scholarly journals Sister Mary Joseph Nodule as a First Manifestation of a Metastatic Ovarian Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Giannina Calongos ◽  
Mai Ogino ◽  
Takatoshi Kinuta ◽  
Masateru Hori ◽  
Tatsuo Mori

A 76-year-old female presented to our hospital with a 2 cm firm, nontender, protuberant umbilical nodule. She received treatment with antibiotics for suspected granuloma, with no improvement after two months. High levels of CA125 as well as an ovarian cyst and intrathoracic and intra-abdominal lesions on imaging studies made us suspect an ovarian cancer with a Sister Mary Joseph nodule (SMJN) and other metastases. A bilateral salpingo-oophorectomy and umbilical and omentum tumor resections were performed and a metastatic ovarian serous adenocarcinoma was diagnosed by histopathology. After surgery, the patient received chemotherapy with paclitaxel, carboplatin, and bevacizumab; however paclitaxel allergy was observed. As a result, chemotherapy continued with carboplatin and bevacizumab every three weeks for a total of 6 courses. Currently, she is still undergoing treatment with bevacizumab and CA125 levels have been progressively decreasing. SMJN is a rare umbilical metastasis which needs to be considered as a differential diagnosis in the presence of an umbilical tumor for prompt treatment initiation.

2020 ◽  
Author(s):  
Jia-Mei Wang ◽  
Qi Zhang ◽  
Liang Hao ◽  
Jing-Yi Jiang ◽  
Ling-Yue Huyan ◽  
...  

Abstract Background: Ovarian cancer is the most frequent cause of death among gynecologic malignancies due to the absence of an early effective diagnostic approach. Although the majority of patients typically respond well to the first line of chemotherapy based on platinum compounds and taxanes, recurrence and chemoresistance limits its clinical utility. Remarkably, cancer stem cells (CSC) tend to form minimal residual disease after chemotherapy and exhibit recurrent potential. The ability of cancer cells to reprogram their metabolism has recently been related with resistance to chemotherapies.Methods: BAG5 expression was studied in 16 cisplatin-sensitive and 8 cisplatin-resistant ovarian cancer tissues by Western blot. BAG5-induced cell proliferation, migration and invasion were investigated by CCK-8 assay, colony formation assay, wound healing and Transwell assay. To investigate whether BAG5 is implicated in metabolism regulation, mitochondrial function was monitored by real-time measurement of changes in the oxygen consumption rate (OCR) and glycolysis was also determined by measuring the extracellular acidification rate (ECAR). Immunohistochemical staining measured correlations between BAG5 and Bcl6, Rictor in most ovarian serous adenocarcinoma tissues.Results: The current study found BAG5 expression was decreased in cisplatin-resistant ovarian cancer cells and clinical tissues. Our data demonstrated that BAG5 knockdown was implicated in metabolic reprogramming and maintenance of cancer stem cell (CSC)-like features of cisplatin-resistant ovarian cancer cells via regulation of Rictor and subsequent mTORC2 signaling pathway. In addition, the current study demonstrated that Bcl6 upregulation was responsible for repression of BAG5 transactivation via recruitment on the BAG5 promoter in cisplatin-resistant ovarian cancer. The current study also demonstrated reverse correlations between BAG5 and Bcl6, BAG5 and Rictor in ovarian serous adenocarcinoma tissues. Conclusions: Collectively, the current study identified the implication of Bcl6/BAG5/Rictor-mTORC2 signaling pathway in metabolic reprograming and maintenance of CSC-like features including cisplatin-resistance in cisplatin-resistant ovarian cancer cells. Therefore, further studies on the mechanism underlying regulation of metabolic reprogramming and CSC-like characteristics of cisplatin-resistant ovarian cancer cells may contribute to the establishment of novel therapeutic strategy for cisplatin-resistance.


Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1804
Author(s):  
Shih-Lung Chen ◽  
Tsan-Yu Hsieh ◽  
Shih-Wei Yang

Low-grade ovarian serous adenocarcinoma is rarely encountered in the neck region. The diagnosis of this rare malignancy entity in the neck is challenging for both clinicians and pathologists. A 53-year-old female with a chief complaint of a right lower neck mass that had been growing for approximately 2 weeks. The ultrasound-guided fine needle aspiration cytology favored malignancy. The positron emission tomography/computed tomography scan revealed the clustered enlarged lymph nodes with increased radioactivity uptake in the right neck level V, and strong radioactivity uptake was also displayed in the right ovarian regions. Pelvis magnetic resonance imaging displayed right adnexal complex mass supporting the ovarian cancer. An en bloc resection of the right neck lymph node was conducted. Ovarian serous adenocarcinoma with metastasis of lymph nodes in the neck was confirmed through histopathological findings. This study reviews the clinical features of low-grade ovarian serous carcinoma metastasizing to lymph nodes in neck. Although very rare, ovarian cancer with neck metastasis should be considered in the differential diagnosis of a neck mass lesion. The clinical staging would be relatively high due to the quiet entity of the cancer.


Author(s):  
Hiroyuki Terada ◽  
Ken-ichi Honda ◽  
Tomoko Nakagawa ◽  
Aki Takase ◽  
Yasushi Kurihara ◽  
...  

Here we present postoperative pathology of an 82-year-old woman who presented with massive ascites, and an implant-like adenocarcinoma on her intrapelvic peritoneum, which revealed a minimal (<5mm) serous adenocarcinoma on her left ovary and an intraepithelial carcinoma on inner surface of her right Fallopian tube.  The left ovarian serous adenocarcinoma may have originated as an intraepithelial carcinoma on contralateral Fallopian tube.


BMC Cancer ◽  
2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Jun Shi ◽  
Zhou Zhou ◽  
Wen Di ◽  
Ningli Li

Abstract Background Previously some groups demonstrated that CD44 variant 6 (CD44v6) is correlated with progression and metastasis of ovarian cancer. However, a number of other groups failed to find such an association. Moreover, epithelial ovarian cancer is known to easily metastasize to distinct sites such as the pelvic and abdominal cavities, but the potential association of CD44v6 expression with site-specific metastasis of ovarian cancer has not been explored. This study sought to evaluate the expression of CD44 standard (CD44s) and CD44v6 in primary, metastatic and recurrent epithelial ovarian cancer to explore the potential association of CD44s and CD44v6 with tumor progression and recurrence. Methods Tumor specimens were procured from patients with advanced (FIGO III, G3) and recurrent ovarian serous adenocarcinoma. CD44s and CD44v6 expression in the tumor tissues was evaluated by real-time RT-PCR and Western blot. Moreover, serum soluble CD44s or CD44v6 concentrations of early stage (FIGO I, G1), advanced (FIGO III, G3) and recurrent ovarian serous adenocarcinoma patients were determined by enzyme-linked immunosorbent assays (ELISA). CD44v6 expression in a different set of tumor samples on an ovarian cancer tissue chip was evaluated by immunohistochemistry (IHC) and the correlation of CD44v6 expression with clinicopathologic features was analyzed. Finally, the effects of knockdown of CD44v6 in SKOV3 cells on cell adhesion, invasion and migration were assessed. Results The expression of CD44v6, but not CD44s, is up-regulated in recurrent ovarian serous cancer compared to advanced primary tumor. CD44v6 expression is also preferentially increased in the tumor at the abdominal cavity metastasis site of advanced diseases. Consistently, serum soluble CD44v6 levels of recurrent ovarian cancer were higher than those of early stage and advanced primary diseases. The IHC data demonstrate that CD44v6 expression is correlated with clinicopathologic features and tumor progression. Lastly, knockdown of CD44v6 decreases the adhesion and migration but not invasion capacities of SKOV3 cells. Conclusions CD44v6 expression levels are associated with epithelial ovarian cancer progression, metastasis and relapse. Moreover, serum soluble CD44v6 may be used as a potential marker for identifying tumor relapse. Finally, CD44v6 may play a role in ovarian cancer metastasis by mediating tumor cell adhesion and migration.


2017 ◽  
Vol 63 (4) ◽  
pp. 627-631
Author(s):  
Tatyana Ivanova ◽  
Nataliya Sychenkova ◽  
Vera Khorokhorina ◽  
Nikolay Ryabchenko ◽  
Sergey Ivanov ◽  
...  

The distribution of APOE 4 allele (rs 429358, C) was analyzed in healthy women (N=454) and patients with ovarian serous adenocarcinoma (N=114) in order to identify genetic predisposition to the disease. We determined the prognostic indicators of the E4 allele as a marker: odds ratio (OR) and AUC (Area Under Curve) - an area under the ROC curve. It was shown that APOE 4 allele was significantly associated with ovarian serous adenocarcinoma (p = 0,003; 0R=1,94; AUC=0,55). The Е4 genotypes frequency was significantly increased among patients (p = 0.02; 0R=1,8). Separate analysis of the two age subgroups (over 46 years and younger) found that the chance of developing ovarian serous adenocarcinoma was significantly increased for older women (p = 0,006; OR = 2,24, AUC = 0,76). Possible associations of APOE 4 with the ovarian serous adenocarcinoma in women of reproductive age deserve further studying.


2021 ◽  
Vol 10 (14) ◽  
pp. 3144
Author(s):  
Danilo L. Andrade ◽  
Marina C. Viana ◽  
Sandro C. Esteves

The differential diagnosis between obstructive and nonobstructive azoospermia is the first step in the clinical management of azoospermic patients with infertility. It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. A testicular biopsy is reserved for the cases of doubt, mainly in patients whose history, physical examination, and endocrine analysis are inconclusive. The latter should be combined with sperm extraction for possible sperm cryopreservation. We present a detailed analysis on how to make the azoospermia differential diagnosis and discuss three clinical cases where the differential diagnosis was challenging. A coordinated effort involving reproductive urologists/andrologists, geneticists, pathologists, and embryologists will offer the best diagnostic path for men with azoospermia.


2021 ◽  
pp. 172460082199235
Author(s):  
Weina Zhang ◽  
Yu-min Zhang ◽  
Yuan Gao ◽  
Shengmiao Zhang ◽  
Weixin Chu ◽  
...  

Objective: CA-125 is widely used as biomarker of ovarian cancer. However, CA-125 suffers low accuracy. We developed a hybrid analytical model, the Ovarian Cancer Decision Tree (OCDT), employing a two-layer decision tree, which considers genetic alteration information from cell-free DNA along with CA-125 value to distinguish malignant tumors from benign tumors. Methods: We consider major copy number alterations at whole chromosome and chromosome-arm level as the main feature of our detection model. Fifty-eight patients diagnosed with malignant tumors, 66 with borderline tumors, and 10 with benign tumors were enrolled. Results: Genetic analysis revealed significant arm-level imbalances in most malignant tumors, especially in high-grade serous cancers in which 12 chromosome arms with significant aneuploidy ( P<0.01) were identified, including 7 arms with significant gains and 5 with significant losses. The area under receiver operating characteristic curve (AUC) was 0.8985 for copy number variations analysis, compared to 0.8751 of CA125. The OCDT was generated with a cancerous score (CScore) threshold of 5.18 for the first level, and a CA-125 value of 103.1 for the second level. Our most optimized OCDT model achieved an AUC of 0.975. Conclusions: The results suggested that genetic variations extracted from cfDNA can be combined with CA-125, and together improved the differential diagnosis of malignant from benign ovarian tumors. The model would aid in the pre-operative assessment of women with adnexal masses. Future clinical trials need to be conducted to further evaluate the value of CScore in clinical settings and search for the optimal threshold for malignancy detection.


Author(s):  
Виталий Вячеславович Аксёнов ◽  
Николай Михайлович Агарков ◽  
Александра Игоревна Сурнина

Заболеваемость раком яичников в России в последнее время остается на высоком уровне. В мире более ста тысяч женщин умирают вследствие протекания данного заболевания. За последнее десятилетие заболеваемость острым эндометритом также неуклонно возрастает. Острый эндометрит обладает полиморфизмом симптомов, лабораторных и ультразвуковых изменений и вследствие этого тяжело поддается диагностике и дифференциальной диагностике. В условиях стационара обследованы 100 пациенток с раком яичников II-III стадии и 90 пациенток с диагнозом острого эндометрита. Им выполнялось ультразвуковое исследование. Полученные результаты подвергались обработке и математико-статистическому анализу, включающему расчёт показателей дезинтеграции, сетевое моделирование, математическое ранжирование. Изучение ультразвуковых изменений кровотока в маточных и яичниковых сосудах и венах у 100 заболевших раком яичников и 90 заболевших острым эндометритом дал возможность выделить ведущие дифференциально-диагностические аспекты. Характеристики дезинтеграции, в одном ряду со средними значениями локального кровотока, объективизируют дифференциацию рака яичников и острого эндометрита. В согласовании с дифференциально-диагностической значимостью ультразвуковых характеристик артериального кровотока в маточных и яичниковых сосудах построена сетевая модель дифференциальной диагностики рака яичников и острого эндометрита по более приоритетным переменам, собственно, что разрешает уменьшить размер и время обследования пациента и постановки верного диагноза The incidence of ovarian cancer in Russia has recently remained at a high level. In the world, more than a hundred thousand women die as a result of the course of this disease. The incidence of acute endometritis has also been steadily increasing over the past decade. Acute endometritis has a polymorphism of symptoms, laboratory and ultrasound changes and, as a result, is difficult to diagnose and differential diagnosis. 100 patients with stage II-III ovarian cancer and 90 patients with acute endometritis were examined in the hospital. They performed an ultrasound examination. The obtained results were processed and subjected to mathematical and statistical analysis, including the calculation of disintegration indicators, network modeling, and mathematical ranking. The study of ultrasound changes in blood flow in the uterine and ovarian vessels and veins in 100 patients with ovarian cancer and 90 patients with acute endometritis made it possible to identify the leading differential diagnostic aspects. The characteristics of disintegration, along with the average values of local blood flow, objectify the differentiation of ovarian cancer and acute endometritis. In accordance with the differential diagnostic significance of the ultrasound characteristics of arterial blood flow in the uterine and ovarian vessels, a network model for the differential diagnosis of ovarian cancer and acute endometritis is constructed according to higher priority changes, which actually allows reducing the size and time of the patient's examination and making the correct diagnosis


2021 ◽  
Vol 14 (3) ◽  
pp. e237165
Author(s):  
Martha Sara Kedrzycki ◽  
Jaya Roy Choudhury ◽  
Sherif Hakky

Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis. Here, we present a single-centre case series of two patients presenting with caecal volvulus to an Emergency Surgery Unit at a University Hospital.


Author(s):  
Christian Pina ◽  
Ahmed Khattab ◽  
Philip Katzman ◽  
Lauren Bruckner ◽  
Jeffrey Andolina ◽  
...  

AbstractA 14-year-old female with classical congenital adrenal hyperplasia because of 21-hydroxylase deficiency underwent bilateral adrenalectomy at 6 years of age as a result of poor hormonal control. Because the patient was adrenalectomized, extra adrenal androgen production was suspected. Imaging studies including pelvic ultrasound and pelvic magnetic resonance imaging (MRI) were obtained to evaluate for adrenal rest tumors of the ovaries. Abdominal MRI was obtained to evaluate for residual adrenal tissue. A cystic lesion arising from her right ovary suspicious for ovarian neoplasm was noted on pelvic MRI. Right salpingo-oophorectomy was performed and histopathological examination revealed ovarian serous adenocarcinoma, low-grade, and well-differentiated. Tumor marker CA-125 was elevated and additional ovarian cancer staging workup confirmed stage IIIC due to one lymph node positive for carcinoma. The patient then developed a large left ovarian cyst, which led to a complete total abdominal hysterectomy and removal of the left ovary and fallopian tube. Pathology confirmed ovarian serous adenocarcinoma with microscopic focus of carcinoma in the left ovary. After numerous complications, the patient responded well to chemotherapy, CA-125 levels fell and no evidence of carcinoma was observed on subsequent imaging. To our knowledge, this is the first reported case of an ovarian serous adenocarcinoma in a patient with CAH. Although rare, we propose that the ovaries were the origin of androgen production and not residual adrenal tissue. The relationship between CAH and ovarian carcinomas has yet to be established, but further evaluation is needed given the poor survival rate of high-grade serous ovarian carcinoma.


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