scholarly journals Bilateral Serous Psammocarcinoma of Ovary: Rare Variant Low Grade Serous Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Saubhagya Kumar Jena ◽  
Pritinanda Mishra ◽  
Vandana Mohapatra ◽  
Sweta Singh
Keyword(s):  
Rare Variant ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade ◽  
Primary Debulking Surgery ◽  
Stage Disease ◽  
Enhanced Computed Tomography

Serous psammocarcinoma is a rare variant of serous carcinoma arising from either ovary or peritoneum, characterized by massive psammoma body formation, low grade cytologic features, and invasiveness. Its clinical behavior is similar to serous borderline tumors with relatively favorable prognosis. We report herein a case of a 60-year-old postmenopausal woman who presented with abdominal distension. Contrast enhanced computed tomography (CECT) revealed calcified pelvic masses with ascites. Elevated serum CA-125 (970 U/mL) suggested malignant ovarian neoplasm. Patient underwent exploratory laparotomy with primary debulking surgery. Histopathology showed bilateral serous psammocarcinoma of ovary with invasive implants on omentum. Adjuvant chemotherapy was advised in view of advanced stage disease, although its benefits are poorly defined due to rarity of the tumor. However, patient opted out of it and is now on follow-up.

Outcomes of comprehensive lymphadenectomy for patients with advanced stage ovarian carcinoma and rare histologic sub-types

2021 ◽  
pp. ijgc-2021-002559
Author(s):  
Dimitrios Nasioudis ◽  
Nawar A Latif ◽  
Ashley F Haggerty ◽  
Robert L Giuntoli II ◽  
Sarah H Kim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Ovarian Carcinoma ◽  
Epithelial Ovarian Carcinoma ◽  
Disease Stage ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Advanced Stage ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Stage Disease

ObjectiveTo investigate the prognostic significance of comprehensive lymphadenectomy at the time of primary debulking surgery for patients with rare histologic sub-types of epithelial ovarian carcinoma and clinically advanced stage disease who underwent complete gross resection.MethodsThe National Cancer Database was accessed and patients diagnosed between January 2010 and December 2015 with stage III–IV clear cell, endometrioid, mucinous, and low-grade serous carcinoma who underwent primary debulking surgery and achieved complete gross resection were identified. Patients who did not undergo lymphadenectomy and those who underwent comprehensive lymphadenectomy (defined as at least 20 lymph nodes removed) were selected for further analysis. Overall survival was compared with the log-rank test and a Cox model was constructed to control for confounders.ResultsA total of 381 patients were identified; 133 (34.9%) patients underwent comprehensive lymphadenectomy while 248 (65.1%) patients did not. There were no differences between the two groups in terms of patient race, age, presence of co-morbidities, type of treatment facility, disease stage, histology, and extent of intra-abdominal disease (p>0.05). There was no difference in overall survival between patients who did and did not undergo comprehensive lymphadenectomy (p=0.42); median overall survival was 51.48 and 47.38 months, respectively. After controlling for patient age, race, insurance status, presence of co-morbidities, intra-abdominal tumor spread, stage and histology, performance of systematic lymphadenectomy was not associated with better survival (HR 0.96, 95% CI 0.69 to 1.35).ConclusionComprehensive lymphadenectomy is not associated with a survival benefit for patients with rare histologic sub-types of epithelial ovarian carcinoma and advanced stage disease who underwent primary debulking surgery and complete gross resection.

Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5571-5571
Author(s):  
K. M. Schmeler ◽  
C. C. Sun ◽  
D. C. Bodurka ◽  
M. T. Deavers ◽  
R. L. Coleman ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Progression Free Survival ◽  
Exploratory Laparotomy ◽  
Complete Response ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade ◽  
High Grade ◽  
Ovarian Carcinomas ◽  
Platinum Based Chemotherapy

5571 Background: Neoadjuvant chemotherapy (NACT) has been associated with significant tumor reduction prior to interval debulking surgery, enabling optimal cytoreduction in up to 50% of patients with high-grade ovarian carcinomas deemed initially unresectable. Since low-grade serous carcinoma (LGSC) appears to be relatively less chemosensitive, we sought to evaluate the outcomes of women with ovarian LGSC treated with platinum-based NACT. Methods: Using institutional databases, we identified 18 women with low-grade serous carcinomas of the ovary who were treated with neoadjuvant platinum-based chemotherapy between 1978 and 2003. Patient demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan-Meier. Results: The median age at diagnosis was 44 years (range, 21 to 81 years). NACT was given for extensive or non-resectable disease in 16 patients (89%) and for unknown reasons in 2 patients (11%). Ten patients (42%) underwent exploratory laparotomy with biopsy only prior to beginning chemotherapy. A median of 6 cycles of chemotherapy was given (range, 2 to 16) and included the following regimens: platinum/taxane (n=12 patients); platinum/cyclophosphamide (n=3 patients); and platinum/leuprolide acetate (n=3 patients). Of the 13 patients who had CA-125 levels available, 8 (62%) had a ≥50% reduction between pre- and post-NACT levels. However, response, determined by radiographic survey at completion of NACT, demonstrated one patient (6%) with a complete response, no patients (0%) with a partial response, and 16 patients (89%) with stable disease. One patient (6%) was not evaluable. Fifteen patients (83%) underwent interval cytoreductive surgery, which was optimal in 8 cases (53%), suboptimal in 4 cases (27%) and unknown in 3 cases (20%). Median PFS and OS for all patients were 18.6 and 56.1 months, respectively. Conclusions: A low response rate to platinum-based NACT was observed among women with LGSC of the ovary. These findings suggest that LGSC is not as responsive to conventional chemotherapy as high-grade serous carcinoma. Prospective clinical trials, focusing specifically on LGSC, are needed to make meaningful advances for this group of patients. No significant financial relationships to disclose.

Total Infragastric Omentectomy Including the Vascular Perigastric Arcade in Patients With Advanced Serous Ovarian Tumors

2017 ◽  
Vol 27 (2) ◽  
pp. 252-257
Author(s):  
Gloria Cordeiro Vidal ◽  
Sabrina Croce ◽  
Frédéric Guyon ◽  
Guillaume Babin ◽  
Denis Querleu
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Ovarian Tumors ◽  
Serous Carcinoma ◽  
Pathological Examination ◽  
Low Grade ◽  
Debulking Surgery ◽  
Macroscopic Appearance ◽  
Primary Debulking Surgery ◽  
Interval Debulking Surgery

ObjectiveThe aim of this study was to document the need of including the perigastric area when performing omentectomy in patients with stage III to IV serous epithelial ovarian tumors.Patients and MethodsPatients undergoing omentectomy in the setting of surgery for advanced epithelial serous ovarian cancer between February and September 2015 were included. Patients with macroscopic involvement of the perigastric area, nonepithelial serous tumors, and recurrences of ovarian cancer were excluded. The perigastric area was isolated and comprehensively processed for pathological examination.ResultsTwenty-four patients were included. Six patients underwent primary debulking surgery, and 18 patients underwent an interval debulking surgery. The mean number of pathologic blocks in the perigastric area was 24 (range, 8–41). Microscopic involvement of the perigastric omentum area was found in 62.5% of the cases. One patient had a low-grade serous carcinoma, with microscopic involvement of the perigastric area. Among the 23 patients with a high-grade serous carcinoma, 10 (83%) of 12 patients with a gross involvement of the rest of the omentum had a microscopic involvement of the perigastric area. The presence of microscopic disease in the perigastric arcade was found in 4 (36.3%) of 11 patients with a macroscopically normal omentum.ConclusionsIn this study, evidence is given that total omentectomy including the perigastric area is a necessary component of complete cytoreductive surgery in advanced ovarian cancer, whatever the macroscopic appearance of the omentum.

Preoperative CA-125 predicts extra-uterine disease and survival in uterine papillary serous carcinoma patients

2012 ◽  
Vol 27 (3) ◽  
pp. 263-271 ◽  
Author(s):  
Thijs Roelofsen ◽  
Marjanka Mingels ◽  
Jan C.M. Hendriks ◽  
Rahul A. Samlal ◽  
Marc P. Snijders ◽  
...  
Keyword(s):  
Elevated Serum ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Uterine Disease ◽  
Uterine Papillary Serous Carcinoma ◽  
Kaplan Meier ◽  
Preoperative Serum ◽  
Papillary Serous Carcinoma

Objective We determined the clinical utility of preoperative serum CA-125 as predictor of extra-uterine disease and as prognosticator for survival in patients with uterine papillary serous carcinoma (UPSC). Methods Patients diagnosed with UPSC, identified between 1992 and 2009, and with preoperative CA-125 measurement were included. A receiver operator characteristic (ROC) curve was used to quantify marker performance. Overall and progression free survival were analyzed using the Kaplan-Meier method. Regression analyses were used to investigate the association of preoperative CA-125 levels and other clinicopathological variables with the presence of extra-uterine disease and the effects on survival. Results Sixty-six patients met the study criteria. Using ROC, the CA-125 concentration of 45 U/mL as cutoff level provided the best sensitivity (75%) and specificity (74%) for extra-uterine disease, with a positive predictive value of 86%. Survival was significantly longer in patients with preoperative CA-125 =45 U/mL (p<0.001). Only preoperative CA-125 >45 U/mL remained significantly associated with extra-uterine disease (OR=6.30, 95% CI 1.93–20.62). Furthermore, advanced FIGO stage (HR=4.53, 95% CI 1.50–13.62) and preoperative CA-125 >45 U/mL (HR=3.12, 95% CI 1.13–8.73) were associated with decreased survival. Conclusion Preoperative elevated serum CA-125 is an independent predictor for the presence of extra-uterine disease and an independent risk factor for survival in UPSC patients.

scholarly journals Clinicopathological Spectrum of Surface Epithelial Ovarian Carcinoma and its Association with Serum CA-125 Levels: A Cohort Study

2021 ◽  
Author(s):  
Nisha Singla ◽  
Sarita Nibhoria ◽  
Kanwardeep Kaur Tiwana ◽  
Prince Gupta
Keyword(s):  
Cohort Study ◽  
Ovarian Carcinoma ◽  
World Health ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Categorical Variables ◽  
Low Grade ◽  
High Grade ◽  
History Of ◽  
Epithelial Tumours

Introduction: The ovaries are the primary female reproductive organs and endocrine glands. Ovarian carcinoma has often been called as the silent killer because the symptoms may develop so late that the chances of cure are very poor. According to World Health Organisation (WHO) ovarian tumours are classified based upon their most probable tissue of origin: surface epithelial (65%), germ cell (15%), sex cord-stromal (10%), metastases (5%) and miscellaneous. The malignant surface epithelial tumours are further classified by cell type into serous, mucinous, endometrioid, clear cell, brenner, seromucinous and undifferentiated carcinoma. The most widely used tumour marker in ovarian carcinoma is CA-125 which is considered as gold standard. Aim : To find the utility of serum CA-125 levels in histopathological variants of malignant surface epithelial tumours, degree of differentiation and their distribution according to clinical data pertaining to age, parity, history of use of oral contraceptive pills/ovulation inducing drugs and family history of carcinoma ovary/breast or colon. Materials and Methods: A prospective study (cohort study) was done at Guru Gobind Singh Medical College and Hospital, Faridkot over a period of 1.5 year (April 2017-oct 2018) on 50 ovarian masses which were diagnosed as ovarian carcinoma. Data was represented as frequencies and percentages for categorical variables and as means and standard deviations for continuous variables. Analysis was done using Statistical Package for Social Sciences (SPSS) v 20.0.0. Results: Serous carcinoma (80%) topped among all the histological variants. Serous high grade carcinoma was more common than serous low grade carcinoma. Maximum rise of serum CA-125 levels were seen in serous carcinoma. Among serous carcinomas, mean serum CA-125 levels were more in high grade serous carcinoma than low grade serous carcinoma and the results were statistically significant. conclusion: Serum CA-125 level is a great tool for diagnosis, follow-up and prognosis of ovarian carcinomas.

scholarly journals Sclerosing sex cord stromal tumour of the ovary: A rare variant of ovarian neoplasms in childhood and adolescence

2016 ◽  
Author(s):  
Seema Chopra
Keyword(s):  
Ovarian Neoplasms ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Stromal Tumour ◽  
Ca 125 ◽  
Childhood And Adolescence ◽  
Menstrual Cycles ◽  
Sclerosing Stromal Tumor ◽  
Loss Of Appetite ◽  
Unmarried Girl

Case Report: 19 yr old unmarried girl c/o abdominal distension, loss of appetite and Irregular menstrual cycles x 5 months. USG: gross ascites, liver, Lobulated isoechoic mass in right adnexa, 7x5 cm, abutting right ovary. CA125: 1297 U/ml. FNAC Degenerated crushed cells & stromal fragments. Few scattered benign oval/spindle cells. Laparoscopy f/b laparotomy: 6 litres of straw colored asciic fluid drained. Uterus, left adnexa normal. Rt ovarian mass 6x7 cm, bilobed, arising from ovary. Solid, stuck in POD Adherent to gut. Right oophrectomy done. CA-125: 22 u/ml on day 6 post op. HPE – Sclerosing stromal tumor. Discussion: Sclerosing sex cord stromal tumour of the ovary is a rare tumor; accounts for 6% of ovarian stromal tumors Over a 100 reported tumors in literature. 80% of SST seen in second and third decade of life. Essentially a benign tumour, Usually a unilateral nonfunctioning tumor. Few cases with elevated serum CA-125 and hormonal abnormalities have been reported. Endocrine alterations caused by secretion of estrogen, progesterone or testosterone; induction of precocious puberty. Conclusion: Unilateral oophrectomy is the treatment. No recurrence of the tumor in the patients treated by oophorectomy or by conservative resection of the tumor. Excision of the tumor isfollowed by normal menses, pregnancy has also been reported.

scholarly journals Pericardial Tamponade and Elevated Serum CA-125 Level in Inadequately Treated Hypothyroidism

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Moaaz Baghal ◽  
Viralkumar Amrutiya ◽  
Bhoomi Patel ◽  
Rutwik Patel ◽  
Jonathan Hernandez ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Young Female ◽  
Pericardial Tamponade ◽  
Medical Emergency ◽  
Ca 125 ◽  
Pericardial Window ◽  
Abdominal Paracentesis ◽  
Shed Light

Cardiac tamponade is a medical emergency and must be managed promptly, and reaching a diagnosis is imperative to prevent recurrence. Herein, we present a case of a young female patient that presented with progressive shortness of breath and abdominal distension and was found to have cardiac tamponade with the finding of elevation of a blood tumor marker, CA-125, in the setting of nonadherence to thyroid replacement therapy. She was managed by surgical pericardial window and abdominal paracentesis, with replacement of thyroid hormones leading to resolution of the tamponade and ascites. CA-125 elevation associated with cardiac tamponade and myxedema ascites due to hypothyroidism is very rare, and we aim to shed light on the importance of having a broad differential when approaching cardiac tamponade and understand the association between CA-125 and hypothyroidism.

scholarly journals Karsinoma Ovarii Serosa pada Kehamilan dengan Komplikasi IUGR : Laporan Kasus di RSUP Dr. Kariadi, Semarang

2020 ◽  
Vol 7 (1) ◽  
pp. 108-112
Author(s):  
Anggiyasti Vidya Hapsari ◽  
Ediwibowo Ambari ◽  
Julian Dewantiningrum ◽  
Ery Perdana Ushan
Keyword(s):  
Germ Cell ◽  
Frozen Section ◽  
Surgical Staging ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade

Karsinoma ovarium merupakan keganasan ginekologi terbanyak kedua yang terjadi pada kehamilan. Dilaporkan terjadi 1:10.000 sampai 1:25.000 kehamilan. Histopatologi karsinoma ovarium jenis epitelial lebih jarang terjadi dibandingkan germ cell tumor1,2. Kehamilan tidak mempengaruhi prognosis karsinoma ovarium, akan tetapi komplikasi yang mungkin terjadi adalah torsi tumor, ruptur dan meningkatkan kemungkinan terjadinya persalinan prematur16. Tulisan ini melaporkan seorang wanita, 31 tahun, primigravida, hamil 34 minggu, dengan pembesaran abdomen melebihi usia kehamilan, peningkatan kadar Ca-125 darah dan massa solid ovarium sinistra disertai ascites pada pemeriksaan ultrasonografi. Pemeriksaan histopatologi jaringan tumor ovarium, uterus dan omentum menunjukkan diagnosis low grade serous carcinoma ovarii bilateral dengan infiltrasi hingga tuba dan omentum. Pemeriksaan rutin kehamilan dengan ultrasonografi penting dilakukan untuk skrining adanya neoplasma ovarium yang menyertai kehamilan. Penatalaksanaan hamil dengan  tumor padat ovarium tergantung dari usia kehamilan. Menurut algoritme dilakukan operasi pengangkatan massa dan dilakukan frozen section (FS) untuk mengetahui sifat tumor jinak atau ganas pada usia kehamilan 18-22 minggu dan dilanjutkan dengan operasi lanjutan setelah kelahiran bayi16. Pada kasus ini dengan mempertimbangkan kehamilan ini merupakan kehamilan pertama dengan tidak adanya keluhan dan secara prinsip tidak adanya perubahan anatomi untuk dapat dilakukan operasi complete surgical staging saat bayi dilahirkan pada usia kehamilan 34 minggu, maka dari hasil rapat medis diambil keputusan untuk dilakukan operasi complete surgical staging bersamaan setelah sectio caesaria. Prosedur operasi ini tidak mudah dilakukan dan banyak dihindari, tetapi dengan kehati-hatian dan identifikasi struktur anatomi yang baik, maka operasi berjalan lancar.

scholarly journals Primary Hepatic Epithelioid Hemangioendothelioma: A Case Report and Literature Review

2020 ◽  
Author(s):  
Jing Rui Wang ◽  
Bei Lu ◽  
Yang Cai
Keyword(s):  
Malignant Tumor ◽  
Vascular Endothelial Cells ◽  
Clinical Manifestations ◽  
Abdominal Distension ◽  
Epithelioid Hemangioendothelioma ◽  
Patient Choice ◽  
Low Grade ◽  
Vascular Origin ◽  
Low Incidence ◽  
Enhanced Computed Tomography

Abstract Background: Epithelioid hemangioendothelioma(EHE) is a low-grade malignant tumor of vascular origin. The rarity of HEHE make the diagnosis and treatment of this entity very challenging. Case presentation: We report a case of a 69-year-old female patient suffering from HEHE who complained of "Abdominal distension pain with dizziness, appetite loss more than half a month". Enhanced computed tomography (CT) of the upper abdomen indicated multiple space-occupying lesions in the liver. The pathological results of color ultrasound puncture suggested HEHE. We performe transcatheter arterial chemoembolization (TACE) and relevant examinations according to the patient's condition and the patient choice. Follow-up examinations 18 months after discharge did not demonstrate tumor recurrence.Conclusions:HEHE is a relatively rare hepatic malignant tumor derived from vascular endothelial cells, with low incidence, atypical clinical manifestations, difficult diagnosis, and the diagnosis can only be confirmed with pathological results. Currently, appropriate treatment methods should be selected according to the specific conditions of patients.

scholarly journals Low-grade appendiceal mucinous neoplasms with bowel obstruction

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Constance Houlzé-Laroye ◽  
Clarisse Eveno
Keyword(s):  
Intestinal Obstruction ◽  
Peritoneal Cavity ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Low Grade ◽  
Atypical Symptoms ◽  
Abdominal Symptoms ◽  
Clinical Presentations ◽  
Mucinous Neoplasms ◽  
Abdominal Ct Scan

AbstractBackgroundPerforation of low-grade appendiceal mucinous neoplasms (LAMN) is characterized by its potential to spread mucin into peritoneal cavity, giving rise to pseudomyxoma peritonei, commonly treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Symptoms of intestinal obstruction and appendiceal infection are rare at early stages of the disease, while abdominal distension are observed in the later stages due to mucin spread.MethodsWe report herein a case of LAMN with atypical symptoms in a 35-year-old woman with abdominal symptoms evoking an intestinal obstruction.ResultsAn abdominal CT scan revealed an ileo-caecal intussusception. An exploratory laparotomy and examination of the peritoneal cavity ruled out an exteriorization of mucin and the bowel was resected.ConclusionsThe pathology analysis confirmed the diagnostic of LAMN. This report aims to raise awareness among surgeons, of rare clinical presentations that LAMN may show, to adapt the surgical treatment to these patients and assign them to referral centers.

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