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.

Surgical tactic in treatment of ovarian masses in adolescents

2015 ◽  
Vol 6 (1) ◽  
pp. 81-86
Author(s):  
Svetlana Alekseevna Leontyeva ◽  
Elena Aleksandrovna Ulrikh ◽  
Nadezda Anatolyevna Kokhreidze
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Acute Abdominal Pain ◽  
Malignant Tumors ◽  
Ovarian Torsion ◽  
Reproductive Status ◽  
Gonadotropin Stimulation ◽  
Ovarian Masses ◽  
Status Of Women

Ovarian lesions in children are most frequently diagnosed in pubertal period. That could be associated with increased gonadotropin stimulation in this period. Most of the andexal masses in adolescents are benign. Malignant tumors of the ovary account less than 2 % in girls. Every girl with ovarian tumor and acute abdominal pain requires urgent differential diagnostic intervention and/or surgical treatment. The proportion of ovarian torsion is 2-3 % of all cases of abdominal pain in girls. This condition is an emergent gynecological pathology. One of the main aim of surgical treatment in young is to preserve fertility. Different surgery tactics in cases of ovarian masses in adolescents are reviewed in the article. The reproductive status of women underwent treatment for ovarian masses in childhood requires further investigations.

Diagnostic approach using the expression profiling of the P53 tumor suppressor gene and its related proteins in ovarian epithelial tumors

2005 ◽  
Vol 15 (3) ◽  
pp. 453-461 ◽  
Author(s):  
H. Lee ◽  
G. Park ◽  
J. H. Jung ◽  
W. S. Ahn ◽  
J. M. Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Malignant Tumors ◽  
Cyclin E ◽  
Receiver Operating Curve ◽  
Benign Tumors ◽  
Cutoff Value ◽  
Borderline Tumors ◽  
Expression Levels ◽  
Epithelial Tumors ◽  
Ovarian Epithelial Tumors

The initial aim of this study was to examine the expression profiles of P53 and its upstream genes, downstream genes, and cell cycle regulators to determine whether these markers are useful for making a differential diagnosis among the benign, borderline, and malignant ovarian epithelial tumors. Between borderline and malignant tumors, the increased expression levels of P53, Bax, Cyclin E, and cyclin-dependent kinase-2 as well as the decreased expression levels of growth arrest and DNA damage (GADD45) and murine double minute-2 (MDM2) were significantly associated with malignancy (P < 0.01, each). Using the receiver operating curve (ROC), the most reliable cutoff value of the added-up staining scores of those markers was 4.5 with 79% sensitivity and 89% specificity for malignancy. Between benign and borderline tumors, the P21 and Bax expression levels were significantly higher in borderline tumors, whereas the Bcl-2 expression level was much higher in benign tumors (P < 0.01, each). Using the ROC, the cutoff value of the added-up staining scores used to discriminate between the two groups was 2.5 with 70% sensitivity and 74% specificity for borderline tumors. Thus, for the differential diagnosis between borderline and malignant tumors, the cutoff value 4.5 of the cumulative staining scores can be used. However, the cutoff value 2.5 for discrimination between benign and borderline tumors may not be useful because of its relatively low sensitivity and specificity. In addition, the P53, GADD45, Cyclin E, and MDM2 expression levels in malignant ovarian tumors might be useful for determining the histologic grade and type.

scholarly journals Analysis of DNA Aneuploidy and c-myc Oncoprotein Content of Canine Plasma Cell Tumors Using Flow Cytometry

1993 ◽  
Vol 30 (6) ◽  
pp. 505-511 ◽  
Author(s):  
K. S. Frazier ◽  
M. E. Hines ◽  
A. I. Hurvitz ◽  
P. G. Robinson ◽  
A. J. Herron
Keyword(s):  
Flow Cytometry ◽  
Plasma Cell ◽  
Malignant Tumors ◽  
Malignant Potential ◽  
Benign Tumors ◽  
Malignant Plasma Cell ◽  
Formalin Fixed Paraffin ◽  
Significant Difference ◽  
Formalin Fixed Paraffin Embedded ◽  
Canine Plasma

To derive a method for determining malignant potential of plasma cell tumors, a retrospective analysis of the DNA ploidy and relative p62c-myc oncoprotein content using bivariate flow cytometry was performed on 23 formalin-fixed, paraffin-embedded tissues from 23 dogs. The samples included one tissue each from 17 males and six females 2 to 16 years of age (mean = 7.5 years). Twelve breeds were represented, including three Cocker Spaniels, three Golden Retrievers, and five of mixed breed. Ten of the samples were histologically classified as malignant-plasma cell tumors, and ten specimens were classified as benign. Three samples of plasmacytic inflammation, from two Cocker Spaniels and one Shih Tsu, were included as controls. The ploidy and relative c-myc content data obtained were compared with the histologic grade. A significant difference in ploidy was found between benign and malignant tumors (P ≤ 0.05). Five of nine malignant plasma cell tumors were aneuploid; the remainder were diploid (4/9) or tetraploid (1/9). Only one of the benign plasmacytomas was aneuploid (1/10), whereas six were diploid (6/10), and three were tetraploid (3/10). All of the controls were diploid (3/32). When relative amounts of p62c-myc from malignant and benign tumors were compared by flow cytometry, a greater significant difference was established (P ≤ 0.01) than by using aneuploidy alone. Relative values of p62c-myc content ranged from 219 to 553 units in 8/10 malignant plasma cell tumors and from 86 to 392 units in 3/10 benign plasmacytomas. The remainder of the neoplasms (2/10 malignant and 7/10 benign) lacked measurable values of p62c-myc above background fluorescence concentrations. Two atypical cutaneous plasmacytomas with later metastasis were included in the study. The results indicate that simultaneous analysis of ploidy and relative p62c-myc concentration can be used as an aid in assessment of malignant potential in canine plasma cell tumors.

Surgical Treatment of Primary Cardiac Tumors—Experience with 45 Patients

1995 ◽  
Vol 3 (2) ◽  
pp. 49-52
Author(s):  
Lin Jue Yi ◽  
Chu Shu Hsun ◽  
Lee Yuan Teh ◽  
Wang Shoei Shen ◽  
Lin Fang Yue ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Left Atrium ◽  
Malignant Tumors ◽  
Thyroid Tissue ◽  
University Hospital ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Incomplete Resection ◽  
Long Term Result ◽  
Primary Cardiac Tumors

Primary cardiac tumors are very rare and the majority of them are histologically benign and surgically curable. During a 30-year period from 1963 to January 1993, 45 cases of primary cardiac tumors were surgically excised at the National Taiwan University Hospital, representing 0.52% of 8,695 open heart surgical cases during the same period. In this series, 42 cases (94%) were benign tumors; 39 (88%) were myxoma (30 female, 9 male), and 32 (82%) originated in the left atrium. None were discovered in the left ventricle. In all but the first 6 cases, tumors in patients with myxoma in the left atrium were successfully excised by the transseptal approach. There were 3 patients with rare benign tumors: intracardiac goiter, rhabdomyoma, and hemangioma respectively. The intracardiac goiter was completely excised with no ectopic thyroid tissue after operation and the other 2 received palliative resection. The latter 2 patients suffered no recurrence. Rhabdomyosarcoma, leiomyosarcoma and malignant lymphoma were noted in one patient each, all of whom died of low cardiac output in the early postoperative course. In our experience, the majority of primary cardiac tumors were benign and located in the left atrium. The long-term result of surgical treatment of benign cardiac tumors is excellent, even incases of incomplete resection, while the results from surgical treatment of malignant tumors is poor.

scholarly journals Surgical treatment of recurrent borderline serous ovarian tumor

2021 ◽  
Vol 67 (4) ◽  
pp. 538-546
Author(s):  
Irina Davydova ◽  
Apollon Karseladze ◽  
Viktor Kuznetsov ◽  
Liudmila Meshcheriakova
Keyword(s):  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Clinical Observation ◽  
Favorable Outcome ◽  
Multiple Recurrence ◽  
Borderline Tumors ◽  
Factors Influencing

Recurrences of serous borderline tumors (PCOS) are quite rare and, as a result, have not been sufficiently studied and presented in the literature. Despite the obvious relative «benignity» of borderline tumors, the course and prognosis of recurrent PCOS may be unfavorable. The article describes the reasons influencing the development of recurrence of PCOS, presents various options for recurrence of PCOS, methods of their treatment. This publication highlights the factors influencing the effectiveness of treatment, survival and prognosis of the disease. The article is illustrated with a rare clinical observation of multiple recurrence of PCOS with a favorable outcome.

Quantitative biochemical analysis of lactate dehydrogenase in human ovarian tissues: correlation with tumor grade

2005 ◽  
Vol 15 (3) ◽  
pp. 438-444 ◽  
Author(s):  
Š. ŠIMAGA ◽  
M. Osmak ◽  
D. Babič ◽  
M. ŠPREM ◽  
B. Vukelič ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Specific Activity ◽  
Malignant Tumors ◽  
Ovarian Tissue ◽  
Tumor Grade ◽  
Benign Tumors ◽  
Ovarian Carcinomas ◽  
Lactate Dehydrogenase Activity ◽  
Ldh Activity ◽  
Benign Ovarian Tumor

In an attempt to identify glycolytic capacity of normal and neoplastic human ovary, total lactate dehydrogenase (LDH) activity was measured in tissue cytosol originating from 69 patients (18 with benign ovarian tumor, 34 with ovarian carcinoma, six with nonepithelial ovarian malignant tumors, and 11 with tumor metastatic to ovary) and compared to the LDH activity of normal ovarian tissues (n = 19). Median value of total LDH-specific activity expressed as U/mg protein was 0.546 in normal tissues, 0.584 in benign tumors, 1.071 in malignancies metastatic to ovaries, 0.872 in nonepithelial primary ovarian tumors, and 0.818 in primary carcinomas. A significant rise in LDH-specific activity was found in malignant primary and secondary tumors of epithelial and nonepithelial origin, but not in benign neoplasms, compared to the activity in normal tissue. Ovarian carcinomas of serous histologic type did not differ in LDH activity from mucinous tumors. However, poorly differentiated carcinomas (grade 3) showed significantly enhanced activity of this glycolytic enzyme when compared to its grade 1 counterpart. The subgroup of grade 1 tumors did not differ in LDH activity from normal and benign ovarian tissue. Obtained results suggest that direct correlation might exist between ovarian epithelial tumor grade and lactate dehydrogenase activity.

Surgical management of brain-stem tumors in children: results and statistical analysis of 75 cases

1993 ◽  
Vol 79 (6) ◽  
pp. 845-852 ◽  
Author(s):  
Alain Pierre-Kahn ◽  
Jean-François Hirsch ◽  
Mathieu Vinchon ◽  
Christine Payan ◽  
Christian Sainte-Rose ◽  
...  
Keyword(s):  
Brain Stem ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Patient Age ◽  
Content Type ◽  
Patient Âgé ◽  
Significant Difference ◽  
Brain Stem Tumors ◽  
Subtotal Removal ◽  
Fine Print

A study was made of 75 children treated between 1970 and 1990, with partial, subtotal, or total removal of three intrinsic and 72 exophytic or surface brain-stem tumors. In all cases, the goal of surgery was to remove as much tumor as possible. Extent of removal was defined according to data obtained from postoperative computerized tomography or magnetic resonance imaging, and was considered partial when only a small amount of tumor was removed, subtotal when a few cubic millimeters of tumor was left, and total when no residual tumor was seen on postoperative radiological investigations. An ultrasonic aspirator was used for the 43 most recent operations. Among tumor removals without the aspirator, 24 (75%) were partial, eight (25%) subtotal, and none total; with the use of the aspirator, the number of partial removals decreased to 44.5% while that of subtotal and total removals increased to 32% and 23.5%, respectively. There were 69 gliomas (92%) and 47 benign tumors (62.6%). Forty-nine patients were irradiated postoperatively, and 14 of the 23 patients whose benign tumors were removed totally or subtotally did not undergo irradiation. This study showed that: 1) the overall prognosis of patients with malignant tumors was poor and was not improved by surgery; 2) the survival rate of those with benign tumors was significantly (p < 0.01) lower after partial removal than after total or subtotal removal (52% and 94%, respectively, at 5 years); 3) comparison of means and proportions (Student's and chi-squared tests) between benign and malignant tumors showed a significant difference relating to patient age (p < 0.03), peritumoral hypodensity (p < 0.001), and preoperative duration of symptoms (p < 0.001); 4) stepwise logistic regression analysis confirmed that two of these three variables were related to malignancy: namely, patient age at surgery (p < 0.03) and presence of peritumoral hypodensity (p < 0.001); and 5) routine postoperative irradiation was contraindicated after total or subtotal removal of benign tumors.

Surgical Treatment of Primary Cardiac Tumors

1997 ◽  
Vol 5 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Gu Chun Jiu ◽  
Bao Wei Ke ◽  
Guo Bin Xun ◽  
Yuan Hong ◽  
Xiu Zhong Yi
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Right Atrial ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Long Term Result ◽  
The Right ◽  
Medical University ◽  
Primary Cardiac Tumors

During a 16-year period from 1980 to 1996, 101 patients with primary cardiac tumors underwent surgery at the 1st Affiliated Hospital of China Medical University, which represented 2.44% of 4142 open-heart surgical cases during this period. Most tumors were benign; 94 were myxomas, 2 were fibromas, and 1 was a hemangioma. Three myxomas were in the right atrium and 91 were in the left atrium. The 4 malignant tumors comprised 2 mesothelioma, 1 histiocytoma, and 1 right atrial malignant myxoma. All benign tumors were completely excised with 4.95% mortality. Only 1 malignant tumor was completely excised. In our experience, the long-term result of surgical treatment of benign cardiac tumors is excellent, whereas the prognosis for patients with malignant cardiac tumors is very poor. The incidence of malignant tumors was lower than in other studies.

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.

scholarly journals Estimating the Risk of Malignancy in Adnexal Masses: Validation of the ADNEX Model in the Hands of Non-expert Ultrasonographers in a Gynecological Oncology Center in China

2021 ◽  
Author(s):  
Ping He ◽  
Jingjing Wang ◽  
Wei Duan ◽  
Chao Song ◽  
Yu Yang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ovarian Tumor ◽  
Ovarian Metastasis ◽  
Stage I ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Gynecological Oncology ◽  
Benign Ovarian Tumor ◽  
Oncology Center

Abstract Background: The diagnosis of adnexal masses depends more on ultrasonography. This study aim to validate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) ADNEX model in the preoperative diagnosis of adnexal masses in the hands of non-expert ultrasonographers in a gynecological oncology center in China. Methods: This was a single oncology center, retrospective diagnostic accuracy study from 620 patients. All patients underwent surgery and the histopathological diagnosis was used as reference standard. The masses were divided into five types according to the ADNEX model: benign ovarian tumor, borderline ovarian tumor (BOT), Stage-I ovarian cancer (OC), Stages-II-IV OC and ovarian metastasis. Receiver-operating characteristics (ROC) curve analysis was used to evaluate the ability of the ADNEX model to classify tumors into different histological types with and without Cancer antigen 125 (CA 125) results. Results: Of the 620 women, 402 (64.8%) had a benign ovarian tumor and, 218 (35.2%) had a malignant ovarian tumor, including 86 (13.9%) with BOT, 75 (12.1%) with Stage-I OC, 53 (8.5%) with Stages-II-IV OC and 4 (0.6%) with ovarian metastasis. The AUC of the model to differentiate between benign and malignant adnexal masses was 0.97 (95% CI, 0.96–0.98). Performance was excellent for the discrimination between benign vs Stage II-IV OC, benign vs ovarian metastasis with AUCs of 0.99 (95% CI, 0.99-1.00) and 0.99 (95% CI, 0.98-1.00), respectively. Performance of the model was less effective at distinguishing between BOT and Stage I OC and between BOT and ovarian metastasis, with AUC of 0.54 (95% CI, 0.45–0.64) and 0.66 (95% CI, 0.56–0.77), respectively. When including CA125 in the model, performance in discriminating between Stages II–IV OC with stage I OC and ovarian metastasis were improved (AUC increased from 0.88 to 0.94, P = 0.01; 0.86 to 0.97, p = 0.01, respectively). Conclusions: The IOTA ADNEX model has excellent performance in differentiating benign and malignant adnexal masses in the hands of non-expert ultrasonographers with limited experienced in China. Between classification different subtypes of ovarian cancers, the model has difficulty to differentiate BOT from stage I OC, BOT from ovarian metastases.

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