scholarly journals Karsinoma Ovarii Serosa pada Kehamilan dengan Komplikasi IUGR : Laporan Kasus di RSUP Dr. Kariadi, Semarang

2020 ◽  
Vol 7 (1) ◽  
pp. 108-112
Author(s):  
Anggiyasti Vidya Hapsari ◽  
Ediwibowo Ambari ◽  
Julian Dewantiningrum ◽  
Ery Perdana Ushan
Keyword(s):  
Germ Cell ◽  
Frozen Section ◽  
Surgical Staging ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade

Karsinoma ovarium merupakan keganasan ginekologi terbanyak kedua yang terjadi pada kehamilan. Dilaporkan terjadi 1:10.000 sampai 1:25.000 kehamilan. Histopatologi karsinoma ovarium jenis epitelial lebih jarang terjadi dibandingkan germ cell tumor1,2. Kehamilan tidak mempengaruhi prognosis karsinoma ovarium, akan tetapi komplikasi yang mungkin terjadi adalah torsi tumor, ruptur dan meningkatkan kemungkinan terjadinya persalinan prematur16. Tulisan ini melaporkan seorang wanita, 31 tahun, primigravida, hamil 34 minggu, dengan pembesaran abdomen melebihi usia kehamilan, peningkatan kadar Ca-125 darah dan massa solid ovarium sinistra disertai ascites pada pemeriksaan ultrasonografi. Pemeriksaan histopatologi jaringan tumor ovarium, uterus dan omentum menunjukkan diagnosis low grade serous carcinoma ovarii bilateral dengan infiltrasi hingga tuba dan omentum. Pemeriksaan rutin kehamilan dengan ultrasonografi penting dilakukan untuk skrining adanya neoplasma ovarium yang menyertai kehamilan. Penatalaksanaan hamil dengan  tumor padat ovarium tergantung dari usia kehamilan. Menurut algoritme dilakukan operasi pengangkatan massa dan dilakukan frozen section (FS) untuk mengetahui sifat tumor jinak atau ganas pada usia kehamilan 18-22 minggu dan dilanjutkan dengan operasi lanjutan setelah kelahiran bayi16. Pada kasus ini dengan mempertimbangkan kehamilan ini merupakan kehamilan pertama dengan tidak adanya keluhan dan secara prinsip tidak adanya perubahan anatomi untuk dapat dilakukan operasi complete surgical staging saat bayi dilahirkan pada usia kehamilan 34 minggu, maka dari hasil rapat medis diambil keputusan untuk dilakukan operasi complete surgical staging bersamaan setelah sectio caesaria. Prosedur operasi ini tidak mudah dilakukan dan banyak dihindari, tetapi dengan kehati-hatian dan identifikasi struktur anatomi yang baik, maka operasi berjalan lancar.

scholarly journals Clinicopathological Spectrum of Surface Epithelial Ovarian Carcinoma and its Association with Serum CA-125 Levels: A Cohort Study

2021 ◽  
Author(s):  
Nisha Singla ◽  
Sarita Nibhoria ◽  
Kanwardeep Kaur Tiwana ◽  
Prince Gupta
Keyword(s):  
Cohort Study ◽  
Ovarian Carcinoma ◽  
World Health ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Categorical Variables ◽  
Low Grade ◽  
High Grade ◽  
History Of ◽  
Epithelial Tumours

Introduction: The ovaries are the primary female reproductive organs and endocrine glands. Ovarian carcinoma has often been called as the silent killer because the symptoms may develop so late that the chances of cure are very poor. According to World Health Organisation (WHO) ovarian tumours are classified based upon their most probable tissue of origin: surface epithelial (65%), germ cell (15%), sex cord-stromal (10%), metastases (5%) and miscellaneous. The malignant surface epithelial tumours are further classified by cell type into serous, mucinous, endometrioid, clear cell, brenner, seromucinous and undifferentiated carcinoma. The most widely used tumour marker in ovarian carcinoma is CA-125 which is considered as gold standard. Aim : To find the utility of serum CA-125 levels in histopathological variants of malignant surface epithelial tumours, degree of differentiation and their distribution according to clinical data pertaining to age, parity, history of use of oral contraceptive pills/ovulation inducing drugs and family history of carcinoma ovary/breast or colon. Materials and Methods: A prospective study (cohort study) was done at Guru Gobind Singh Medical College and Hospital, Faridkot over a period of 1.5 year (April 2017-oct 2018) on 50 ovarian masses which were diagnosed as ovarian carcinoma. Data was represented as frequencies and percentages for categorical variables and as means and standard deviations for continuous variables. Analysis was done using Statistical Package for Social Sciences (SPSS) v 20.0.0. Results: Serous carcinoma (80%) topped among all the histological variants. Serous high grade carcinoma was more common than serous low grade carcinoma. Maximum rise of serum CA-125 levels were seen in serous carcinoma. Among serous carcinomas, mean serum CA-125 levels were more in high grade serous carcinoma than low grade serous carcinoma and the results were statistically significant. conclusion: Serum CA-125 level is a great tool for diagnosis, follow-up and prognosis of ovarian carcinomas.

Diagnostic Discordance in Intraoperative Frozen Section Diagnosis of Ovarian Tumors: A Literature Review and Analysis of 871 Cases Treated at a Japanese Cancer Center

2020 ◽  
pp. 106689692096051
Author(s):  
Hiroshi Yoshida ◽  
Hiroki Tanaka ◽  
Takafumi Tsukada ◽  
Naoko Abeto ◽  
Mayumi Kobayashi-Kato ◽  
...  
Keyword(s):  
Literature Review ◽  
Frozen Section ◽  
Malignant Potential ◽  
Ovarian Tumors ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Borderline Tumor ◽  
Mucinous Tumor ◽  
Ovarian Metastases ◽  
Frozen Section Diagnosis

Background This study examined the accuracy and pitfalls associated with frozen section diagnosis of primary ovarian tumors and ovarian metastases based on the 2014 World Health Organization classification (WHO) criteria and proposed improvements from a pathologist’s perspective. Methods We microscopically reviewed 871 cases of primary ovarian tumor (N = 802) and ovarian metastasis (N = 69) and compared the results of frozen sections with the final diagnosis. Malignant potential concordance (benign, borderline, or malignant) and specific discordant diagnosis rates were analyzed. Finally, we conducted a unique literature review of specific diagnostic errors in the frozen section diagnosis of primary ovarian tumors. Results Of 802 primary ovarian tumors, 50 (6.2%) cases showed discordant diagnoses in which mucinous carcinoma (40.5%), low-grade serous carcinoma (LGSC; 31.3%), and mucinous borderline tumor (18.4%) were frequently misinterpreted. Of 69 ovarian metastases, all 4 cases of low-grade appendiceal mucinous neoplasm (LAMN) were misdiagnosed as primary ovarian mucinous tumor. A literature review revealed that mucinous/serous borderline tumor or carcinoma accounted for approximately 70% of 217 reported discordant diagnoses. Conclusion In the present study, the concordance rate of malignant potential of the tumor was comparable to that previously reported. Even in the 2014 WHO classification, primary ovarian mucinous borderline tumor/carcinoma and LGSC still comprised the majority of discordant cases. Grossing methods that reduce sampling error are required. LAMN was frequently misinterpreted as a benign or borderline ovarian mucinous tumor. To prevent this error, a differential algorithm integrating clinical information and gross findings should be developed.

scholarly journals Bilateral Serous Psammocarcinoma of Ovary: Rare Variant Low Grade Serous Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Saubhagya Kumar Jena ◽  
Pritinanda Mishra ◽  
Vandana Mohapatra ◽  
Sweta Singh
Keyword(s):  
Rare Variant ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade ◽  
Primary Debulking Surgery ◽  
Stage Disease ◽  
Enhanced Computed Tomography

Serous psammocarcinoma is a rare variant of serous carcinoma arising from either ovary or peritoneum, characterized by massive psammoma body formation, low grade cytologic features, and invasiveness. Its clinical behavior is similar to serous borderline tumors with relatively favorable prognosis. We report herein a case of a 60-year-old postmenopausal woman who presented with abdominal distension. Contrast enhanced computed tomography (CECT) revealed calcified pelvic masses with ascites. Elevated serum CA-125 (970 U/mL) suggested malignant ovarian neoplasm. Patient underwent exploratory laparotomy with primary debulking surgery. Histopathology showed bilateral serous psammocarcinoma of ovary with invasive implants on omentum. Adjuvant chemotherapy was advised in view of advanced stage disease, although its benefits are poorly defined due to rarity of the tumor. However, patient opted out of it and is now on follow-up.

Prognostic Determinants in Patients With Stage I Uterine Papillary Serous Carcinoma: A 15-Year Multi-Institutional Review

2012 ◽  
Vol 22 (3) ◽  
pp. 417-424 ◽  
Author(s):  
Whitfield B. Growdon ◽  
J. Jose A. Rauh-Hain ◽  
Adriana Cordon ◽  
Leslie Garrett ◽  
John O. Schorge ◽  
...  
Keyword(s):  
Overall Survival ◽  
Univariate Analysis ◽  
Hazard Ratio ◽  
Stage I ◽  
Surgical Staging ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Second Malignancy ◽  
Institutional Review ◽  
Gynecology And Obstetrics

ObjectiveThe aim of this retrospective, multi-institutional study was to evaluate the importance of surgical staging for stage I uterine papillary serous carcinomas (UPSCs) to determine optimal management of this rare tumor.MethodsWith institutional review board approval from both participating institutions, all patients with 2009 International Federation of Gynecology and Obstetrics stage I mixed serous and UPSC diagnosed between January 1, 1992, and December 31, 2007, were identified at the 2 institutions. Clinical factors were correlated using Spearman correlation coefficients, Kaplan-Meier survival estimates and a Cox proportional hazards model.ResultsOf the 204 UPSC patients treated during this period, 84 were classified as stage I, with substages as follows: stage IA, n = 71; stage IB, n = 13. Thirty-seven patients (44%) had a history of a second cancer (22 breast tumors, 9 synchronous müllerian cancers). Surgical staging with at least hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and bilateral pelvic lymph node dissection was performed in 60 (71%) of 84 patients. The median survival for all patients was 10 years. Univariate analysis revealed surgical staging (P < 0.001), normal preoperative CA-125 (P < 0.001), and absence of additional cancers (P < 0.01) to be associated with improved survival. Age-adjusted multivariate analysis incorporating these factors revealed that advancing substage (hazard ratio, 4.59; P < 0.05), a second malignancy (hazard ratio, 2.75; P < 0.04), and surgical staging (hazard ratio, 0.18; P < 0.001) were independent factors associated with overall survival. In a subset analysis excluding patients with a second malignancy, substage (hazard ratio, 3.52; P < 0.05), and surgical staging (hazard ratio, 0.16; P < 0.001) were independent factors affecting overall survival.ConclusionsIndependent of adjuvant chemotherapy or radiation, stage of disease, comprehensive surgical staging, and the presence of a second malignancy were predictors of overall survival.

HER-2 Is an Independent Prognostic Factor in Endometrial Cancer: Association With Outcome in a Large Cohort of Surgically Staged Patients

2006 ◽  
Vol 24 (15) ◽  
pp. 2376-2385 ◽  
Author(s):  
Carl Morrison ◽  
Vanna Zanagnolo ◽  
Nilsa Ramirez ◽  
David E. Cohn ◽  
Nicole Kelbick ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Outcome Data ◽  
Large Cohort ◽  
Surgical Staging ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Endometrioid Adenocarcinoma ◽  
High Grade ◽  
Her 2

Purpose To evaluate HER-2 expression and amplification in a large cohort of endometrial cancer with complete surgical staging and outcome data. Patients and Methods A tissue microarray was constructed of 483 patients with endometrial cancer of diverse histologic type and stage and tested for HER-2 expression and amplification using current standards of practice. There was outcome data for 83% of all patients and 81% with complete surgical staging. Results Both expression and amplification of HER-2 was associated with high-grade (P = .0001) and high stage (P = .0001) endometrial cancer. The highest rate of HER-2 expression and amplification was seen in serous carcinoma (43% and 29%), while grade 1 endometrioid adenocarcinoma showed the lowest levels (3% and 1%). For all histologic types, the rate of HER-2 expression and amplification was remarkably different (P < .0001) for grade 3 cancers (31% and 15%) versus grade 2 (7% and 3%) and grade 1 cancers (3% and 1%), with similar results for endometrioid type (P < .0001). Both HER-2 expression and amplification correlated with disease-specific survival and progression-free survival in univariate analyses. By multivariate analysis HER-2 expression in the presence of amplification (P = .012) correlated with overall survival, but not expression in the absence of amplification. Overall survival was significantly shorter (P = .0001) in patients who overexpressed (median, 5.2 years) and/or showed amplification of HER-2 (median, 3.5 years) versus those that did not (median of all cases, 13 years). Conclusion Our results would suggest that HER-2 is an important oncogene in high grade and stage endometrial cancer, but plays only a minor role in the much more common low grade and stage tumors that encompass the majority of clinical practice.

Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5571-5571
Author(s):  
K. M. Schmeler ◽  
C. C. Sun ◽  
D. C. Bodurka ◽  
M. T. Deavers ◽  
R. L. Coleman ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Progression Free Survival ◽  
Exploratory Laparotomy ◽  
Complete Response ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade ◽  
High Grade ◽  
Ovarian Carcinomas ◽  
Platinum Based Chemotherapy

5571 Background: Neoadjuvant chemotherapy (NACT) has been associated with significant tumor reduction prior to interval debulking surgery, enabling optimal cytoreduction in up to 50% of patients with high-grade ovarian carcinomas deemed initially unresectable. Since low-grade serous carcinoma (LGSC) appears to be relatively less chemosensitive, we sought to evaluate the outcomes of women with ovarian LGSC treated with platinum-based NACT. Methods: Using institutional databases, we identified 18 women with low-grade serous carcinomas of the ovary who were treated with neoadjuvant platinum-based chemotherapy between 1978 and 2003. Patient demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan-Meier. Results: The median age at diagnosis was 44 years (range, 21 to 81 years). NACT was given for extensive or non-resectable disease in 16 patients (89%) and for unknown reasons in 2 patients (11%). Ten patients (42%) underwent exploratory laparotomy with biopsy only prior to beginning chemotherapy. A median of 6 cycles of chemotherapy was given (range, 2 to 16) and included the following regimens: platinum/taxane (n=12 patients); platinum/cyclophosphamide (n=3 patients); and platinum/leuprolide acetate (n=3 patients). Of the 13 patients who had CA-125 levels available, 8 (62%) had a ≥50% reduction between pre- and post-NACT levels. However, response, determined by radiographic survey at completion of NACT, demonstrated one patient (6%) with a complete response, no patients (0%) with a partial response, and 16 patients (89%) with stable disease. One patient (6%) was not evaluable. Fifteen patients (83%) underwent interval cytoreductive surgery, which was optimal in 8 cases (53%), suboptimal in 4 cases (27%) and unknown in 3 cases (20%). Median PFS and OS for all patients were 18.6 and 56.1 months, respectively. Conclusions: A low response rate to platinum-based NACT was observed among women with LGSC of the ovary. These findings suggest that LGSC is not as responsive to conventional chemotherapy as high-grade serous carcinoma. Prospective clinical trials, focusing specifically on LGSC, are needed to make meaningful advances for this group of patients. No significant financial relationships to disclose.

scholarly journals Immature teratoma

2016 ◽  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Frozen Section ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Pelvic Lymphadenectomy ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
Ca 125 ◽  
Grade Iii

Introduction: Immature teratoma represents 3% of all teratomas, 1 % of all ovarian cancers and 20% of malignant ovarian germ cell tumors. It is found either in pure form or as a component of a mixed germ cell tumor. It occurs essentially during the first two decades of life. According to WHO, immature teratoma is defined as a teratoma containing a variable amount of immature embryonal type neuroectodermal tissue Case: We present here a report of 23 years old unmarried female who presented with complaint of abdominal pain since 1 month and her CT scan done outside, showed fibroid uterus. She had history of typhoid fever 1 month back for which USG was done which suggested large uterine fibroid. On examination she was hemodynamically stable. On abdominal examination a non-tender supra-pubic mass of 24 weeks size with firm consistency, irregular margin was felt. On investigation CA 125 was 64.90 IU/L, LD- 223, beta HCG- 1.14. On MRI a large abdomino-pelvic lesion, likely left adnexal lesion with multiple cystic areas, with hemorrhage, with ascites and enlarged retroperitoneal lymph nodes with omental infiltration suggestive of a possibility of malignant germ cell tumor. In view of large ovarian tumor, possibly malignant decision for staging laparotomy was taken. Intra-operatively a large irregular vascular solid mass of 20 x 20 cms with bosselated appearance with few cystic lesions over it was seen, arising from left ovary and was sent for frozen section which reported malignant mature teratoma with components of immature teratoma. She underwent laparotomy with left salpingo-oophorectomy with right ovarian biopsy, omentectomy, appendectomy with B/L pelvic lymphadenectomy. Histopathology was suggestive of grade III immature teratoma. In view of grade III immature teratoma, she received chemotherapy (BEP regimen) post-operatively and is currently under follow up. Conclusion: This case reflects the importance of early diagnosis in cases of pelvic masses in young females. Fertility preservation should be considered in young women with germ cell tumors. Patients with grade II or III tumors or a mere advanced stage disease should be treated with adjuvant chemotherapy (BEP) in addition to surgery.

Primary Peritoneal Serous Psammocarcinoma: a Case Report

2015 ◽  
Vol 24 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Răzvan Dan Togănel ◽  
Ioan Şimon ◽  
Adriana Zolog ◽  
Răzvan Simescu ◽  
Angela Cozma ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Posterior Wall ◽  
Ca 125 ◽  
Low Grade ◽  
Abdominal Girth ◽  
Treatment Protocols ◽  
Standardized Treatment ◽  
Pelvic Peritonectomy ◽  
Optimal Debulking ◽  
Douglas Pouch

Background: Psammocarcinomas (PCas) are rare epithelial tumors, usually originating in the ovaries or the peritoneum. These tumors are morphologically characterized by extensive psammomatous calcifications, invasiveness and low-grade cytological features.Case report: We present the case of a 54-year-old woman who was referred to our department with an umbilical tumor and increasing abdominal girth. The patient had had an umbilical hernia for more than 20 years. The CA 125 level was normal. The CT scan showed small peritoneal nodules at the level of the Douglas pouch, including the posterior wall of the uterus, and the entire colon, as well as large nodules located on the caecum and the sigmoid colon. We performed partial enterectomy, total colectomy with ileo-rectal anastomosis, omentectomy, total histerectomy and bilateral adnexectomy, pelvic peritonectomy of the Douglas pouch. Pathology findings were consistent with F.I.G.O. stage IIIC peritoneal PCa. The patient received adjuvant chemotherapy with Taxol and Carboplatin. To date, twelve months after surgery, the follow-up shows no evidence of disease.Conclusion: Standardized treatment protocols are hindered by the rarity of the PCas. However, literature concludes that optimal debulking is mandatory, whereas the efficacy of adjuvant chemotherapy remains to be elucidated.

scholarly journals Immunohistochemical Biomarkers as a Surrogate of Molecular Analysis in Ovarian Carcinomas: A Review of the Literature

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 199 ◽  
Author(s):  
Giacomo Santandrea ◽  
Simonetta Piana ◽  
Riccardo Valli ◽  
Magda Zanelli ◽  
Elisa Gasparini ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Molecular Analysis ◽  
Immunohistochemical Analysis ◽  
Cost Effective ◽  
Mucinous Carcinoma ◽  
Serous Carcinoma ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
Ovarian Carcinomas ◽  
Novel Target

The term “ovarian carcinoma” encompasses at least five different malignant neoplasms: high-grade serous carcinoma, low-grade serous carcinoma, endometrioid carcinoma, mucinous carcinoma, and clear cell carcinoma. These five histotypes demonstrated distinctive histological, molecular, and clinical features. The rise of novel target therapies and of a tailored oncological approach has demanded an integrated multidisciplinary approach in the setting of ovarian carcinoma. The need to implement a molecular-based classification in the worldwide diagnostic and therapeutic setting of ovarian cancer demanded a search for easy-to-use and cost-effective molecular-surrogate biomarkers, relying particularly on immunohistochemical analysis. The present review focuses on the role of immunohistochemistry as a surrogate of molecular analysis in the everyday diagnostic approach to ovarian carcinomas.

Sign in / Sign up

Export Citation Format

Share Document