian Tumor during Pregnancy: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Joao Casanova ◽  
Raquel Maciel ◽  
Vânia Ferreira ◽  
Eugénia Fernandes ◽  
Rosa Maria Rodrigues
Keyword(s):  
Best Management Practices ◽  
Ovarian Tumor ◽  
Management Practices ◽  
Frozen Section ◽  
First Trimester ◽  
Ca 125 ◽  
Borderline Ovarian Tumor ◽  
Term Survival ◽  
Liquid Component ◽  
The Right

We report a case of a 33 year-old pregnant woman who was diagnosed at the time of the first trimester ultrasound with a multilocular solid arising form the right ovary. An abdominal MRI was performed afterwards and it revealed a pelvic mass, developing from the right ovary, with a liquid component but with a major solid area. CA 125 was within the normal range values. A laparotomy followed by right salpingo-oophorectomy was performed at 14 weeks of gestation and both the frozen section and the definitive histology revealed a borderline mucinous ovarian tumor. Ovarian tumors of low malignant potential comprise 10%–20% of all ovarian malignancies. They carry an excellent prognosis with 95%–99% long-term survival. Whereas in the past, radical surgery (hysterectomy and bilateral salpingo-oophorectomy with peritoneal staging) was standard regardless of the age of the patient, unilateral salpingo-oophorectomy with or without staging has become the recommended management for women who desire childbearing. In the absence of large prospective randomized trials it is difficult to know which are the best management practices and especially to determine the right moment during pregnancy to perform surgery in these patients.

scholarly journals Accuracy of intraoperative frozen section analysis in borderline ovarian tumor and the factors affecting it

2020 ◽  
Vol 7 (09) ◽  
pp. 4960-4964
Author(s):  
Hacı öztürk ŞAHİN ◽  
Alpay YILMAZ ◽  
Mehmet BAYRAK ◽  
Kemal ÖZERKAN ◽  
Hakan OZAN
Keyword(s):  
Ovarian Tumor ◽  
Frozen Section ◽  
Correct Selection ◽  
Ca 125 ◽  
Borderline Ovarian Tumor ◽  
Accuracy Rate ◽  
Factors Affecting ◽  
Frozen Section Analysis ◽  
Section Analysis ◽  
Selection Of

Objective: To analyze the accuracy of frozen section (FS) examination of a borderline ovarian tumor (BOT) and the factors affecting it.Methods : We retrospectively evaluated 132 patients who were operated on in our clinic for ovarian mass between 1996 and 2016, who underwent FS examination and who had a BOT as a result of the final pathology. We investigated the Frozen accuracy, overdiagnosis and underdiagnosis rates and the factors affecting the accuracy of the diagnosis.Results : The mean age of the sample group was 44.6 ± 15.2 years. 50.8% of our patients were serous, 34.8% were mucinous and 14.4% were sero-mucinous in histology. Our Frozen Section accuracy rate was 75%, and underdiagnosis and overdiagnosis rates were 20.5% and 4.5%, respectively.The factors affecting the accuracy of the frozen section were histological type (p = 0.003), presence of solid component (p = 0.002) and preoperative CA 125 value (p = 0.001).Conclusion : Frozen examination has a low accuracy rate that affects the correct selection of surgical treatment for BOTs. FS should be performed by experienced gyneco-pathologists and it is necessary to consider carefully the factors that may cause misdiagnosis of the pathology.

Adnexal mass in pregnancy

2021 ◽  
Vol 10 (3) ◽  
pp. 1154
Author(s):  
Marilia Lima Freixo ◽  
Elisa Soares ◽  
Maria Liz Coelho ◽  
Fernanda Costa ◽  
Ana Rita Pinto
Keyword(s):  
Best Management Practices ◽  
Management Practices ◽  
Total Abdominal Hysterectomy ◽  
First Trimester ◽  
Abdominal Hysterectomy ◽  
Adnexal Masses ◽  
Best Management ◽  
Increased Risk ◽  
The Right ◽  
In Pregnancy

Adnexal masses in pregnancy are a rare finding. The majority of these masses are discovered incidentally during routine follow-up. The differential diagnosis of adnexal masses discovered during pregnancy is broad and the management of such lesions has been a subject of debate for years with no consensus regarding the best management plan. We report a case of a 38 year-old pregnant woman who was diagnosed at the time of the first trimester ultrasound with a multilocular solid arising form the right ovary. A laparoscopy followed by left oophorectomy was performed at 22 weeks and the definitive histology revealed a borderline ovarian cyst/proliferative mucinous atypical cyst. The patient delivered via vaginal at 38 weeks of gestation. This case was discussed and a secondary staging surgery (peritoneal washing, total abdominal hysterectomy, salpingo-oophorectomy, omentectomy, appendectomy, and peritoneal biopsies) was performed with no evidence of disease found. The surgical approach is controversial due to the increased risk of complications. In the absence of large prospective randomized trials it is difficult to know which are the best management practices and especially to determine the right moment during pregnancy to perform surgery in these patients. 

scholarly journals Meigs' syndrome with elevated CA 125: case report

2003 ◽  
Vol 121 (5) ◽  
pp. 210-212 ◽  
Author(s):  
Sabas Carlos Vieira ◽  
Leonardo Halley Carvalho Pimentel ◽  
José Carlos Castelo Branco Ribeiro ◽  
Argemiro Ferreira de Andrade Neto ◽  
Jerúsia Oliveira Ibiapina de Santana
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Ovarian Tumor ◽  
Frozen Section ◽  
Transvaginal Ultrasound ◽  
Elevated Serum ◽  
Ca 125 ◽  
Brazilian Woman ◽  
Thoracic Drainage ◽  
Benign Ovarian Tumor

CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.

scholarly journals THE INSTITUTE OF COUNSELOR IN THE DOMESTIC SYSTEM OF PUBLIC SERVICE: THE STATE AND PROBLEMS OF LEGAL FIXING

2021 ◽  
pp. 106-112
Author(s):  
O. Pronevych
Keyword(s):  
Public Service ◽  
Best Management Practices ◽  
Local Governments ◽  
Management Practices ◽  
Legal Framework ◽  
The State ◽  
Public Authorities ◽  
Legal Personality ◽  
Social Mission ◽  
The Right

The article is devoted to understanding the specifics of the social mission and the state of legal consolidation of the administrative legal personality of councilors in public authorities and local governments. It is emphasized that the problem of selection of candidates for the positions of advisers to the heads of public authorities is the subject of lively discussion, as a rather controversial collective image of the adviser has formed in the public consciousness. This is due to his belonging to officials who hold a particularly responsible position and perform official duties in the presence of a high level of corruption risks. It is established that the commitment of candidates for advisers is carried out in the context of providing scientific support for the formation and implementation of public policy, implementation of best management practices, finding optimal management and legal algorithms for resolving conflicts, improving the quality of management decisions. The urgent need to improve the domestic service legislation by adopting a special law on patronage service in order to unify the legal framework for the organization and operation of patronage services. First of all, it is necessary to normatively enshrine the right of specific public authorities to establish a patronage service, to provide an exhaustive list of patronage service positions for each of these bodies, to provide the right of equal access to patronage service, to introduce a single mechanism for selection and appointment of patronage service employees. professional achievements and personal business qualities, to differentiate their powers depending on the specifics of public authority of individual officials, which create patronage services. There is also a need to specify the functions, main tasks and powers of advisers to heads of public authorities, articulation of basic qualification requirements for candidates for advisers, clear definition of legal bases of interaction of advisers with career civil servants and communication with civil society institutions, articulation of moral and ethical imperatives. official activity of advisers. Keywords: public service, patronage service, adviser in state authorities and local self-government bodies, staff adviser, advisor on a voluntary basis.

scholarly journals Borderline ovarian tumor frozen section diagnoses with features suspicious of invasive cancer: a retrospective study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Koen De Decker ◽  
Karina H. Jaroch ◽  
Joost Bart ◽  
Loes F. S. Kooreman ◽  
Roy F. P. M. Kruitwagen ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Invasive Carcinoma ◽  
Frozen Section ◽  
Paraffin Section ◽  
Final Diagnosis ◽  
Borderline Ovarian Tumor ◽  
Histopathological Diagnosis ◽  
Frozen Section Diagnosis ◽  
Histologic Subtypes ◽  
Section Evaluation

Abstract Background A frozen section diagnosis of a borderline ovarian tumor with suspicious features of invasive carcinoma (“at least borderline” or synonymous descriptions) presents us with the dilemma of whether or not to perform a full ovarian cancer staging procedure. Quantification of this dilemma may help us with the issue of this clinical decision. The present study assessed and compared both the prevalence of straightforward borderline and “at least borderline” frozen section diagnoses and the proportion of these women with a final histopathological diagnosis of invasive carcinoma, with a special interest in histologic subtypes. Methods A retrospective cohort study was performed in three hospitals in The Netherlands. All women that underwent ovarian surgery with perioperative frozen section evaluation in one of these hospitals between January 2007 and July 2018 were identified and included in case of a borderline or “at least borderline” frozen section diagnosis and a borderline ovarian tumor or invasive carcinoma as a final diagnosis. Results A total of 223 women were included, of which 41 women (18.4%) were diagnosed with “at least borderline” at frozen section. Thirteen of forty-one women (31.7%) following “at least borderline” frozen section diagnosis and 14 of 182 women (7.7%) following a straightforward borderline frozen section diagnosis were diagnosed with invasive carcinoma at paraffin section evaluation (p < 0.001). When compared to straightforward borderline frozen section diagnoses, the proportion of women diagnosed with invasive carcinoma increased from 3.1 to 35.7% for serous tumors (p = 0.001), 10.0 to 21.7% for mucinous tumors (p = 0.129) and 50.0 to 75.0% (p = 0.452) in case of other histologic subtypes following an “at least borderline” frozen section diagnosis. Conclusions Overall, when compared to women with a decisive borderline frozen section diagnosis, women diagnosed with “at least borderline” frozen section diagnoses were found to have a higher chance of carcinoma upon final diagnosis (7.7% vs 31.7%). Especially in the serous subtype, full staging during initial surgery might be considered after preoperative consent to prevent a second surgical procedure or chemotherapy in unstaged women. Further studies are needed to evaluate whether additional sampling in case of an “at least borderline” diagnosis may decrease the risk of surgical over-treatment.

Is CA-125 an additional help to radiologic findings for differentiation borderline ovarian tumor from stage I carcinoma?

2011 ◽  
Vol 52 (4) ◽  
pp. 458-462 ◽  
Author(s):  
Eun Joo Lee ◽  
See Hyung Kim ◽  
Young Hwan Kim ◽  
Hee Jung Lee
Keyword(s):  
Ovarian Tumor ◽  
Stage I ◽  
Ca 125 ◽  
Borderline Ovarian Tumor ◽  
Radiologic Findings

scholarly journals Pseudomyxoma Peritonei Revisited: A Case Report

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Immunohistochemical Staining ◽  
Frozen Section ◽  
Exploratory Laparotomy ◽  
Ca 125 ◽  
Abdominal Girth ◽  
Negative Results ◽  
Histopathology Result ◽  
Disseminated Peritoneal Adenomucinosis ◽  
The Right ◽  
Lost To Follow Up

Bleeding after menopause raises suspicion of malignancy; more so, if combined with increased abdominal girth and constitutional symptoms. This is a case of a 74-year-old Gravida 10 Para 8 (8026) who presented with generalized abdominal pain, enlargement, bloatedness and vaginal bleeding. Ultrasound revealed a complex abdominopelvic mass, likely ovarian in origin. Tumor markers CA-125 and CA-199 were elevated. Endometrial curettage with frozen section revealed Leiomyosarcoma. It was followed by exploratory laparotomy revealing gelatinous material in the peritoneum with seeding of mucoid material into the omentum, ovary and appendix. Frozen section of the right ovary revealed Atypical Mucinous Proliferative Ovarian Tumor (APMOT). Final histopathology result of the endometrial curetting revealed adenomatoid tumor of the uterus. Immunohistochemical staining with desmin and caldesmon revealed negative results implicating the absence of leiomyosarcoma. Final histopathology results were consistent with Disseminated Peritoneal Adenomucinosis (DPAM). Immunohistochemical staining with CK20 was positive and CK7 was negative, consistent with metastases from a primary gastrointestinal tumor. Chemotherapy in the form of FOLFOX regimen was contemplated. However, the patient was lost to follow up.

scholarly journals Frozen section allows more accurate management in suspected ovarian malignancy in young women

2020 ◽  
Vol 28 (3) ◽  
pp. 135
Author(s):  
Laila Nuranna ◽  
Ditha Adriana Loho ◽  
Christin Wigin Hia
Keyword(s):  
Young Women ◽  
Conservative Management ◽  
Frozen Section ◽  
Ovarian Neoplasm ◽  
Fertility Treatment ◽  
Ca 125 ◽  
Borderline Ovarian Tumor ◽  
Ovarian Malignancy ◽  
Intraoperative Frozen Section ◽  
Additional Information

Objectives: To present three cases of young women with suspected ovarian malignancy with the aim to evaluate the role of intraoperative frozen section in suspected malignant ovarian neoplasms in women with young age.Case Report: Mrs. M, 25 years old, is a nullipara with a history of fertility treatment. She presented with bilateral ovarian cysts suspected to be malignant and an elevated CA-125 level. Intraoperative frozen section showed borderline ovarian tumor, allowing for conservative management. Mrs. A, 32-years old, with right cystic ovarian neoplasm suspected to be malignant and elevated CA-125. Frozen section showed results of cystadenocarcinoma, patient’s family was informed of the result during the surgery and the operator continued to manage the patient conservatively. Ms. N, 27 years old, was referred with suspected ovarian malignancy and the differential diagnosis of peritoneal tuberculosis. Frozen section confirmed the presence of tuberculosis infection, and the patient was managed accordingly.Conclusion: Despite conservative management being top priority treatment in young-aged women with ovarian neoplasm, additional information of frozen section allows for more accurate management.

The Case of a Serous Borderline Ovarian Tumor in a 15-Year Old Pregnant Adolescent: Sonographic Characteristics and Surgical Management

2020 ◽  
Vol 37 (S 02) ◽  
pp. S61-S65
Author(s):  
Stefano Uccella ◽  
Manuela Rosa ◽  
Elena Biletta ◽  
Raffaele Tinelli ◽  
Pier C. Zorzato ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Transvaginal Ultrasound ◽  
First Trimester ◽  
Conservative Surgery ◽  
Termination Of Pregnancy ◽  
Pathological Examination ◽  
Borderline Ovarian Tumor ◽  
Ovarian Mass ◽  
Pregnant Adolescent ◽  
Ovarian Lesion

Objective This study aimed to describe a rare case of a serous borderline ovarian tumor (BOT) diagnosed during pregnancy in a 15-year old adolescent. Results The suspect of BOT was raised at a transvaginal ultrasound scan in early first trimester (at 5 weeks of amenorrhea), due to the presence of a moderately vascularized irregular papilla in the context of a unilocular low-level right ovarian cyst. The patient and her parents required termination of pregnancy, irrespective of the diagnosis of an ovarian lesion. After termination of pregnancy, the patient underwent laparoscopic enucleation of the ovarian mass, omentectomy, and peritoneal biopsies. No intra-abdominal spillage of the ovarian mass occurred, and the surgical specimens were put in an endobag and extracted transvaginally. Final pathological examination confirmed the diagnosis of a serous borderline ovarian tumor. The patient of free of disease after 8 months of follow-up. Conclusion Although rare, borderline ovarian tumors can be diagnosed in an adolescent during pregnancy. The combination of specific sonographic assessment and minimally invasive conservative surgery appears as a very effective approach in this type of patient. Key Points

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