Ovarian sex cord stromal tumours: analysis of the clinical and sonographic characteristics of different histopathologic subtypes

Abstract Background Ovarian sex cord stromal tumours (OSCSTs) are rare ovarian tumours and include different histopathologic subtypes. This study aimed to analyse the clinical and sonographic characteristics of different histopathologic OSCST subtypes. Methods A total of 63 patients with surgically proven OSCSTs were enrolled in this retrospective study to analyse their clinical and sonographic features. Ultrasound examinations and predictive models were performed before surgery. The clinical and sonographic findings were compared according to the type of OSCST based on the histopathological diagnosis. Results The mean age of 63 patients was 52.17 years (range: 17–78 years). Eighteen patients experienced irregular vaginal bleeding (28.57% 18/63), 7 patients exhibited abnormal body hair (11.11%). 2 patients (3.17%) showed an increased level of CA125, and 25 patients (39.68%, 25/63) showed an increased level of testosterone. Forty-two patients had ovarian thecoma-fibroma groups (OTFGs). Six patients had Sertoli-Leydig cell tumours (S-LCTs), 4 patients had Leydig cell tumours (LCTs), 8 patients had ovarian granulosa cell tumours (OGCTs), 2 patients had ovarian steroid cell tumours, not otherwise specified (OSCTs-NOS), and one patient had sclerosing stromal tumours (SSTs). The mean diameter of the tumour was 47.9 mm (range: 10–258 mm). Forty-seven masses were hypoechoic (74.60%). Twenty-eight masses had posterior echo attenuation, 22 masses exhibited abundant Doppler flow signals (34.92%), and one patient had ascites (1.59%). The diagnostic accuracy of the Simple Rules (SR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model in distinguishing benign and malignant OSCSTs was 44% (30/63) and 84% (53/63), respectively. The diagnostic accuracy of the SR for OTFGs, S-LCTs & LCTs & OSCTs-NOS, OGCTs, and SSTs was 47.6% (20/42), 16.67% (2/12), 100% (8/8), and 0% (0/1), respectively. The diagnostic accuracy of the ADNEX model for OTFGs, S-LCTs & LCTs & OSCTs-NOS, OGCTs, and SSTs was 93% (31/42), 58.33% (7/12), 75% (6/8), and 100% (1/1), respectively. Conclusions OSCSTs generally appear as a solid mass on ultrasound. Posterior echo attenuation indicates an OTFG. A solid mass with abundant Doppler flow signals indicates an S-LCT, LCT, OSCT-NOS or OGCT. Current predictive models are not very effective, but symptoms, sonographic features and serum hormones are helpful for diagnosis.

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Features of Thrombi and Diagnostic Accuracy of Impedance Plethysmography in Symptomatic and Asymptomatic Deep Vein Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649563 ◽

1993 ◽

Vol 70 (02) ◽

pp. 266-269 ◽

Cited By ~ 21

Author(s):

Giancarlo Agnelli ◽

Benilde Cosmi ◽

Stefano Radicchia ◽

Franca Veschi ◽

Enrico Boschetti ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Diagnostic Accuracy ◽

High Sensitivity ◽

Impedance Plethysmography ◽

Surveillance Programme ◽

Vein Thrombosis ◽

Asymptomatic Patients ◽

High Prevalence ◽

The Mean ◽

Deep Vein

SummaryImpedance plethysmography (IPG) has high sensitivity and specificity in patients with symptomatic deep vein thrombosis (DVT) while it fails to detect asymptomatic DVT. The aim of this study was to determine whether the features of thrombi such as location, size and occlusiveness could explain the different accuracy of IPG in symptomatic and asymptomatic DVT patients. One-hundred and seventeen consecutive outpatients with a clinical suspicion of DVT and 246 consecutive patients undergoing hip surgery were admitted to the study. In symptomatic patients IPG was performed on the day of referral, followed by venography, while in asymptomatic patients IPG was performed as a surveillance programme, followed by bilateral venography.A venography proved DVT was observed in 37% of the symptomatic patients and 34% of the asymptomatic limbs. A significantly higher proportion of proximal DVTs was found in symptomatic patients than in asymptomatic patients (78% vs 46%; p = 0.001). The mean Marder score, taken as an index of thrombus size, was significantly higher in symptomatic patients than in asymptomatic patients (19.0 vs 9.6; p = 0.0001). A significantly higher proportion of occlusive DVTs was observed in symptomatic than in asymptomatic patients (69% vs 36%; p = 0.001).We conclude that the unsatisfactory diagnostic accuracy of IPG in asymptomatic DVT is due to the high prevalence of distal, small and non occlusive thrombi. Such thrombi are unlikely to cause a critical obstruction of the venous outflow and therefore to produce a positive IPG.

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NEW VIEWS ON THE HORMONE-PRODUCING MESENCHYMOMAS OF THE OVARIES

Acta Endocrinologica ◽

10.1530/acta.0.xxxv0513 ◽

1960 ◽

Vol XXXV (IV) ◽

pp. 513-517

Author(s):

W. P. Plate

Keyword(s):

Granulosa Cell ◽

Sertoli Cell ◽

Leydig Cell ◽

Cell Tumour ◽

Theca Cell ◽

Granulosa Cell Tumour ◽

Sertoli Cell Tumours ◽

Leydig Cell Tumours

ABSTRACT The hormone-producing mesenchymomas of the ovaries can be divided into androblastomas and gynaecoblastomas. The former are derived from »male« elements, and consist of Sertoli-cell tumours and Leydig-cell tumours. The latter arise from »female« elements and consist of granulosacell tumours and theca-cell tumours. Sertoli-cell tumours and granulosacell tumours produce oestrogens, while Leydig-cell tumours and theca-cell tumours produce oestrogens or androgens. Histologically, androblastomas and gynaecoblastomas are often difficult to distinguish. Since no »female« elements occur in a testicle, a granulosa-cell tumour in a testicle is improbable. Gynandroblastomas, therefore, can only be found in an ovary.

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Spermatogenesis and testicular tumours in ageing dogs

Reproduction ◽

10.1530/reprod/120.2.443 ◽

2000 ◽

pp. 443-452 ◽

Cited By ~ 20

Author(s):

MA Peters ◽

DG de Rooij ◽

KJ Teerds ◽

I van Der Gaag ◽

FJ van Sluijs

Keyword(s):

Sertoli Cell ◽

Leydig Cell ◽

Seminiferous Tubules ◽

Score System ◽

Testicular Tumours ◽

Severe Impairment ◽

Per Se ◽

Testicular Disease ◽

Sertoli Cell Tumours ◽

Leydig Cell Tumours

Spermatogenesis was examined in testes from 74 dogs of various breeds without clinically detected testicular disease. A modified Johnsen score system was used to determine whether spermatogenesis deteriorates with ageing. The diameter of seminiferous tubules was measured in dogs without testicular disease to examine other possible effects of ageing on tubular performance. There appeared to be no relation between age and these variables. The influence of testicular tumours on spermatogenesis was also investigated in both affected and unaffected testes. The testes of 28 dogs with clinically palpable tumours and 21 dogs with clinically non-palpable tumours were investigated. In cases of unilateral occurrence of a tumour, impairment of spermatogenesis was observed only in the affected testis of dogs with clinically detected tumours. Bilateral occurrence of tumours, whether detected clinically or non-clinically, was associated with severe impairment of spermatogenesis. The prevalence of tumours increased during ageing. Eighty-six per cent of the clinically detected and 57% of the non-clinically detected tumours were found in old dogs. Multiple types of tumour and bilateral occurrence were very common. Seminomas and Leydig cell tumours were more frequent than Sertoli cell tumours. It was concluded that spermatogenesis per se did not decrease during ageing in dogs but the occurrence of testicular tumours increased with ageing and affected spermatogenesis significantly, as reflected by a lower Johnsen score.

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AB1346-HPR REAL-WORLD EFFECTIVENESS AND PERCEIVED USEFULNESS OF SYMPTOM CHECKERS IN RHEUMATOLOGY: INTERIM REPORT FROM THE PROSPECTIVE MULTICENTER BETTER STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1604 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1961.1-1961

Author(s):

J. Knitza ◽

J. Mohn ◽

C. Bergmann ◽

E. Kampylafka ◽

M. Hagen ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Real World ◽

Search Engines ◽

Correct Diagnosis ◽

Perceived Usefulness ◽

Symptom Duration ◽

Research Support ◽

Link Type ◽

The Mean ◽

Research Grant

Background:Symptom checkers (SC) promise to reduce diagnostic delay, misdiagnosis and effectively guide patients through healthcare systems. They are increasingly used, however little evidence exists about their real-life effectiveness.Objectives:The aim of this study was to evaluate the diagnostic accuracy, usage time, usability and perceived usefulness of two promising SC, ADA (www.ada.com) and Rheport (www.rheport.de). Furthermore, symptom duration and previous symptom checking was recorded.Methods:Cross-sectional interim clinical data from the first of three recruiting centers from the prospective, real-world, multicenter bETTeR-study (DKRS DRKS00017642) was used. Patients newly presenting to a secondary rheumatology outpatient clinic between September and December 2019 completed the ADA and Rheport SC. The time and answers were recorded and compared to the patient’s actual diagnosis. ADA provides up to 5 disease suggestions, Rheport calculates a risk score for rheumatic musculoskeletal diseases (RMDs) (≥1=RMD). For both SC the sensitivity, specificity was calculated regarding RMDs. Furthermore, patients completed a survey evaluating the SC usability using the system usability scale (SUS), perceived usefulness, previous symptom checking and symptom duration.Results:Of the 129 consecutive patients approached, 97 agreed to participate. 38% (37/97) of the presenting patients presented with an RMD (Figure 1). Mean symptom duration was 146 weeks and a mean number of 10 physician contacts occurred previously, to evaluate current symptoms. 56% (54/96) had previously checked their symptoms on the internet using search engines, spending a mean of 6 hours. Rheport showed a sensitivity of 49% (18/37) and specificity of 58% (35/60) concerning RMDs. ADA’s top 1 and top 5 disease suggestions concerning RMD showed a sensitivity of 43% (16/37) and 54% (20/37) and a specificity of 58% (35/60) and 52% (31/60), respectively. ADA listed the correct diagnosis of the patients with RMDs first or within the first 5 disease suggestions in 19% (7/37) and 30% (11/37), respectively. The average perceived usefulness for checking symptoms using ADA, internet search engines and Rheport was 3.0, 3.5 and 3.1 on a visual analog scale from 1-5 (5=very useful). 61% (59/96) and 64% (61/96) would recommend using ADA and Rheport, respectively. The mean SUS score of ADA and Rheport was 72/100 and 73/100. The mean usage time for ADA and Rheport was 8 and 9 minutes, respectively.Conclusion:This is the first prospective, real-world, multicenter study evaluating the diagnostic accuracy and other features of two currently used SC in rheumatology. These interim results suggest that diagnostic accuracy is limited, however SC are well accepted among patients and in some cases, correct diagnosis can be provided out of the pocket within few minutes, saving valuable time.Figure:Acknowledgments:This study was supported by an unrestricted research grant from Novartis.Disclosure of Interests:Johannes Knitza Grant/research support from: Research Grant: Novartis, Jacob Mohn: None declared, Christina Bergmann: None declared, Eleni Kampylafka Speakers bureau: Novartis, BMS, Janssen, Melanie Hagen: None declared, Daniela Bohr: None declared, Elizabeth Araujo Speakers bureau: Novartis, Lilly, Abbott, Matthias Englbrecht Grant/research support from: Roche Pharma, Chugai Pharma Europe, Consultant of: AbbVie, Roche Pharma, RheumaDatenRhePort GbR, Speakers bureau: AbbVie, Celgene, Chugai Pharma Europe, Lilly, Mundipharma, Novartis, Pfizer, Roche Pharma, UCB, David Simon Grant/research support from: Else Kröner-Memorial Scholarship, Novartis, Consultant of: Novartis, Lilly, Arnd Kleyer Consultant of: Lilly, Gilead, Novartis,Abbvie, Speakers bureau: Novartis, Lilly, Timo Meinderink: None declared, Wolfgang Vorbrüggen: None declared, Cay-Benedict von der Decken: None declared, Stefan Kleinert Shareholder of: Morphosys, Grant/research support from: Novartis, Consultant of: Novartis, Speakers bureau: Abbvie, Novartis, Celgene, Roche, Chugai, Janssen, Andreas Ramming Grant/research support from: Pfizer, Novartis, Consultant of: Boehringer Ingelheim, Novartis, Gilead, Pfizer, Speakers bureau: Boehringer Ingelheim, Roche, Janssen, Jörg Distler Grant/research support from: Boehringer Ingelheim, Consultant of: Boehringer Ingelheim, Paid instructor for: Boehringer Ingelheim, Speakers bureau: Boehringer Ingelheim, Peter Bartz-Bazzanella: None declared, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Axel Hueber Grant/research support from: Novartis, Lilly, Pfizer, Consultant of: Abbvie, BMS, Celgene, Gilead, GSK, Lilly, Novartis, Speakers bureau: GSK, Lilly, Novartis, Martin Welcker Grant/research support from: Abbvie, Novartis, UCB, Hexal, BMS, Lilly, Roche, Celgene, Sanofi, Consultant of: Abbvie, Actelion, Aescu, Amgen, Celgene, Hexal, Janssen, Medac, Novartis, Pfizer, Sanofi, UCB, Speakers bureau: Abbvie, Aescu, Amgen, Biogen, Berlin Chemie, Celgene, GSK, Hexal, Mylan, Novartis, Pfizer, UCB

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Leydig Cell Tumours: a Case Series from a Single Irish Centre

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-021-00841-3 ◽

2021 ◽

Author(s):

Hailey K. Carroll ◽

Tom Nolis ◽

Waseem Darwish ◽

Michele Harrison ◽

John A. McCaffrey

Keyword(s):

Leydig Cell ◽

Case Series ◽

Leydig Cell Tumours

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The value of the added diffusion-weighted images to multiparametric MRI in the early diagnosis of uterine cervix cancers and nodal assessment

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00420-5 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Nasr Mohamed Osman ◽

Mohamed Aboul-fotouh Mourad

Keyword(s):

Early Diagnosis ◽

Diagnostic Accuracy ◽

Multiparametric Mri ◽

Lesion Group ◽

Cervical Lesions ◽

Adc Value ◽

Diffusion Weighted ◽

Group I ◽

Malignant Lesions ◽

The Mean

Abstract Background Cervical cancer still one of the most common causes of tumor-related death in developing countries presented in younger women. In this study, we aimed to evaluate the value of diffusion-weighted MRI in early diagnosis of malignant cervical lesions, to assess metastatic adenopathy, peritoneal dissemination, and possible tumor recurrence, and determine treatment response. This study included 60 patients with abnormal vaginal bleeding and suspected cervical lesion by US. A histopathological biopsy was done. Pelvic MR with DWI and dynamic contrast-enhanced MRI were done for all patients. Results According to the histopathological findings, we divided our studied 60 patents into two groups: group I, malignant lesions (46 lesions; 76.7%), and group II, benign lesions (14 lesions; 23.3%). Multiparametric MRI could detect all cervical lesions but with poor pathologic characterization, achieving 72.37% sensitivity, 37.50% specificity, 63.33% accuracy, 76.19% PPV, and 33.33% NPV. When compared with DWI with ADC value measurements at high b value (b = 800) to MRI exam, it showed a higher diagnostic accuracy with good lesion pathological characterization that achieved 95.65% sensitivity, 71.43% specificity, 90% accuracy, 91.67 PPV, and 83.33% NPV. The mean ADC value for malignant lesions was 0.86–1.1, mean = 0.92 ± 0.71 × 10−3 mm2/s, while the mean ADC value in the benign lesion group was 1.18 ± 0.1 × 10–3 mm2/s. Conclusion Comparing DWI with ADC values measurements at high b value to the multiparametric MRI examination of the female pelvis increases the sensitivity, specificity, and diagnostic accuracy of characterization and early diagnosis of cervical malignant focal lesions and reduces the need for intravenous contrast administration.

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Usefulness of point-of-care ultrasound in military medical emergencies performed by young military medicine residents

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2018-001132 ◽

2019 ◽

pp. jramc-2018-001132

Author(s):

Pierre Perrier ◽

J Leyral ◽

O Thabouillot ◽

D Papeix ◽

G Comat ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Clinical Examination ◽

Point Of Care ◽

Military Medicine ◽

Final Diagnosis ◽

Absolute Difference ◽

Point Of Care Ultrasound ◽

Medical Emergencies ◽

The Mean ◽

A Prospective Study

IntroductionTo evaluate the usefulness of point-of-care ultrasound (POCUS) performed by young military medicine residents after short training in the diagnosis of medical emergencies.MethodsA prospective study was performed in the emergency department of a French army teaching hospital. Two young military medicine residents received ultrasound training focused on gall bladder, kidneys and lower limb veins. After clinical examination, they assigned a ‘clinicaldiagnostic probability’ (CP) on a visual analogue scale from 0 (definitely not diagnosis) to 10 (definitive diagnosis). The same student performed ultrasound examination and assigned an ‘ultrasounddiagnostic probability’ (UP) in the same way. The absolute difference between CP and UP was calculated. This result corresponded to the Ultrasound Diagnostic Index (UDI), which was positive if UP was closer to the final diagnosis than CP (POCUS improved the diagnostic accuracy), and negative conversely (POCUS decreased the diagnostic accuracy).ResultsForty-eight patients were included and 48 ultrasound examinations were performed. The present pathologies were found in 14 patients (29%). The mean UDI value was +3 (0–5). UDI was positive in 35 exams (73%), zero in 12 exams (25%) and negative in only one exam (2%).ConclusionPOCUS performed after clinical examination increases the diagnostic accuracy of young military medicine residents.

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Sertoli-Leydig Cell Tumour and DICER1 Mutation: A Case Report and Review of the Literature

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/7927362 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

B. Wormald ◽

S. Elorbany ◽

H. Hanson ◽

J. W. Williams ◽

S. Heenan ◽

...

Keyword(s):

Case Report ◽

Gene Mutation ◽

Leydig Cell ◽

Autosomal Dominant ◽

Review Of The Literature ◽

Autosomal Dominant Fashion ◽

Rare Tumours ◽

Leydig Cell Tumour ◽

Underlying Pathology ◽

Leydig Cell Tumours

Sertoli-Leydig cell tumours of the ovary (SLCT) are rare tumours predominantly caused by mutations in the DICER1 gene. We present a patient with a unilateral SLCT who had an underlying germline DICER1 gene mutation. We discuss the underlying pathology, risks, and screening opportunities available to those with a mutation in this gene as SLCT is only one of a multitude of other tumours encompassing DICER1 syndrome. The condition is inherited in an autosomal dominant fashion. As such, genetic counselling is a key component of the management of women with SLCT.

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