scholarly journals Pedunculated Fibroid Mimicking an Ovarian Cancer

2019 ◽  
Vol 14 (1) ◽  
pp. 56-58
Author(s):  
Kabin Bhattachan ◽  
Aruna Karki ◽  
Ganesh Dangal ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha
Keyword(s):  
Ovarian Cancer ◽  
Blood Supply ◽  
Adnexal Mass ◽  
Degenerative Change ◽  
Menstrual Period ◽  
Radiological Diagnosis ◽  
Ca 125 ◽  
Cystic Degeneration ◽  
Radiological Imaging ◽  
Ovarian Mass

Large myoma may show various type of degenerative change and have alteration of radiological view. Subserosal or pedunculated fibroid with cystic degeneration may mimic complex ovarian mass on radiological imaging. A 34 year female, para one, with normal menstrual period presented with radiological diagnosis of complex adnexal mass and CA 125 value  100 u/ml. Postoperative finding revealed cystic degeneration of pedunculated subserosal fibroid receiving blood supply from adherent omentum. Keywords:  Cystic degeneration, pedunculated fibroid, complex ovarian mass.  

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

scholarly journals A Case of Peritoneal-Pelvic Tuberculosis With Elevated CA-125; An Enigma as Ovarian Cancer

2019 ◽  
Vol 18 (2) ◽  
pp. 60-63
Author(s):  
Prakash Raj Oli ◽  
Rosy Vaidya Malla ◽  
Kavita Karmacharya
Keyword(s):  
Ovarian Cancer ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Young Women ◽  
Adnexal Mass ◽  
Elevated Serum ◽  
Young Lady ◽  
Ca 125 ◽  
Rare Form ◽  
Menstrual Irregularities

Peritoneal-pelvic tuberculosis is a rare form of extrapulmonary-TB mainly affecting women of 20-40 years, especially in TB endemic countries. It classically presents with abdominal pain, menstrual irregularities, adnexal mass, and elevated serum CA-125 level, creating confusion with genital malignancy, especially ovarian one leading to difficulty in its management and often leads to devastating surgeries. Here's a case of peritoneal-pelvic TB, a young lady with abdominal pain, radiologic associates and adnexal mass, and elevated serum CA-125 level is presented. So, it should always be one of the differential diagnosis of ovarian cancer especially among young women in TB endemic countries.

Preoperative Identification of Synchronous Ovarian and Endometrial Cancers: The Importance of Appropriate Workup

2012 ◽  
Vol 22 (8) ◽  
pp. 1325-1331 ◽  
Author(s):  
Fieke M. E. Broeders ◽  
Anneke A. M. van der Wurff ◽  
Johanna M. A. Pijnenborg ◽  
M. Caroline Vos
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Young Patients ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Ca 125 ◽  
Primary Tumors ◽  
Endometrial Cancers ◽  
The Right ◽  
Postoperative Findings

ObjectiveFor treatment of patients with both endometrial and ovarian cancer, it is important to discriminate between 2 primary tumors and metastatic disease. Currently, criteria are based on postoperative findings. The aim of this study was to determine whether clinical parameters can discriminate between these groups preoperatively and whether a practical guideline could improve appropriate workup and treatment.MethodsA total of 45 patients with a diagnosis of both endometrium and ovarian cancer between 1998 and 2009 and were included for analysis. Clinical and pathological data were obtained, and initial CA-125 was registered; patients had a diagnosis of 2 primary tumors or tumors with metastasis. All patients were reclassified according to workup and treatment.ResultsPatients with synchronous primary tumors were significantly younger, presented more often with abnormal uterine bleeding, and had a lower initial CA-125 than both metastatic groups (P < 0.05). With age and CA-125 included in a polytomic logistic regression model, 83.3% of diagnoses could be classified correctly. In 15 of 17 patients presented with adnexal mass, workup was incomplete owing to lack on information of the endometrial status. In patients presenting with abnormal uterine bleeding, 13 of 21 patients had an incomplete workup leading to staging laparotomy secondary to initial surgical treatment in 2 patients.ConclusionsPatients with synchronous endometrial and ovarian cancers are young, often present with abnormal uterine bleeding and have a low initial CA-125. Adequate workup with attention to both ovarian and endometrial status, especially in young patients with a wish to preserve fertility, is important to make the right decision for treatment.

scholarly journals Perbandingan Akurasi Skor ROMA dan IOTA dalam Prediksi Keganasan Tumor Ovarium

2020 ◽  
Vol 4 (1) ◽  
pp. 70-76
Author(s):  
Yussya Aulia Malik ◽  
Andi Friadi
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Adnexal Mass ◽  
Ovarian Tumour ◽  
Ca 125 ◽  
Central Hospital ◽  
Ca125 Level ◽  
Serum Test

Ovarian cancer is the sixth most common cancer found among women. Incidence of ovarian cancer in Dr. M. Djamil Central Hospital had increased from 103 cases to 156 cases in 2011-2012. The Risk Of Ovarian Malignancy Algorithm (ROMA) consists of qualitative serum test where several variables including HE4 serum, CA125 serum, and menopausal status are turned into numerical score (Hye Yon Cho et al 2015). The latest diagnostic modalities developed by International Ovarian Tumour Analysis (IOTA) classifies tumour into four sub groups, based on ultrasound characteristics: unilocular, multilocular, adnexal mass with solid component without papilloma projection, adnexal mass with one or more papilloma projection. Based on this knowledge, author would like to investigate accuracy of ROMA and IOTA score in predicting malignancy status of early ovarian tumour.Objective: Determining ROMA and IOTA so thus can be utilised to predict wether the ovarian tumour is benign or malignant.Method: This was analytical study, with cross sectional design and took place in Obstetrical and Gynaecological Outpatient Clinic of Dr. M. Djamil Central Hospital from August 2016 to January 2019. Sample was recruited using consecutive sampling method. Sixty one participants were recruited with CI 99%. Patients who met inclusion criteria would undergo Ca125 serum test and IOTA score. HE4 level was determined after surgery  and the sample of a tumour was sent to pathology anatomy laboratory of Medical Faculty of Andalas University to investigate the malignancy status. Statistical analysis involved univariate and bivariate test. The variables included frequency distribution, ROMA, and IOTA score. Bivariate analysis included specificity, sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio.Result: Thirty one patients (50,8%) from peri menopausal group had HE4 level ≤70 pmol/L and 30 patients (49,2%) from post menopause group had HE4 level ≤140 pmol/L. Eleven patients (18%) had CA125 level <35 and 50 patients (82%) had CA125 level ≥35. ROMA index showed low risk in 17 patients (27,9%) and high risk 44 patients (72,1%). IOTA with M Rules was 51 patients (83,6%) and B rules was 10 patients (16,4%). Diagnostic value for ROMA score had sensitivity of 71,9%; RMI of 84,2%; and IOTA 82,5%. ROMA and IOTA accuracy was 68,9% and 92,2%, respectively.Conclusion: IOTA has better sensitivity in predicting ovarian tumour compared with ROMA. ROMA has higher positive predictive value compared with IOTA positive predictive value. ROMA negative predictive value is 5,9%, meanwhile for IOTA it is hard to determineKeywords: ovarian cancer, ROMA, IOTA, Ca-125, HE4

scholarly journals Evaluation of ovarian cancer biomarkers HE4 and CA-125 in women presenting with a suspicious cystic ovarian mass

2011 ◽  
Vol 22 (4) ◽  
pp. 244 ◽  
Author(s):  
Karolina Partheen ◽  
Björg Kristjansdottir ◽  
Karin Sundfeldt
Keyword(s):  
Ovarian Cancer ◽  
Cancer Biomarkers ◽  
Ca 125 ◽  
Ovarian Mass

scholarly journals Evaluation of Recurrent Ovarian Cancer: An Evolution

2019 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Norazlina Mat Nawi ◽  
Irfan Mohamad
Keyword(s):  
Ovarian Cancer ◽  
Recurrent Ovarian Cancer ◽  
Health Sciences ◽  
Emission Tomography ◽  
Ca 125 ◽  
Radiological Imaging ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Pet Ct ◽  
Higher Sensitivity

Ovarian cancer is one of the top five cancers among female. It is treated with surgery and chemotherapy. Besides the well-known tumor marker CA-125, the treatment response is monitored by radiological imaging. Computed tomography (CT) and magnetic resonance imaging are used to be the primary modalities. With the emergence of positron emission tomography (PET), the detection of residual or recurrence disease can be made more accurate. The fusion of PET/CT has higher sensitivity and specificity.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 15-18

scholarly journals Osteopontin as a Tumor Marker in Ovarian Cancer

2022 ◽  
Author(s):  
Shikha Rani ◽  
Alka Sehgal ◽  
Jasbinder Kaur ◽  
Dilpreet Kaur Pandher ◽  
RPS Punia
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Test ◽  
Ca 125 ◽  
Tumor Biomarker ◽  
Screening Methods ◽  
High Morbidity ◽  
Ovarian Mass ◽  
Likelihood Ratios ◽  
Median Plasma ◽  
Sensitivity Specificity

Abstract Introduction: Ovarian cancer is associated with high morbidity and mortality. This is due to the nonspecific symptoms and no effective screening methods. Currently CA 125 is used as a tumor biomarker for the diagnosis of ovarian cancer, but it has its own limitations. So, there is need for other tumor biomarkers for the diagnosis of ovarian cancer. To determine the diagnostic test characteristics of plasma osteopontin (OPN) in detecting ovarian malignancy and comparing its performance with carbohydrate antigen-125 (CA 125). Methods: This is a prospective cross-sectional diagnostic test evaluation. Women with adnexal mass detected by clinical or radiological examination were enrolled as suspected cases. Women who presented with other gynecological conditions were enrolled as controls. OPN and CA 125 levels were measured in all enrolled subjects. Results: Among 106 women enrolled, 26 were ovarian cancer, 31 had benign ovarian masses and 49 were controls. Median plasma CA 125 levels were higher in subjects with ovarian cancer (298 U/ml; IQR 84-1082 U/ml vs. 37.5U/ml; IQR 17.6-82.9U/ml; P<0.001).CA 125 sensitivity, specificity, positive and negative likelihood ratios were 88.5%, 61.3%,2.10 and 0.19 respectively. Median plasma OPN levels were higher in subjects with ovarian cancer (63.1 ng/ml; IQR 39.3-137 ng/ml vs. 27ng/ml; IQR 20-52ng/ml; P=0.001). Sensitivity, specificity, positive and negative likelihood ratios of OPN were 50%,87%,2.58 and 0.62, respectively. Conclusion: OPN levels were higher in ovarian cancer than in the benign ovarian mass and had better specificity than CA125. OPN can better differentiate between benign and malignant ovarian mass as compared to CA125.

scholarly journals Early Modeled Longitudinal CA-125 Kinetics and Survival of Ovarian Cancer Patients: A GINECO AGO MRC CTU Study

2019 ◽  
Vol 25 (17) ◽  
pp. 5342-5350 ◽  
Author(s):  
Olivier Colomban ◽  
Michel Tod ◽  
Alexandra Leary ◽  
Isabelle Ray-Coquard ◽  
Alain Lortholary ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Ca 125

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.

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