Preoperative analysis of risk of malignancy indices in the distinction of malignant ovarian tumors

2020 ◽  
Vol 9 (6) ◽  
pp. 238
Author(s):  
B Moshina ◽  
Seetesh Ghose
2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Shuang Zhang ◽  
Shan Yu ◽  
Wenying Hou ◽  
Xiaoying Li ◽  
Chunping Ning ◽  
...  

Abstract Background This study aimed to examine the performance of the four risk of malignancy index (RMI) in discriminating borderline ovarian tumors (BOTs) and benign ovarian masses in daily clinical practice. Methods A total of 162 women with BOTs and 379 women with benign ovarian tumors diagnosed at the Second Affiliated Hospital of Harbin Medical University from January 2012 to December 2016 were enrolled in this retrospective study. Also, we classified these patients into serous borderline ovarian tumor (SBOT) and mucinous borderline ovarian tumor (MBOT) subgroup. Preoperative ultrasound findings, cancer antigen 125 (CA125) and menopausal status were reviewed. The area under the curve (AUC) of receiver operator characteristic curves (ROC) and performance indices of RMI I, RMI II, RMI III and RMI IV were calculated and compared for discrimination between benign ovarian tumors and BOTs. Results RMI I had the highest AUC (0.825, 95% CI: 0.790–0.856) among the four RMIs in BOTs group. Similar results were found in SBOT (0.839, 95% CI: 0.804–0.871) and MBOT (0.791, 95% CI: 0.749–0.829) subgroups. RMI I had the highest specificity among the BOTs group (87.6, 95% CI: 83.9–90.7%), SBOT (87.6, 95% CI: 83.9–90.7%) and MBOT group (87.6, 95% CI: 83.9–90.7%). RMI II scored the highest overall in terms of sensitivity among the BOTs group (69.75, 95% CI: 62.1–76.7%), SBOT (74.34, 95% CI: 65.3–82.1%) and MBOT (59.18, 95% CI: 44.2–73.0%) group. Conclusion Compared to other RMIs, RMI I was the best-performed method for differentiation of BOTs from benign ovarian tumors. At the same time, RMI I also performed best in the discrimination SBOT from benign ovarian tumors.


2011 ◽  
Vol 28 (3) ◽  
pp. 259-266 ◽  
Author(s):  
Amos Hong Pheng Loh ◽  
Chiou Li Ong ◽  
Shu Lin Lam ◽  
Joyce Horng Yiing Chua ◽  
Chan Hon Chui

Author(s):  
Alaba Moses Adesina ◽  
John Osaigbovoh Imaralu ◽  
Adebola Olukayode Yusuf ◽  
Mustapha Akanji Ajani

Aim: To highlight the potential for misdiagnosis of ovarian fibromas and need for careful evaluation especially when fertility altering decisions need to be taken in the young adolescent. Presentation of Case: The authors here review literature and present the case of a 15 year old pre-menarchal patient with bilateral, solid hard ovarian tumors with marked ascites, who had bilateral salpingo-oophorectomy, in whom the tumors turned out to be bilateral calcific ovarian fibromas. Discussion: Ovarian neoplasia are often misdiagnosed because of their non-specific symptoms and similarities to other pathologies on radiological imaging. The management of adolescents with ovarian tumors poses peculiar challenges as there is need for a balance between the risk of malignancy and the need to preserve fertility. About 1/3 of pelvic masses in pre-pubertal girls are malignant. This fact in addition to the non-specific features of malignancy in this patient such as weight loss, ascites, necessitated further evaluation which included laparotomy. Conclusion: Ovarian fibromas occur in adolescents and can pose a diagnostic dilemma; a high index of suspicion is required to plan fertility-sparing and cancer-limiting management.


2014 ◽  
Vol 44 (S1) ◽  
pp. 343-344
Author(s):  
M. Canto ◽  
N. Sarasa ◽  
G. Moreno ◽  
S. Palmero ◽  
N. Pons ◽  
...  

Author(s):  
Rao P. S. ◽  
Bala Reenu ◽  
S. Prajwal

Background: Ovarian malignancy is the most common gynecological malignancy after the cancer of the cervix. A woman's risk at birth of ovarian cancer at some time in her life is 1 % to 1.5% and that of dying from cancer is almost 0.5 %. The most commonly occurring ovarian tumors are of epithelial in origin. It has the highest case-fatality ratio of all gynecological malignancies. Hence the early diagnosis is the most important factor for better prognosis. A clinical evaluation of the patient, followed by ultrasonography and CA-125 is helpful. This study aims to determine the role of Risk of Malignancy Index (Jacob’s RMI) in ovarian tumors for prediction of ovarian malignancy.Methods: This is a prospective cohort study. The present study was carried out at department of OBG, in collaboration with the Departments of Radio diagnosis and Pathology, AHRR, New Delhi. 100 patients meeting the inclusion and exclusion criteria were considered. Detailed clinical history, examination and ultrasonography (Abdomen and pelvis) were done. Estimation of CA125 was done thereafter. Calculated JACOBS RMI score was compared with operative surgical staging and histopathological-cytological examination of the specimen. Data obtained thereafter was analysed using appropriate and relevant statistical software.Results: In present study sensitivity of RMI Score in the pre-menopausal women was 66.7% and in post-menopausal women was 83.3%. Specificity of RMI Score in the pre-menopausal women was 96.3% and in post-menopausal women was 81.8%. The positive predictive value in the pre-menopausal women was 40% and in post-menopausal women was 71.4%. The negative predictive value in the pre-menopausal women was 98.7% and in post-menopausal women was 90%. Diagnostic accuracy in a case of premenopausal women was is 95.2% and 82.4% for postmenopausal women.Conclusions: The present study shows that RMI Score helps in identifying effectively those patients who require Staging Laparotomy and hence referral to Gynecologist Oncologist. Patients with ovarian masses with low risk of malignancy index can be treated by minimal access procedures.


2016 ◽  
Vol 133 (3) ◽  
pp. 355-358 ◽  
Author(s):  
Petronella A.J. van den Akker ◽  
Petra L.M. Zusterzeel ◽  
Anette L. Aalders ◽  
Marc P.L.M. Snijders ◽  
Rahul A.K. Samlal ◽  
...  

Цель настоящего исследования - сравнение эффективности алгоритмов ROMA и RMI в прогнозировании злокачественного характера образований яичников. Проведено обследование 188 женщин с одно- или двусторонними образованиями яичников. У 126 (67,0%) пациенток были выявлены доброкачественные образования яичников (первая группа), у 62 (33,0%) - злокачественные (вторая группа). У всех пациенток диагноз был верифицирован по результатам морфологического исследования послеоперационного материала. В первой группе в подгруппе менопаузы было 78 из 126 (61,9%) пациенток, во второй группе - 48 из 62 (77,4%) (P 0,05). При сравнении пациенток с доброкачественными и злокачественными образованиями яичников получены достоверные различия по показателям ROMA и RMI в группах и подгруппах сравнения (P 0,05). Показатель RMI обладает более высокими показателями диагностической эффективности по сравнению с показателем ROMA (AUC, чувствительность и специфичность соответствуют 0,93, 85,5% и 96,8% против 0,89, 87,1% и 83,3% соответственно). Показатель RMI может быть рекомендован в качестве начального этапа дифференциально-диагностического поиска у пациенток с образованиями яичников. Ключевые слова: ультразвуковая диагностика, злокачественные опухоли яичников, онкомаркеры, CA125, HE4, алгоритм расчета риска злокачественного образования яичников (ROMA), индекс риска злокачественности (RMI), ultrasound, malignant ovarian tumors, tumor markers, CA125, HE4, risk of ovarian malignancy algorithm (ROMA), risk of malignancy index (RMI)


Author(s):  
Yasin Durmus ◽  
Mehmet Mutlu Meydanli

<p><strong>Objectives:</strong> To evaluate diagnostic accuracy of "Risk Of Malignancy İndex-1" (RMI-1) for postmenopausal adnexal masses.</p><p><strong>Study Design:</strong> Fifty postmenopausal women who had undergone surgery because of adnexal masses were included in this prospective study. RMI-1 scores were calculated through the formula: [RMI= Ultrasound Score x Menopause Score x Serum Ca-125 Level] and noted preoperatively by the same sonographer for each case. "Final histopathological diagnosis" was accepted as gold standard for benign-malignant categorical distribution. Borderline tumors were categorized in malignant tumor group.<br /><strong></strong></p><p><strong>Results:</strong> According to final histopathological results; 20 of the 50 patients had malignant adnexal masses. Twelve of them had invasive epithelial tumors. The remaining 8 patients had borderline epithelial tumors or non-epithelial ovarian cancers. When the RMI score ≥200 was accepted as a positive test result compatible with the literature; we calculated the sensitivity: 75%, specificity: 93%, positive predictive value: 88%, negative predictive value: 85% predicting malignant adnexal masses. All of the 12 patients with invasive epithelial tumors had RMI-1 scores higher than 200. Nevertheless, only 3 of the 8 patients with borderline epithelial tumors or non-epithelial ovarian cancers had RMI-1 scores higher than 200. We have found out that invasive epithelial tumors had higher USG Scores, Ca-125 Levels and RMI Scores when compared to borderline epithelial tumors and non-epithelial ovarian cancers and the difference was statistically significant.<br /><strong></strong></p><p><strong>Conclusions:</strong> RMI-1 is a valuable and applicable method in the initial evaluation of postmenopausal patients with adnexal masses. İt has a high diagnostic performance in detecting invasive epithelial ovarian cancers, but it has a poor sensitivity in detecting borderline ovarian tumors and non-epithelial ovarian cancers.</p>


Author(s):  
Kanika Chandra ◽  
Neetu Arora

Background: Ovarian tumours are a heterogeneous neoplasm with a varied clinical, morphological and histological feature. Increasing mortality rate due to ovarian cancers has been reported in recent years. Ovarian tumours in post-menopausal females have high risk of malignancy and it has a very poor outcome. The aim and objective of this study was to determine clinical and histopathological spectrum and the frequency and age distribution of various ovarian tumors.Methods: It is a retrospective observational study of patients with ovarian tumors in the department of obstetrics and gynecology, SGRRI of Medical Health & Sciences and Hospital from January 2016 to December 2017 in a total number of 86 patients. All specimens were sent to pathology department and categorised according to WHO  hispathological classification.Results: Out of 86 cases examined, 64 cases were benign (74.4%), 3 cases were borderline (3.4%) and 19 cases were malignant (22.2%). Majority of the ovarian tumors (73.4%) were seen in the age group of 20 to 50 years. Most commonly encountered benign ovarian tumour was serous cystadenoma (58.1%). Surface epithelial tumors were the commonest tumors (64%) followed by germ cell tumors (29%).Conclusions: A variety of benign and malignant tumours of ovary were reported in this study. Early diagnosis and appropriate treatment of ovarian neoplasms favour the good prognosis. Most common benign tumour encountered in this study was serous cystadenoma.


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