scholarly journals An Ominous Sign: Mucinous Ovarian Carcinoma with Sister Mary Joseph Nodule

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Alicia Hunter ◽  
Susan Addley
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Clinical Signs ◽  
Abdominal Distension ◽  
Underlying Disease ◽  
Anaplastic Carcinoma ◽  
Younger Women ◽  
True Incidence ◽  
Sister Mary Joseph ◽  
Mucinous Ovarian Carcinoma

Despite two centuries of progress in its surgical and oncological management, ovarian cancer remains the most lethal of the gynaecological cancers, claiming the lives of nearly 185,000 women globally each year. Historically considered a single disease, there is growing recognition that ovarian cancer is in fact a spectrum of malignancies with distinct cellular origins, molecular driver pathways and clinicopathological features. Mucinous ovarian carcinoma (mOC) is a rare histological subtype that presents a particular challenge in accurate diagnosis and management. Frequently confused with metastatic deposits from extra-ovarian mucinous tumours, the true incidence of primary mOC is estimated to be between 3-5%. Typically affecting younger women, prognosis for late-stage disease is abysmal with a median survival of <15 months. This case report describes a 38-year-old patient who presented with rapidly worsening abdominal distension. Subsequent debulking surgery removed a mass weighing 2.4kg, confirmed by histopathology as a high grade mucinous ovarian carcinoma with a mural nodule of anaplastic carcinoma. Evidence behind the current guidelines for management will be discussed, addressing our recent understanding of mOC as a separate disease from other histotypes and the consequent challenges in interpreting data from large multicentre trials in which patients with mOC are poorly represented. Moreover, using the Sister Mary Joseph nodule (SMJN) as an example, this case also highlights the importance of the physical examination and the value of subtle (and sometimes missed) clinical signs that provide important clues about the extent of a patient’s underlying disease and prognosis.

Aggressive anaplastic ovarian carcinoma in a young nulliparous patient

2021 ◽  
Vol 14 (4) ◽  
pp. e241461
Author(s):  
Alicia Hunter ◽  
Susan Addley ◽  
Hooman Soleymani majd
Keyword(s):  
Ovarian Carcinoma ◽  
Anaplastic Carcinoma ◽  
Optimal Management ◽  
Ovarian Mass ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Ovarian Tumours ◽  
Sister Mary Joseph ◽  
Mucinous Ovarian Carcinoma ◽  
Mural Nodules

Ovarian tumours harbouring foci of anaplastic carcinoma are extremely rare. With just a handful of cases reported in the literature, understanding of the disease and optimal management remains limited. A 38-year-old woman was referred to the gynaeoncologists with a multiloculated complex ovarian mass. High-grade mucinous ovarian carcinoma with mural nodules of anaplastic carcinoma was found on biopsy. Furthermore, an umbilical Sister Mary Joseph nodule signalled advanced metastatic disease. The patient underwent primary debulking surgery and was referred for adjuvant chemotherapy. High-quality radiological and surgical images are included to illustrate the approach taken to preoperative diagnosis and described surgical technique. Our case demonstrates the aggressive and rapidly progressive nature of mucinous ovarian carcinoma bearing anaplastic components. Sharing experience of such cases generates awareness and highlights the need for early detection and thorough investigations to guide subsequent management.

RNF43 mutations are recurrent in Chinese patients with mucinous ovarian carcinoma but absent in other subtypes of ovarian cancer

Gene ◽  
2013 ◽  
Vol 531 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Yang Zou ◽  
Feng Wang ◽  
Fa-Ying Liu ◽  
Mei-Zhen Huang ◽  
Wei Li ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Chinese Patients ◽  
Mucinous Ovarian Carcinoma

MOLECULAR AND GENETIC SUBTYPES OF OVARIAN CANCER: PROSPECTS FOR FURTHER STUDIES

2019 ◽  
Vol 65 (1) ◽  
pp. 56-62
Author(s):  
Alisa Villert ◽  
Larisa Kolomiets ◽  
Natalya Yunusova ◽  
Yevgeniya Fesik
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Molecular Subtypes ◽  
Survival Rates ◽  
Consensus Algorithm ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
High Grade ◽  
Ovarian Carcinomas ◽  
Genetic Subtypes

High-grade ovarian carcinoma is a histopathological diagnosis, however, at the molecular level, ovarian cancer represents a heterogeneous group of diseases. Studies aimed at identifying molecular genetic subtypes of ovarian cancer are conducted in order to find the answer to the question: can different molecular subgroups influence the choice of treatment? One of the achievements in this trend is the recognition of the dualistic model that categorizes various types of ovarian cancer into two groups designated high-grade (HG) and low-grade (LG) tumors. However, the tumor genome sequencing data suggest the existence of 6 ovarian carcinoma subtypes, including two LG and four HG subtypes. Subtype C1 exhibits a high stromal response and the lowest survival. Subtypes C2 and C4 demonstrate higher number of intratumoral CD3 + cells, lower stromal gene expression and better survival than sybtype C1. Subtype C5 (mesenchymal) is characterized by mesenchymal cells, over-expression of N-cadherin and P-cadherin, low expression of differentiation markers, and lower survival rates than C2 and C4. The use of a consensus algorithm to determine the subtype allows identification of only a minority of ovarian carcinomas (approximately 25%) therefore, the practical importance of this classification requires additional research. There is evidence that it makes sense to randomize tumors into groups with altered expression of angiogenic genes and groups with overexpression of the immune response genes, as in the angiogenic group there is a comparative superiority in terms of survival. The administration of bevacizumab in the angiogenic group improves survival, while the administration of bevacizumab in the immune group even worsens the outcome. Molecular subtypes with worse survival rates (proliferative and mesenchymal) also benefit most from bevacizumab treatment. This review focuses on some of the advances in understanding molecular, cellular, and genetic changes in ovarian carcinomas with the results achieved so far regarding the formulation of molecular subtypes of ovarian cancer, however further studies are needed.

scholarly journals Alternative splicing acts as an independent prognosticator in ovarian carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yan Ouyang ◽  
Kaide Xia ◽  
Xue Yang ◽  
Shichao Zhang ◽  
Li Wang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Regression Analysis ◽  
Alternative Splicing ◽  
Ovarian Carcinoma ◽  
Cancer Patients ◽  
Cox Regression ◽  
Excision Repair ◽  
Splicing Factors ◽  
Prognostic Signature ◽  
Cox Regression Analysis

AbstractAlternative splicing (AS) events associated with oncogenic processes present anomalous perturbations in many cancers, including ovarian carcinoma. There are no reliable features to predict survival outcomes for ovarian cancer patients. In this study, comprehensive profiling of AS events was conducted by integrating AS data and clinical information of ovarian serous cystadenocarcinoma (OV). Survival-related AS events were identified by Univariate Cox regression analysis. Then, least absolute shrinkage and selection operator (LASSO) and multivariate Cox regression analysis were used to construct the prognostic signatures within each AS type. Furthermore, we established a splicing-related network to reveal the potential regulatory mechanisms between splicing factors and candidate AS events. A total of 730 AS events were identified as survival-associated splicing events, and the final prognostic signature based on all seven types of AS events could serve as an independent prognostic indicator and had powerful efficiency in distinguishing patient outcomes. In addition, survival-related AS events might be involved in tumor-related pathways including base excision repair and pyrimidine metabolism pathways, and some splicing factors might be correlated with prognosis-related AS events, including SPEN, SF3B5, RNPC3, LUC7L3, SRSF11 and PRPF38B. Our study constructs an independent prognostic signature for predicting ovarian cancer patients’ survival outcome and contributes to elucidating the underlying mechanism of AS in tumor development.

scholarly journals Comparison of dose-dense vs. 3-weekly paclitaxel and carboplatin in the first-line treatment of ovarian cancer in a propensity score-matched cohort

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rafaela Pirolli ◽  
Viviane Teixeira Loiola de Alencar ◽  
Felipe Leonardo Estati ◽  
Adriana Regina Gonçalves Ribeiro ◽  
Daniella Yumi Tsuji Honda ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Ovarian Carcinoma ◽  
Matched Cohort ◽  
Line Treatment ◽  
First Line ◽  
Western Population ◽  
Dose Dense ◽  
First Line Treatment

Abstract Background Benefit of carboplatin and dose-dense weekly paclitaxel (ddCT) in first line treatment of ovarian cancer patients has been different in Western and Asian studies. In the present study we compare progression-free survival (PFS) of ddCT to three-weekly carboplatin and paclitaxel (CT) in first-line treatment of ovarian carcinoma in a single institution in a Western population. Materials and methods We conducted a retrospective review of medical records from patients with ovarian carcinoma treated in a tertiary cancer center from 2007 to 2018. All patients treated with ddCT or CT in the first-line setting were included. Patients who received first-line bevacizumab were not included. PFS and overall survival (OS) were compared in a propensity score-matched cohort to address selection bias. Patients were matched according to age, ECOG performance status, CA 125, FIGO stage, residual disease, and histological subtype, in a 1:2 ratio. Results Five hundred eighty-eight patients were eligible for propensity score matching, the final cohort consisted of 69 patients treated with ddCT and 138 CT group. Baseline characteristics were well-balanced. After a median follow-up of 65.1 months, median PFS was 29.3 vs 20.0 months, favouring ddCT treatment (p = 0.035). In the multivariate cox regression ddCT showed a 18% lower risk of progression (HR 0.82, 95% CI 0.68–0.99, p = 0.04). Overall survival data is immature, but suggested better outcomes for ddCT (not reached versus 78.8 months; p = 0.07). Conclusion Our retrospective study has shown superior PFS of ddCT over CT regimen in first-line treatment of ovarian carcinoma in a Western population not treated with bevacizumab.

Safety of fertility sparing management in invasive mucinous ovarian carcinoma

2021 ◽  
Vol 162 ◽  
pp. S269-S270
Author(s):  
Rachel Soyoun Kim ◽  
Ainhoa Madariaga ◽  
Liat Hogen ◽  
Danielle Vicus ◽  
Allan Covens ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Fertility Sparing ◽  
Mucinous Ovarian Carcinoma

Intraperitoneal Radioactive Phosphorus (32P) Versus Observation After Negative Second-Look Laparotomy for Stage III Ovarian Carcinoma: A Randomized Trial of the Gynecologic Oncology Group

2003 ◽  
Vol 21 (15) ◽  
pp. 2849-2855 ◽  
Author(s):  
Mahesh A. Varia ◽  
Frederick B. Stehman ◽  
Brian N. Bundy ◽  
Jo Ann Benda ◽  
Daniel L. Clarke-Pearson ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Relative Risk ◽  
Ovarian Carcinoma ◽  
Tumor Recurrence ◽  
Stage Iii ◽  
Gynecologic Oncology Group ◽  
Consolidation Therapy ◽  
Risk Of Death ◽  
Second Look ◽  
Significant Difference

Purpose: The objectives of this prospective randomized study of consolidation therapy were to evaluate recurrence-free survival (RFS), overall survival (OS), and the morbidity of intraperitoneal (IP) chromic phosphate suspension (32P) therapy in patients with stage III epithelial ovarian carcinoma who have no detectable evidence of disease at the second-look laparotomy (SLL) procedure after primary chemotherapy. Patients and Methods: In a multi-institution clinical cooperative trial, 202 eligible patients with a negative SLL were randomly selected to receive either 15 mCi IP 32P (n = 104) or no further therapy (NFT; n = 98). Results: With a median follow-up of 63 months in living patients, 68 patients in the IP 32P group (65%) and 63 patients in the NFT group (64%) have developed tumor recurrence. The relative risk of recurrence is 0.90 (IP 32P to NFT) (90% confidence interval [CI], 0.68 to 1.19). The 5-year RFS rate is 42% and 36% for the IP 32P and NFT groups, respectively; the difference is not statistically significant (log-rank test, P = .27). There was no statistically significant difference in OS (P = .19). The relative risk of death is 0.85 (IP 32P to NFT) (90% CI, 0.62 to 1.16). Sixteen patients (8%) experienced grade 3 or 4 adverse effects, with eight in each respective group. Conclusion: Intraperitoneal chromic phosphate did not decrease the risk of relapse or improve survival for patients with stage III epithelial ovarian cancer after a negative SLL. Despite complete pathologic remission at SLL after initial surgery and platinum-based chemotherapy, 61% of stage III ovarian cancer patients had tumor recurrence within 5 years of negative SLL. This indicates a need for more effective initial therapy and further studies of consolidation therapy.

Radiographic Assessment of Dogs with Congestive Heart Failure

2021 ◽  
Author(s):  
N. Saini ◽  
S.K. Uppal ◽  
A. Anand
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Clinical Signs ◽  
Abdominal Distension ◽  
Cardiac Insufficiency ◽  
Exercise Intolerance ◽  
Pulmonary Vasculature ◽  
Non Invasive ◽  
Valvular Diseases

Background: Radiography is widely used for diagnosis of congestive heart failure as it enables non-invasive assessment of cardiac size, shape and pulmonary vasculature. So, the present study was conducted to record the radiographic changes in dogs with congestive heart failure.Methods: Fifty-one dogs with cardiac insufficiency brought to Teaching Veterinary Hospital of GADVASU, showing one of the clinical signs of chronic cough, dyspnea, exercise intolerance, abdominal distension, syncope and cyanosis were selected and were subjected to Lateral and Ventro-dorsal chest radiography. Result: Dilated cardiomyopathy was present in 24 dogs. Radiographically, pulmonary edema, cardiomegaly, vessel congestion were more common in dilated cardiomyopathy (DCM). Valvular diseases were present in 16 dogs and radiographically left atrial (LA) dilatation was present in dogs with valvular diseases. Pericardial effusions were present in 11 dogs showing enlarged globoid heart radiographically.

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