scholarly journals Clinical analysis of 52 adolescent patients with ovarian masses ≥10 cm in diameter

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110327
Author(s):  
Bo Zhang ◽  
Lu Zhang ◽  
Ge Meng
Keyword(s):  
Malignant Tumors ◽  
Postoperative Recurrence ◽  
Clinical Analysis ◽  
Carbohydrate Antigen ◽  
Benign Tumors ◽  
Recurrence Rates ◽  
Carbohydrate Antigen 125 ◽  
Fertility Sparing ◽  
Laparotomy Group ◽  
Ovarian Masses

Objective To investigate the clinical characteristics and treatment of large ovarian masses in adolescents. Methods Adolescents with large ovarian masses (≥10 cm in diameter) who were treated in Beijing Obstetrics and Gynecology Hospital from March 2010 to December 2018 were retrospectively assessed. Results Fifty-two female patients (mean age: 16.17±2.04 years [11–19 years]) were included and 19 (36.5%) presented with abdominal pain. The blood flow signal rate in ultrasonography was significantly different among benign, borderline and malignant ovarian masses, unlike strong echo, dotted echo and septation rates. Carbohydrate antigen 125 positivity rates were significantly different among pathological types and the endometriotic cyst group showed the highest value (75.0%). Alpha-fetoprotein positivity rates were also different among pathological types. For ovarian cystectomy, 14 and 32 patients underwent laparotomy and laparoscopy, respectively. Mass diameters were significantly higher in the laparotomy group and the operative duration was significantly shorter in the laparoscopy group. There were no significant differences in intraoperative blood loss or postoperative recurrence rates between the two groups. Conclusion Teratomas constitute the greatest group of large ovarian masses in adolescents. Benign tumors should be treated by laparoscopic resection, while borderline or malignant tumors require individualized treatment of tumors and fertility-sparing treatments.

Meningioma Radiosurgery: Tumor Control, Outcomes, and Complications among 190 Consecutive Patients

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1029-1038 ◽  
Author(s):  
Scott L. Stafford ◽  
Bruce E. Pollock ◽  
Robert L. Foote ◽  
Michael J. Link ◽  
Deborah A. Gorman ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
External Beam Radiotherapy ◽  
Survival Rates ◽  
Internal Carotid Artery Stenosis ◽  
Benign Tumors ◽  
Tumor Control ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Tumor Margin ◽  
Cause Specific Survival

ABSTRACT OBJECTIVE To determine local control (LC) and complication rates for patients with intracranial meningiomas who underwent radiosurgery. METHODS One hundred ninety consecutive patients with 206 meningiomas underwent radiosurgery between 1990 and 1998. One hundred forty-seven tumors (77%) involved the cranial base. The median age at the time of radiosurgery was 58 years (range, 20–90 yr). There were 126 female patients (66%). One hundred twelve patients (59%) had undergone one or more previous operations (median, 1; range, 1–5). Twenty-two patients (12%) had either atypical (n = 13) or malignant (n = 9) tumors. The median prescription isodose volume was 8.2 cm3 (range, 0.5–50.5 cm3), and the median tumor margin dose was 16 Gy (range, 12–36 Gy). The median imaging and clinical follow-up periods were 40 and 47 months, respectively. RESULTS Overall survival rates for the entire cohort at 5 and 7 years were 82 and 82%, respectively; cause-specific survival rates at 5 and 7 years were 94 and 92%, respectively. The cause-specific survival rates at 5 years for patients with benign, atypical, and malignant tumors were 100, 76, and 0%, respectively (P < 0.0001). The 5-year LC rate was 89%, with 114 tumors (56%) decreasing in size. LC rates were correlated with tumor histological features (P < 0.0001); patients with benign tumors exhibited a 5-year LC rate of 93%, compared with 68 and 0% for patients with atypical or malignant meningiomas, respectively. No correlation was observed between radiation dose and LC rate. Twenty-four patients (13%) experienced treatment-related complications, including cranial nerve deficits (8%), symptomatic parenchymal changes (3%), internal carotid artery stenosis (1%), and symptomatic cyst formation (1%). Only six patients (3%) exhibited decreases in functional status that were directly related to radiosurgery. Tumor volume, tumor margin dose, or previous radiotherapy was not associated with the development of radiation-related complications. CONCLUSION Radiosurgery is an effective management strategy for many patients with meningiomas. Patients with atypical or malignant tumors exhibit high recurrence rates despite the use of radiosurgery, and these patients continue to exhibit worse cause-specific survival rates despite aggressive treatment, including surgery, external-beam radiotherapy, and radiosurgery. Further study is needed to determine the tumor control and complication rates 10 years or more after meningioma radiosurgery.

scholarly journals Ovarian Masses-Applicable IOTA ADNEX Model versus Morphological Findings for Accurate Diagnosis and Treatment

2021 ◽  
Vol 11 (22) ◽  
pp. 10789
Author(s):  
Tudor Butureanu ◽  
Demetra Socolov ◽  
Daniela Roxana Matasariu ◽  
Alexandra Ursache ◽  
Ana-Maria Apetrei ◽  
...  
Keyword(s):  
At Risk ◽  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Adnexal Masses ◽  
Borderline Tumors ◽  
Benign Ovarian Tumor ◽  
Significant Difference ◽  
Ovarian Masses

A common problem in gynecological practice is the differential diagnosis of the ovarian masses. The clinician must apply the IOTA (International Ovarian Tumor Analysis) ADNEX (Assessment of Different Neoplasia in the Adnexa) model criteria to evaluate the risk of benign, borderline or malignant tumors. The aim of this study was to verify if the IOTA ADNEX model is a practical tool to be used before surgery and if there is a significant difference between IOTA ADNEX criteria and histological findings. A prospective single center study was performed between January 2017 and December 2019 in Obstetrics and Gynecology Hospital “Cuza-Voda”, Iasi, Romania. The study included 230 patients between 17 and 74 years old diagnosed with persistent adnexal masses. We applied the IOTA ADNEX model protocol predicting the risk of benign, borderline or malignant masses. The golden standard remains the histological diagnosis of the surgically removed mass. The patients that had been diagnosed using ultrasonography with persistent adnexal masses between 30 and 291 mm were operated on in our clinic. In our study. the majority of patients had benign ovarian tumor mass, these being 223 (96.96%) patients, from whom, according to IOTA ADNEX protocol, the correspondence was: 91.8–99.7% at risk of benign tumors, 0.3–4.5% at risk of borderline tumors and 0.3–8.2% at risk of malignant masses. Unexpected findings were obtained from the malignant group that included five patients (2.17%) with the following correspondence: 96.1–99% at risk of benign tumors, 0.6–2.4% at risk of borderline tumors and 1–3.9% at risk of malignant masses. After applying the IOTA ADNEX model criteria, the patients with a suspicion of malignant disease were correctly guided towards surgical treatment in an oncological center. In our hospital, surgical treatment was only proposed to those patients with high suspicion of benign masses.

scholarly journals Histopathological diagnosis of ovarian mass

2018 ◽  
Vol 8 (1) ◽  
pp. 1261-1264
Author(s):  
Shahali Shadab ◽  
Tadayon Tadayon
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Age Groups ◽  
Germ Cell Tumors ◽  
Cystic Teratoma ◽  
Mature Cystic Teratoma ◽  
Benign Tumors ◽  
Histopathological Diagnosis ◽  
Hospital Data ◽  
Ovarian Masses

Background:  Ovarian cysts are common forms of gynecological problems that can be range from physiological cysts to highly aggressive neoplastic lesions. The purpose of this study was to investigate prevalence and frequency of different histopathological patterns of ovarian lesions and their correlation with various parameters in Ahvaz, Iran.Materials and Methods: This is the retrospective study of patients with the ovarian masses at Ahvaz Imam Khomeini Hospital from 2010 - 2015. The relevant clinical details about the patient were retrieved from hospital data. Clinical characteristics of patients such as patient's age, presenting signs and symptoms, histopathological diagnosis, mass type, mass subtype, size of cysts and ovary which is involved were noted. Results: Two hundred sixty seven specimens of ovarian tumor obtained for histopathological examination. Of these, 163(61.0%) were tumor like, 96(36.0%) were benign tumor and 8(3.0%) were malignant. The most common tumor like conditions was Corpus luteum cyst (43.4% cases), among benign and malignant tumors, mature cystic teratoma (17.2% of total) and Epithelial tumors (n=4) were most common. There is a statistically significant positive relation between age and various ovarian masses. (P= 0.002). Histopathological diagnosis wasn't correlated with ovarian involvement.Conclusion: Benign tumors are more common than malignant tumors in all age groups. Germ cell tumors followed by surface epithelial cell tumors are the commonest tumor. Mature cystic teratoma was the most common tumor. Unilaterality is more frequently seen in ovarian tumors and various tumors are seen in various age groups.

scholarly journals Do women with benign versus malignant ovarian masses demonstrate variable clinical presentation?

2020 ◽  
Vol 10 (1) ◽  
pp. 132
Author(s):  
Nilajkumar D. Bagde ◽  
Madhuri Bagde ◽  
Sarita Agrawal ◽  
Zamir A. Lone ◽  
Nighat Hussain
Keyword(s):  
Early Diagnosis ◽  
Malignant Tumors ◽  
Tertiary Care ◽  
Ovarian Tumors ◽  
Lumbar Pain ◽  
Benign Tumors ◽  
Tertiary Care Centre ◽  
History Of ◽  
Ovarian Pathology ◽  
Ovarian Masses

Background: Early diagnosis of ovarian tumors is a challenge due to variable presentation. Early diagnosis of ovarian cancers aids in timely management and better clinical outcomes. Aim of study was to determine the different clinical presentations of ovarian tumors and compare those in benign tumors versus malignancies.Methods: Clinical data of all women operated for ovarian masses was extracted from case files at a tertiary care centre and evaluated and clinical features compared in women with benign versus malignant tumors.  Results: We found 50 cases of ovarian tumors with 26% malignancies. The mean age was 38.48+14.9 years. Malignancies were significantly common in menopausal than menstruating (χ2=13.57, p=0.001, fishers exact). Pain was the commonest symptom and combined lumbar and iliac pain was reported in 67% cases. The location of pain was not significantly different in women with malignancy compared to those with benign tumors (likelihood ratio χ2=7.93, p=0.24). The odds of reporting a mass in abdomen were significantly greater in women with cancers than benign tumors (OR= 4.9, 95%CI 1.07-24.06, p=0.01). More women with cancer had history of distension of abdomen compared to women with benign tumors (χ2=9.43, p=0.002).Conclusions: Lumbar pain is most frequent complaint in women with ovarian pathology. Symptoms of distension in abdomen or presence of lump in abdomen are a significant guide to alert the physician regarding possibility of malignancy must be evaluated without delay.

OVARIAN MASQUERADES: A COMPARATIVE STUDY OF FROZEN SECTION REPORTING OF OVARIAN MASSES WITH FINAL HISTOPATHOLOGICAL DIAGNOSIS AT A TERTIARY CANCER CENTRE: A TWO YEAR STUDY.

2021 ◽  
pp. 22-24
Author(s):  
Champaka G ◽  
Akkamahadevi S Patil ◽  
Geeta V. Patil Okaly ◽  
Suma M N ◽  
Usha Amirtham ◽  
...  
Keyword(s):  
Ovarian Neoplasms ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Treatment Plan ◽  
Benign Tumors ◽  
Malignant Neoplasms ◽  
Histopathological Diagnosis ◽  
Ovarian Carcinomas ◽  
Predictive Values ◽  
Ovarian Masses

Introduction: Intraoperative assessment of ovarian neoplasms on Frozen section (FS) as epithelial and non-epithelial types is crucial for appropriate surgical management. Accurate categorization is important as treatment plan includes cystectomy for benign tumors, extensive staging procedures for ovarian carcinomas and oophorectomy or limited surgical staging for borderline tumors especially in younger patients to preserve fertility. Objectives: To study the accuracy of ovarian FS interpretation with reference to nal histopathological (HPE) diagnosis on parafn embedded sections after analyzing by morphology and immunohistochemistry (IHC) wherever necessary. Materials and Methods:Aretrospective analysis of 170 cases of FS study on ovarian masses during the period of two years (2017, 2018) was done at a tertiary oncology center. Results: Of the total 170 cases on frozen, 74 cases were benign, 27 cases borderline and 69 cases malignant. On nal HPE 73 cases were benign, 20 cases borderline and 77 cases malignant neoplasms. The sensitivity and specicity were 95.89%, 95.87% in benign tumors, 80%, 92.66% in borderline and 88.3%, 98.92% in malignant tumors respectively. The positive and negative predictive values were 94.59%, 96.87% in benign lesions, 59.25%, 97.20% in borderline, 98.55%, and 91.08% in malignant neoplasms respectively. Conclusions:In our study there was a good concordance between frozen and nal histopathology in the diagnosis of benign and malignant ovarian neoplasms. Ovarian FS study is a reliable tool for intraoperative decision making regarding the extent of surgery

Retrospective study on parotid gland tumors

ORL ro ◽  
2016 ◽  
Vol 4 (1) ◽  
pp. 22-23
Author(s):  
Ibric Cioranu ◽  
Vlad Petrescu Seceleanu ◽  
Viorel Ibric Cioranu ◽  
Andreea Smarandache ◽  
Sorin Vasilescu ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Maxillofacial Surgery ◽  
Squamous Carcinoma ◽  
Benign Tumors ◽  
Warthin Tumor ◽  
Parotid Tumors ◽  
Non Hodgkin Lymphoma ◽  
Adenoid Cystic ◽  
Modal Treatment ◽  
Surgery Department

During 2011-2012, 56 patients diagnosed with parotid tumors were admitted to the Maxillofacial Surgery Department of “Lucian Blaga” University and in Euroclinic Hospital. 72% were benign tumors and 28% malignant. All patients received surgical treatment (total or partial parotidectomy). For the malignant tumors, radiotherapy was added to the modal treatment (94% of the cases). Pleomorphic adenoma was encountered in 70% of the benign cases, followed by Warthin tumor in 15%. Adenoid cystic carcinoma was noticed in 31% of the malignant cases, mucoepidermoid carcinoma in 25% of the cases, and squamous carcinoma and non-Hodgkin lymphoma on 12.5% of the malignant cases.  

scholarly journals Benign Ovarian Cysts with Raised CA-125 Levels: Do We Need to Evaluate the Fallopian Tubes?

2020 ◽  
Vol 12 (04) ◽  
pp. 276-280
Author(s):  
Devesh Sharma ◽  
Anjali Vinocha
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Cyst ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Carbohydrate Antigen ◽  
Ca 125 ◽  
Ovarian Cysts ◽  
Fallopian Tubes ◽  
Case Record ◽  
Carbohydrate Antigen 125

Abstract Objectives It is not clearly known whether some benign (simple) ovarian cysts can convert into cancerous cysts. Size of cyst and wall abnormalities do predict the potentiality of malignancy. Not many studies have been done to explore the malignant potential of large-sized (> 5 cm) unilocular ovarian cysts without wall abnormalities. This study evaluated the correlation between ultrasonographic size of benign ovarian cysts and carbohydrate antigen 125 (CA-125) levels. Methodology Sixty (60) premenopausal women were recruited for the study preoperatively, based on transvaginal ultrasound (TVUS) findings present in the case record sheet received along with the CA-125 sample in the biochemistry laboratories. Those cases with elevated CA-125 levels were selected, where patients had unilocular ovarian cysts without wall abnormalities. CA-125 was done using ECLIA methodology (Cobas e411, Germany). Statistical correlation was calculated between the ovarian cyst size and CA-125 levels using Spearman’s Rho coefficient. Results Mean age group of subjects were 29.7 ± 7.3 years and mean value of CA-125 (normal < 35 IU/mL) was found to be increased: 118.0 ± 147.1 IU/mL so was the mean diameter of cysts (cut off ≤ 5 cm): 48.6 ± 59.8 cm. No correlation was found between CA-125 levels and volume of ovarian cyst (r = 0.005, p = 0.680) for all subjects. Conclusions The lack of correlation between size of ovarian cysts and CA-125 levels provides a hint that the ovarian cyst epithelium does not directly express CA-125 and it may come from sites like the fallopian tube. Thus, raised level of CA-125 in benign ovarian cyst should be followed-up more closely, demanding assessment of fallopian tubes for early diagnosis of ovarian cancer. Also, algorithms can be explored to include size of ovarian cyst and CA 125 levels to predict ovarian cancer.

scholarly journals Multimodality imaging review of focal renal lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Jonathan Lyske ◽  
Rishi Philip Mathew ◽  
Christopher Hutchinson ◽  
Vimal Patel ◽  
Gavin Low
Keyword(s):  
Malignant Tumors ◽  
Multimodality Imaging ◽  
Lymphoproliferative Disease ◽  
Benign Tumors ◽  
Main Body ◽  
Imaging Features ◽  
Focal Lesions ◽  
Renal Lesions ◽  
Positron Emission ◽  
Neoplastic Lesions

Abstract Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.

The Correlation between Vitamin D Levels and the Risk of Postoperative Recurrence in Crohn’s Disease

Digestion ◽  
2021 ◽  
pp. 1-9
Author(s):  
Akihiro Yamada ◽  
Yuga Komaki ◽  
Fukiko Komaki ◽  
Haider Haider ◽  
Dejan Micic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Reactive Protein ◽  
Endoscopic Recurrence ◽  
Vitamin D Levels ◽  
Endoscopic Remission ◽  
The University

<b><i>Background and Aims:</i></b> Vitamin D deficiency has been associated with disease activity in Crohn’s disease (CD). We assessed whether there is a correlation between vitamin D levels and the risk of postoperative recurrence in CD. <b><i>Methods:</i></b> CD patients who underwent surgery were identified from a prospectively maintained database at the University of Chicago. The primary endpoint was the correlation of serum 25-hydroxy vitamin D levels measured at 6–12 months after surgery and the proportion of patients in endoscopic remission, defined as a simple endoscopic score for CD of 0. Clinical, biological (C-reactive protein), and histologic recurrences were also studied. <b><i>Results:</i></b> Among a total of 89 patients, 17, 46, and 26 patients had vitamin D levels of &#x3c;15, 15–30, and &#x3e;30 ng/mL, respectively. Patients with higher vitamin D levels were significantly more likely to be in endoscopic remission compared to those with lower levels (23, 42, and 67% in ascending tertile order; <i>p</i> = 0.028). On multivariate analysis, vitamin D &#x3e;30 ng/mL (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.07–0.66, <i>p</i> = 0.006) and anti-tumor necrosis factor agent treatment (OR 0.25, 95% CI 0.08–0.83, <i>p</i> = 0.01) were associated with reduced risk of endoscopic recurrence. Rates of clinical, biological, and histologic remission trended to be higher in patients with higher vitamin D levels (<i>p</i> = 0.17, 0.55, 0.062, respectively). <b><i>Conclusion:</i></b> In the present study, higher vitamin D level was associated with lower risk of postoperative endoscopic CD recurrence. Further, studies are warranted to assess the role of vitamin D in postoperative CD recurrence.

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