Endovideosurgical technology in the diagnosis and treatment of benign ovarian tumors

2021 ◽  
Vol 50 (3) ◽  
pp. 63-65
Author(s):  
B. L. Tsivyan ◽  
A. N. Maklyak ◽  
V. F. Bezhenar
Keyword(s):  
Tumor Marker ◽  
Ovarian Tumors ◽  
Diagnosis And Treatment ◽  
Ca 125 ◽  
Differential Diagnostics ◽  
Laparoscopic Technique ◽  
Preoperative Preparation ◽  
Early Stages ◽  
Before And After ◽  
Benign Ovarian Tumors

The article deals with the new possibilities of laparoscopic technique in diagnosis and treatment of ovarian tumors. The authors elaborate the criteria of differential diagnostics of benign and malignant ovarian tumors at early stages. The research is based on the analysis of 222 cases of different ovarian tumors. The authors state the necessity of rational preoperative preparation and obligatory screening in patients with ovarian tumors before and after the operation with the use of tumor marker CA-125.

scholarly journals Diagnosis and treatment characteristics of mucinous ovarian tumors

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Tudor Rotaru ◽  
◽  
Rotaru Ludmila ◽  
Daniela Mocan ◽  
Nicu Balan ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Laboratory Diagnosis ◽  
Ovarian Tumors ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Ca 125 ◽  
Benign Ovarian Tumor ◽  
Mucinous Ovarian Tumors

Ovarian tumors occupy a special place in gynecological pathology due to their great diversity, diagnostic difficulties, specifying their evolutionary nature, establishing the prognosis and treatment. Ovarian mucinous tumors are a group of rare formations, with a cell of as yet undefined origin, but with an apparent progression from benign to borderline and carcinoma. The treatment of a benign ovarian tumor is surgical. Material and methods. The research in question was performed on a group of 50 patients, who were treated in the gynecology department of the IMSP Oncological Institute of the Republic of Moldova, with the diagnosis of mucinous ovarian tumors. Results. The study analyzed data on the diagnosis and treatment of mucinous ovarian tumors. The clinical diagnosis showed a unilateral ovarian involvement in 41 cases (82%) compared to the bilateral one registered in 9 patients (18%). All tumors were large and irregularly shaped. In the case of laboratory diagnosis in assessing the benign or malignant tumor potential, the tumor marker CA-125 was performed, in 41 patients the index was within the norm range from 0-35U / ml and only in 9 cases were there insignificant increases of 50-100U / ml. Ultrasonographic diagnosis is an important method in detecting mucinous ovarian tumors. The treatment of patients is surgical and, depending on the appearance of the tumor intraoperatively and age, they had a radical or less radical character. Conclusions. The most common clinical signs were fullness in the pelvis, dysuria, pain in the lumbar or sacral region. As usual, the mucous ovarian tumors are large. The CA-125 tumor marker was in most cases within the normal range. Imaging investigations are informative and some of them applied to all patients in the study. Endoscopic diagnostic methods are less informative in mucinous ovarian tumors due to bulky formations and the risk of effusion of the mucin into the abdominal cavity.

Analysis of Metastatic Ovarian Tumors from Extragenital Primary Sites

2006 ◽  
Vol 92 (6) ◽  
pp. 491-495 ◽  
Author(s):  
Taner Turan ◽  
Burcu Aykan ◽  
Sevgi Koc ◽  
Nurettin Boran ◽  
Gokhan Tulunay ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Primary Tumor ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Adequate Treatment ◽  
Presenting Symptoms ◽  
Preoperative Serum

Aims and background The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. Methods The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Results Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Conclusions Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.

scholarly journals Role of PET/CT in Assessment of Recurrent Ovarian Tumors

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S Kadry ◽  
A Haggag ◽  
A Ekbal
Keyword(s):  
Ovarian Cancer ◽  
Tumor Marker ◽  
Early Stage ◽  
Ovarian Tumors ◽  
University Hospital ◽  
Ca 125 ◽  
Early Stage Disease ◽  
Major Health Problem ◽  
Pet Ct ◽  
Suspected Recurrence

Abstract Background Ovarian cancer remains a major health problem worldwide, with over 225,000 new cases and 140,000 deaths reported annually. Despite high response after initial treatment, 20-30% of patients with early-stage disease and up to 75% of patients with advanced disease present with recurrence within two years. Early diagnosis of recurrence is crucial for determination of the best treatment. Aim of the Work is to detect the significance of PET/CT in the early detection of recurrent ovarian tumors. Patients and Method The study included 25 patients who have been diagnosed with ovarian cancer, received treatment and achieved complete response. All of the 25 patients had suspected recurrence either due to elevated tumor markers or suspicious clinical findings. The 25 patients have been referred for PET/CT scan at ElDemerdash university hospital from July 2017 to August 2018. Results Total of 25 patients were included in the study. 18 of 25 patients had high tumor marker (CA 125) level. The remaining 7 patients had suspected recurrence with normal tumor marker levels. Recurrence was confirmed by histopathology or clinical and imaging follow up in 19 patients of the 25 patients. Recurrent disease was not shown in 5 of 19 patients on CECT imaging and 1 of 19 patients on PET/CT imaging. PET/CT had a sensitivity of (94.74%), specificity of (100%) and accuracy of (96%). CECT has been reported with sensitivity of (73.68), specificity of (83.33%) and accuracy of (76%). Conclusion PET/CT is a useful tool and has a higher sensitivity, specificity and accuracy than CECT in detection of recurrent ovarian cancer.

THE INFLUENCE OF ENDOMETRIOID HETEROTOPIAS ON THE RED BLOOD PARAMETERS

2020 ◽  
Vol 65 (7) ◽  
pp. 424-427
Author(s):  
R. V. Ukrainets ◽  
Yulia Sergeevna Korneva
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Blood Parameters ◽  
Blood Analysis ◽  
Ca 125 ◽  
Differential Diagnostics ◽  
Ovarian Cysts ◽  
Control Group ◽  
Before And After ◽  
Medical Histories

Endometrioid heterotopia can have an adverse systemic effect on the organism through erythropoietin synthesis, which can affect erythropoiesis and reflect in blood analysis. The aim of the study was to investigate the effect of endometrioid heterotopia on parameters of red blood. The investigated group included patients with endometrioid heterotopias of various localisations (115 cases), functional ovarian cysts made up the control group (28 cases). Retrospectively, the number of red blood cells, the amount of hemoglobin, and the level of (CA-125) were recorded in the medical histories. The parameters were taken into account both before and after radical surgery. The highest values of the number of red blood cells and hemoglobin are observed in endometrioid ovarian cysts, followed by adenomyosis, endometriosis of the pelvic peritoneum and skin scar, respectively. After surgery, these differences have disappeared. Comparison of the number of red blood cells and hemoglobin before and after surgery revealed significant changes for both parameters in the group of patients with endometriosis, while in the control group the number of red blood cells and the level of hemoglobin did not change significantly. The number of cases with endometrioid ovarian cysts, where the red blood cell count was higher than normal, significantly differed from the control group; on the contrary, with non-endometrioid ovarian cysts, a significantly more frequent decreased number of red blood cells was observed. In addition, red blood counts in patients with endometriosis before surgery had a moderate negative correlation with the level of CA-125 protein.The possible systemic influence of endometrioid heterotopias on erythropoiesis in the form of its stimulation is demonstrated. In non-endometrioid ovarian cysts a significantly more frequent decrease in the number of red blood cells is observed. The reveales pecularities can be used for complex differential diagnostics of ovarian cysts at the preoperative stage due to their easy accessibility and minimally invasive nature.

scholarly journals Mass lesions of ovary - Tumor markers can be misleading

2014 ◽  
Vol 6 (3) ◽  
pp. 26-29
Author(s):  
Moothiringode Chitrabhanu Savithri ◽  
Usha Mary Abraham
Keyword(s):  
Tumor Marker ◽  
Tumor Markers ◽  
Ovarian Tumors ◽  
Treatment Modalities ◽  
Ca 125 ◽  
Medical Sciences ◽  
Ovarian Carcinomas ◽  
Ovary Tumor ◽  
Mass Lesions ◽  
Sex Cord Stromal Tumors

Background: Ovarian mass lesions could be neoplastic or non neoplastic. The less aggressive lesions should be distinguished from carcinomas which require extensive surgical procedures. CA-125 is a tumor marker used for evaluating ovarian carcinomas. In this series we found seven cases of sex cord stromal tumors (SCT) and endometriotic cysts with raised CA-125 levels, the highest value being 1540 IU/ml. Aims and Objectives: 1) To retrospectively evaluate cases which presented as mass lesions of ovary over a two year period along with CA-125 levels if available. 2) To find out the number of non carcinomatous lesions with elevation of the tumor marker CA-125. Materials and Methods: Total number of ovarian tumors and endometriotic cysts reported in the Department of Pathology, Amala Institute of Medical Sciences, Thrissur, Kerala, India in the two year period of 2012 and 2013 were retrospectively identified. CA-125 levels if available were noted. Results: Primary ovarian tumors comprised 180 cases, the rest being metastastic adenocarcinomas. There were 15 cases of SCT and 21 endometriotic cysts. CA 125 levels were increased in 2 cases each of granulosa cell tumors and fibrothecomas and 3 cases of endometriotic cysts. Highest value was 1540 IU/ml. Conclusion: Elevation of the tumor marker CA 125 often tricks the clinician into making a provisional diagnosis of carcinoma of ovary. It is important to understand the limitations in the interpretation of tumor markers so that more aggressive treatment modalities are avoided. DOI: http://dx.doi.org/10.3126/ajms.v6i3.10983  Asian Journal of Medical Sciences Vol.6(3) 2015 26-29 

Peritoneal Fluid Cytokines and the Differential Diagnosis of Benign and Malignant Ovarian Tumors and Residual/Recurrent Disease Examination

2007 ◽  
Vol 22 (3) ◽  
pp. 172-180 ◽  
Author(s):  
M. Chechlinska ◽  
J. Kaminska ◽  
J. Markowska ◽  
A. Kramar ◽  
J. Steffen
Keyword(s):  
Ovarian Cancer ◽  
Differential Diagnosis ◽  
Cancer Patients ◽  
Peritoneal Fluid ◽  
Recurrent Disease ◽  
Ovarian Tumors ◽  
Therapy Outcome ◽  
Ca 125 ◽  
Benign Ovarian Tumors ◽  
Local Cytokine

This study aimed to assess the potential value of peritoneal fluid cytokine examination for the differential diagnosis of ovarian tumors and for evaluating residual or recurrent disease after treatment. The cytokines that are commonly elevated in ovarian cancer, VEGF, IL-6, bFGF, IL-8 and M-CSF, and a reference ovarian tumor marker, CA 125, were measured in peritoneal fluids of 53 previously untreated patients with epithelial ovarian cancer, 18 ovarian cancer patients after surgical treatment and chemotherapy, and 17 patients with benign epithelial ovarian tumors. Non-parametric statistical analysis of data was performed. Ovarian cancer peritoneal fluids, as compared to peritoneal fluids of patients with benign ovarian tumors, contained significantly higher concentrations of IL-6, VEGF and CA 125, and significantly lower concentrations of bFGF and M-CSF, but only the levels of IL-6 and VEGF were significantly higher in peritoneal fluids of stage I and II ovarian cancer patients than of patients with benign ovarian conditions. IL-6 at the cutoff level of 400 pg/mL discriminated benign and malignant ovarian tumors with 92% sensitivity and 60% specificity, while VEGF at the cutoff of 400 pg/mL had 90% sensitivity and 80% specificity. At the cutoff level of 1200 pg/mL, IL-6 had 84% sensitivity and 87% specificity. A radical decrease in local cytokine and CA 125 levels in patients after treatment was independent of therapy outcome. IL-6 and VEGF measurements in peritoneal fluids might be useful for the differential diagnosis of malignant and benign ovarian conditions, but not for residual or recurrent disease examination.

scholarly journals Color Doppler sonography with contrast in the differentiation of ovarian tumors

2003 ◽  
Vol 58 (4) ◽  
pp. 185-192 ◽  
Author(s):  
Eduardo Cardoso Blanco ◽  
Ayrton Roberto Pastore ◽  
Angela Maggio da Fonseca ◽  
Filomena Marino Carvalho ◽  
Jesus Paula Carvalho ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Malignant Tumors ◽  
Color Doppler ◽  
Resistance Index ◽  
Ovarian Tumors ◽  
Benign Tumors ◽  
Positive Finding ◽  
Vascular Flow ◽  
Before And After ◽  
Benign Ovarian Tumors

The objective of this study was to differentiate benign ovarian tumors from malignant ones before surgery using color and pulsed Doppler sonography, and to compare results obtained before and after use of contrast medium, thereby verifying whether contrast results in an improvement in the diagnostic sensitivity. METHODS: Sixty two women (mean age 49.9 years) with ovarian tumors were studied, 45 with benign and 17 with malignant tumors. All women underwent a transvaginal color Doppler ultrasonographic exam. A study of the arterial vascular flow was made in all tumor areas, as well as an impedance evaluation of arterial vascular flow using the resistance index. RESULT: Localization of the vessels in the tumor revealed a greater proportion of malignant tumors with detectable internal vascular flows (64%) than benign tumors with such flows (22%). There was a considerable overlap of these findings. The use of contrast identified a greater number of vessels with confirmation in the totality of tumors, but did not improve the Doppler capacity in tumoral differentiation. Malignant tumors presented lower values of resistance index than the benign ones, whether or not contrast was used. The cutoff value for resistance index that better maximized the Doppler sensitivity and specificity was 0.55. Through this value, an increase of the sensitivity after contrast use was obtained, varying from 47% to 82%, while specificity remained statistically unchanged. CONCLUSION: Although the injection of a microbubble agent improved the sensitivity of the method detecting vascularization of tumors, a positive finding for vascularization by this method was not clinically useful in the differentiation of benign and malignant ovarian tumors.

scholarly journals Diagnostic Accuracy and Appropriate Cut Off Value of Risk of Malignancy Index in Preoperative Discrimination Between Malignant and Benign Ovarian Tumors: Prospective Cross-sectional Study

2021 ◽  
Author(s):  
bezza Kedida Dabi ◽  
Fanta Asefa Disasa ◽  
Ayantu Kebede Olika
Keyword(s):  
Diagnostic Accuracy ◽  
Menopausal Status ◽  
Cross Sectional Study ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Benign Tumors ◽  
Cross Sectional ◽  
Malignant Ovarian Tumor ◽  
Ultrasound Score ◽  
Benign Ovarian Tumors

Abstract BackgroundRisk of malignancy index (RMI) is scoring system which was introduced to differentiate between benign and malignant ovarian tumor. It incorporates CA-125, ultrasound score and menopausal status for prediction of ovarian malignancies in preoperative period. There is no universal screening method to discriminate between benign and malignant adnexal masses yet. So, this study was conducted to determine the diagnostic accuracy of RMI and determine best cut off value for RMI.MethodsProspective cross-sectional study was carried out among women with ovarian mass admitted to Gynecology ward and operated from September 1, 2019 to June 30, 2020.Data analysis was carried out using SPSS version 26. CA-125 level, menopausal status and ultrasound score were used to calculate RMI. Finally, RMI score was compared to histopathology result used as gold standard.ResultsNinity nine patients were enrolled in this study. Prevalence of benign ovarian tumors were 61.6% (61/99) and that of malignant ovarian tumors were 38.4% (38/99). The mean age for benign tumors was 30±9yrs and the mean age for malignant tumors was 50.6±10.8yrs. Among benign tumors, serous cystadenoma was the most common (36%), followed by dermoid cyst (32.9%), mucinous cyst adenoma (14.8%). The most common malignant ovarian tumor was serous cyst adenocarcinoma (63.2%), followed by mucinous cystadenocarcinoma (23.8%) and dysgerminoma (5.3%). Overall, using RMI score cut off value 220 has good sensitivity (84.2%), specificity (77%), PPV (69.5%), NPV (88.7%) and diagnostic accuracy (79.8%) for discriminating between benign and malignant ovarian tumors.ConclusionFrom this study there were high proportion of women with RMI>=220 in malignant ovarian tumors group. The study shows that there is significant role of RMI in prediction of ovarian malignancy thus helping in deciding which patients need referral to a center where gynecologic oncologists are available. It is good practice to use it in developing countries including our country because of its simplicity, safety and applicability in initial evaluations of patients with adnexal mass.

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