scholarly journals Primary appendiceal adenocarcinoma presenting as advanced ovarian cancer: a case report

2020 ◽  
Author(s):  
Kung-Chuan Cheng ◽  
Ko-Chao Lee ◽  
Hong-Hwa Chen ◽  
YC Ou
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Ovarian Metastasis ◽  
Advanced Stage ◽  
Primary Ovarian Cancer ◽  
Appendiceal Adenocarcinoma ◽  
Menopausal Women ◽  
Initial Symptoms

Abstract BackgroundAlthough Primary appendiceal malignancies are rare accounting for less than 1% of all gastrointestinal tumors, the incidence of ovarian metastasis in appendiceal adenocarcinoma is encountered in 16.7 to 37% of all ovarian malignancy. The diagnosis is usually made after an exploratory laparotomy. Most of these tumors present with nonspecific symptoms, such as abdominal pain, abdominal fullness and huge pelvic mass, mimicking advanced stage ovarian cancer.Case PresentationWe described two menopausal women who were referred to our institution under the diagnostic impression of advanced stage of primary ovarian cancer. However, both patients were eventually found to have primary appendiceal adenocarcinoma with ovarian metastasis at laparotomy. Initial symptoms, intraoperative finding, pathology finding, and postoperative clinical courses were documented.ConclusionsComparing with primary ovarian tumor, ovarian metastasis is relatively rare. The clinical presentation can be misleading and the differential diagnoses of primary appendiceal cancer should be considered when preoperative workup is planned.

scholarly journals Primary appendiceal adenocarcinoma presenting as advanced ovarian cancer: a case report

2020 ◽  
Author(s):  
Kung-Chuan Cheng ◽  
Ko-Chao Lee ◽  
Hong-Hwa Chen ◽  
YC Ou
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Ovarian Metastasis ◽  
Advanced Stage ◽  
Primary Ovarian Cancer ◽  
Appendiceal Adenocarcinoma ◽  
Menopausal Women ◽  
Initial Symptoms

Abstract Background Account for less than 1% of all gastrointestinal tumors, primary appendiceal malignancies are rare and their diagnoses are usually made after exploratory laparotomy. Most of them present with nonspecific symptoms, such as abdominal pain, abdominal fullness and huge pelvic mass, mimicking advanced stage ovarian cancer.Case Presentation We described two menopausal women who were referred to our institution under the impression of advanced stage of primary ovarian cancer. However, both patients were eventually found to have primary appendiceal adenocarcinoma with ovarian metastasis at laparotomy. Initial symptoms, intraoperative finding, pathology finding, and postoperative clinical courses were recorded.Conclusions Comparing with primary ovarian tumor, ovarian metastasis is relatively rare. The clinical picture can be misleading and the differential diagnoses of primary appendiceal cancer should be considered when preoperative workup is planned.

scholarly journals Preoperative Lymphocyte-to-monocyte Ratio and CA125 Level as Risk Factors for Advanced Ovarian Cancer

2020 ◽  
Author(s):  
Ying Tang ◽  
Huiquan Hu ◽  
Yalan Tang ◽  
Fangxiang Tang ◽  
Dan Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Logistic Regression ◽  
Early Stage ◽  
Advanced Ovarian Cancer ◽  
High Specificity ◽  
Advanced Stage ◽  
Binary Logistic Regression Model ◽  
Lymphocyte To Monocyte Ratio ◽  
The Relationship

Abstract Background: Detailed descriptions of the relationship between lymphocyte-to-monocyte ratio alone and combined with CA125 (COLC) and advanced stage of ovarian cancer (OC) have been lacking to date. This study is to analyze the relationship between LMR, CA125 and COLC and advanced stage of OC.Methods: A retrospective clinicopathologic review was performed. The receiver-operating characteristic (ROC) curves of LMR, CA125, and COLC staging OC were constructed. Furthermore, a binary logistic regression model was used to assay the independent risk factors.Results: A total of 225 patients with OC were identified in this cohort. Eighty-five patients with OC were diagnosed at an early stage, and 140 OC patients were diagnosed at an advanced stage. The median of LMR at the early stage was higher than the advanced stage (4.39 vs. 2.78), and the median of CA125 was lower than the advanced stage (80 U/mL vs. 251.25 U/mL). Multivariate logistic regression indicated that LMR (OR=0.314, 95% confidence interval [CI]: 0.143–0.687, P=0.004) and CA125 (OR=4.045, 95%CI: 1.883–8.692, P<0.001) were associated with OC staging. Furthermore, the area under the curve of COLC was higher than that of LMR (0.779 vs. 0.732) or CA125 (0.779 vs. 0.708) in staging OC. The specificity of COLC was higher than that of LMR (87.11% vs. 70.61%) or CA125 (87.11% vs. 61.21%) in staging OC.Conclusions: LMR alone or in combination with CA125 might be associated with OC staging. Besides, as a predictive factor, COLC may have high specificity in staging OC.

Peritoneal tuberculosis simulating advanced ovarian carcinoma: is clinical impression sufficient to administer neoadjuvant chemotherapy for advanced ovarian cancer?

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 307-312
Author(s):  
A. Gurbuz ◽  
A. Karateke ◽  
C. Kabaca ◽  
G. Kir ◽  
E. Cetingoz
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Frozen Section ◽  
Clinical Signs ◽  
Advanced Ovarian Cancer ◽  
Signs And Symptoms ◽  
Exploratory Laparotomy ◽  
Clinical Impression ◽  
Peritoneal Tuberculosis ◽  
Clinical Signs And Symptoms

Peritoneal tuberculosis mimics advanced ovarian cancer because of the similarities in clinical signs and symptoms such as ascites, pelvic and abdominal pain and mass, and elevation of serum CA125 level. We have presented four cases of peritoneal tuberculosis that underwent exploratory laparotomy for suspected advanced ovarian cancer during a 3-year period. Definitive diagnosis of tuberculosis was performed at laparotomy in all the cases. The frozen-section analysis seems to be the gold standard in the differential diagnosis. In view of these data, clinical diagnosis of advanced ovarian cancer is not sufficient for administering neoadjuvant chemotherapy. Cytologic or pathologic findings must be consistent with ovarian cancer for candidates who are being considered for neoadjuvant chemotherapy.

Chemotherapy or upfront surgery for newly diagnosed advanced ovarian cancer: Results from the MRC CHORUS trial.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5500-5500 ◽  
Author(s):  
Sean Kehoe ◽  
Jane Hook ◽  
Matthew Nankivell ◽  
Gordon C. Jayson ◽  
Henry Charles Kitchener ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Controlled Trial ◽  
Advanced Ovarian Cancer ◽  
Pelvic Mass ◽  
Stage Iv ◽  
Figo Stage ◽  
Phase Iii ◽  
Initial Surgery ◽  
Platinum Based Chemotherapy ◽  
Optimal Debulking

5500 Background: First line treatment of advanced ovarian cancer (OC) is accepted to be primary surgery (PS) followed by adjuvant platinum-based chemotherapy (P-CT). However, the EORTC55971 trial suggested neoadjuvant chemotherapy (NACT) is an alternative, showing increased optimal debulking rates and reduced surgical complications without detriment to survival. CHORUS (CRUK 07/009) is the 2nd phase III randomized controlled trial to investigate timing of initial surgery in OC. Methods: Patients (pts) with clinical FIGO stage III-IV OC (pelvic mass, extrapelvic metastases and CA125/CEA ratio >25) were randomized to standard treatment (PS followed by 6 cycles P-CT) or NACT (3 cycles P-CT either side of surgery). CHORUS was designed to demonstrate non-inferiority of NACT, excluding a 6% absolute detriment in 3yr survival from 50% expected with PS (1-sided alpha 10%). Primary outcome was overall survival (OS) and secondary outcomes were progression free survival (PFS), toxicity and quality of life. Results: 550 women (276 PS, 274 NACT) were randomized from 74 centres (72 UK, 2 NZ) between Mar 2004 and Aug 2010. Baseline characteristics were well balanced: median age 65yrs, median tumor size 80mm, 25% FIGO stage IV, 19% WHO PS 2. Median follow-up was 3yrs, 410 pts have died. Treatment data are summarized in the Table. 3yr survival in the control arm was 32%. Intention to treat analysis showed a median OS of 22.8 months for PS vs 24.5 months for NACT (hazard ratio (HR) 0.87 in favor of NACT, 80% CI 0.76 – 0.98) and median PFS of 10.2 vs 11.7 months (HR 0.91, 0.81 – 1.02). OS results represent a 5% absolute benefit in 3yr survival for NACT to 37% and the upper 80% CI allows us to exclude a survival benefit for PS. Conclusions: NACT was associated with increased optimal debulking, less early mortality and similar survival in this poor prognosis group. CHORUS results are consistent with EORTC55971 and strengthen evidence that NACT is a viable alternative to PS. Clinical trial information: ISRCTN74802813. [Table: see text]

Prognostic Value of Human Epidermal Growth Factor Receptor 2 (Her-2)/neu in Patients With Advanced Ovarian Cancer Treated With Platinum/Paclitaxel as First-Line Chemotherapy: A Retrospective Evaluation of the AGO-OVAR 3 Trial by the AGO OVAR Germany

2009 ◽  
Vol 19 (1) ◽  
pp. 109-115 ◽  
Author(s):  
Jacobus Pfisterer ◽  
Andreas Du Bois ◽  
Eva-Katrin Bentz ◽  
Friedrich Kommoss ◽  
Philipp Harter ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Prognostic Value ◽  
Growth Factor Receptor ◽  
Advanced Ovarian Cancer ◽  
Advanced Stage ◽  
First Line ◽  
Her 2 ◽  
Epidermal Growth ◽  
Line Chemotherapy

Objectives:Results on the prognostic value of human epidermal growth factor receptor 2 (HER-2)/neu in ovarian cancer are inconsistent. This exploratory analysis evaluates Her-2/neu as a prognostic factor in a large cohort of patients with advanced-stage ovarian cancer treated with platinum/paclitaxel as first-line chemotherapy within a prospective randomized trial.Methods:Her-2/neu expression was assessed by immunohistochemistry in 359 patients (46%) treated within the AGO-OVAR 3 trial (n = 783). Patients received either cisplatin/paclitaxel or carboplatin/paclitaxel according to the study protocol. Immunohistochemistry results were scored according to the Dako score.Results:Her-2/neu Dako scores of 0 or 1+ was found in 337 patients (94%) and a score of 2+ or 3+ in 22 patients (6%). Her-2/neu overexpression (2+/3+) was associated with a higher International Federation of Gynecology and Obstetrics stage and larger postoperative residual disease. There were no significant differences in response to chemotherapy between the Her-2/neu score subgroups and in progression-free survival time. In a multivariate analysis, the Her-2/neu score had no significant impact on overall survival time.Conclusions:In the present study, Her-2/neu overexpression in patients with advanced-stage ovarian cancer was rare and provided no evidence for a prognostic value of Her-2/neu in patients with advanced ovarian cancer treated with platinum/paclitaxel.

scholarly journals A case of pelvic actinomycosis affecting genital, urinary and digestive tracts: a rare misleading diagnosis

2021 ◽  
pp. FSO740
Author(s):  
Bernard Najib ◽  
Wissam Arab ◽  
Joseph Khazen ◽  
Yara Abdelkhalek ◽  
Wael Abdallah ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Genital Tract ◽  
Advanced Ovarian Cancer ◽  
Pelvic Mass ◽  
Invasive Disease ◽  
Pelvic Organs ◽  
Clinical Challenge ◽  
Pelvic Actinomycosis ◽  
Extensive Involvement ◽  
Chronic Invasive

Pelvic actinomycosis is an uncommon chronic invasive disease caused by a bacteria of the Actinomyces spp. Its diagnosis constitutes a clinical challenge and is usually reached in the postoperative period after resecting a pelvic mass that usually mimics advanced ovarian cancer. Although pelvic actinomyocosis involving the digestive and genital tract has been commonly described, very few reports have described cases involving both ovaries and requiring partial cystectomy for bladder involvement. Herein, we illustrate a case of pelvic actinomycosis with extensive involvement of multiple pelvic organs, misleading the surgeon into undergoing a complete clearance of the wrongfully thought adnexal malignancy.

The Emerging Role of Neutral Argon Plasma (PlasmaJet) in the Treatment of Advanced Stage Ovarian Cancer: A Systematic Review

2020 ◽  
Vol 27 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Anastasia Prodromidou ◽  
Anastasios Pandraklakis ◽  
Christos Iavazzo
Keyword(s):  
Ovarian Cancer ◽  
Full Text ◽  
Case Reports ◽  
Intraoperative Complications ◽  
Argon Plasma ◽  
Postoperative Mortality ◽  
Advanced Ovarian Cancer ◽  
Advanced Stage ◽  
Debulking Surgery ◽  
Primary Debulking Surgery

Objective. To evaluate the contribution of PlasmaJet application in achieving optimal cytoreduction in advanced ovarian cancer. Methods. We systematically searched for articles published up to June 2019 using MEDLINE, Scopus, Google Scholar databases and clinicaltrials.gov along with the references of the articles retrieved in full text. Observational studies and case reports addressing cases of women with peritoneal spread due to advanced stage ovarian cancer who were treated with application of PlasmaJet device were considered eligible for inclusion. Results. Three studies were excluded from further analysis when they were retrieved in full text. Five studies (2 retrospective, 1 prospective, and 2 case reports) that comprised 77 patients with age range from 38 to 85 years were included. Forty-three women underwent interval debulking surgery, 24 patients primary debulking surgery, and 6 had optimal debulking surgery, while in the remaining 4, a secondary debulking surgery was performed. Incidence of intraoperative complications was 32% (8/25), but none of them was due to the application of PlasmaJet. Complete macroscopic resection was achieved in 59 out of 70 (84.3%) women. Postoperatively, 17 out of 72 patients (23.6%) developed complications such as pneumothorax due to diaphragmatic resection, systemic infections, or wound-related complications. No postoperative mortality was recorded. Conclusions. Preliminary data on the use of PlasmaJet for ablation of ovarian cancer implants in the peritoneal cavity showed its safety and presented with promising outcomes in achieving complete cytoreduction.

p53 Autoantibodies in Patients with Primary Ovarian Cancer Are Associated with Higher Age, Advanced Stage and a Higher Proportion of p53-Positive Tumor Cells

Oncology ◽  
1999 ◽  
Vol 57 (4) ◽  
pp. 324-329 ◽  
Author(s):  
F.D. Vogl ◽  
E. Stickeler ◽  
M. Weyermann ◽  
T. Köhler ◽  
H.-J. Grill ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Tumor Cells ◽  
Advanced Stage ◽  
Primary Ovarian Cancer

The relationship between tumor size and stage in early versus advanced ovarian cancer: A retrospective chart review

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5580-5580
Author(s):  
L. E. Horvath ◽  
T. Werner ◽  
K. Jones
Keyword(s):  
Ovarian Cancer ◽  
Chart Review ◽  
Advanced Disease ◽  
Early Stage ◽  
Abdominal Cavity ◽  
Advanced Ovarian Cancer ◽  
Retrospective Chart Review ◽  
Advanced Stage ◽  
Early Stage Disease ◽  
Stage Disease

5580 Background: Ovarian cancer has a different prognosis between early (I and II) and advanced stage (III and IV). The mechanism of disease progression is unknown, but patients with advanced disease may have a higher propensity for seeding of the abdominal cavity early in the disease process than those with early stage. Theoretically if this is so, then patients with advanced stage should have smaller sized tumors than patients with early stage. Methods: This was a retrospective chart review of patients in the tumor registry in 2003 to 2006. Patients had epithelial ovarian cancer, other cell types were excluded. Only cases with documentation of surgical and pathologic staging and measured dimensions on pathologic specimen were included. Patient stage and all available dimensions measured on diseased ovaries were recorded. The dimensions for each patient were averaged into a single dimension for that patient, and then these measurements were totaled and averaged. Results: There were 110 patients analyzed: 85 with advanced disease, 25 with early stage. The average measurement was 4.8 cm in advanced disease, and was 10.7 cm in early stage disease. This difference was statistically significant (p < 0.001). Conclusions: Overall, patients with early stage ovarian cancer have diseased ovaries that are more than twice as large as those found in advanced disease. This finding supports the fact that early versus advanced ovarian cancer are 2 separate disease processes. Early stage grows locally and does not disseminate, and advanced stage disseminates while the tumor is still relatively small. Theoretically there may be a factor that separates these 2 into different diseases, where advanced disease patients have a substance produced by their tumor that allows for early dissemination, and early stage lacks this substance and only grows locally. Basic science research comparing the tissue microarrays of early versus advanced stage disease may be able to identify this difference. If the difference is found, perhaps therapy can be targeted against this difference. No significant financial relationships to disclose.

scholarly journals Ovarian metastasis from nongynecologic primary sites: a retrospective analysis of 177 cases and 13-year experience

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Jing-Jing Zhang ◽  
Dong-Yan Cao ◽  
Jia-Xin Yang ◽  
Keng Shen
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Treatment ◽  
Cytoreductive Surgery ◽  
Ovarian Metastasis ◽  
Primary Site ◽  
Prognostic Indicators ◽  
Ca 125 ◽  
College Hospital ◽  
Primary Ovarian Cancer ◽  
Postoperative Adjuvant Treatment

Abstract Background Metastasis to the ovary from nongynecologic organs accounts for 9% of all ovarian malignancies. Although the most common nongynecologic primary site of ovarian metastasis is the gastrointestinal tract, metastasis from other sites to the ovary is not uncommon. Differential diagnosis of primary and metastatic ovarian tumors is important; otherwise, appropriate treatment cannot be determined. Furthermore, an optimal treatment strategy for ovarian metastasis from nongynecologic primary sites still needs to be explored. Methods One hundred seventy-seven patients with ovarian metastasis from nongynecologic primary sites admitted to Peking Union Medical College Hospital between May 2005 and May 2018 were retrospectively evaluated. Results The mean age was 48 years (range, 18–83). Approximately 60% of patients were premenopausal women. The two most common nongynecologic primary sites of ovarian metastasis were the colorectum (68 cases) and stomach (61 cases). In addition to the most common symptoms of abdominal distension (39.0%), abdominal pain (37.9%), and ascites (27.7%), 18.1% of patients presented with abnormal uterine bleeding. Half of the patients who tested serum CA-125 preoperatively had elevated CA-125 levels within the range of 35 U/ml to 200 U/ml. More than 70% of synchronous ovarian metastases were preoperatively misdiagnosed as primary ovarian cancer. Of all included cases, 56.5% achieved optimal cytoreductive surgery (the diameter of the largest residual lesion < 2 cm). The overall 5-year survival rate and median survival time were 10% and 20 months, respectively. The primary site, optimal cytoreductive surgery, tumor differentiation, and postoperative adjuvant treatment were identified as prognostic indicators. Conclusions The colorectum and stomach are the most common nongynecologic primary sites of ovarian metastasis. Synchronous ovarian metastasis is easily misdiagnosed as primary ovarian cancer. Optimal cytoreductive surgery and postoperative adjuvant treatment can be performed to confer survival benefit in selected patients.

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