Osteopontin as a Tumor Marker in Ovarian Cancer

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.

Torsion of ovarian mass-A diagnostic dilemma to tissue diagnosis

A holistic and multidisciplinary approach is required for ovarian cancer diagnosis and management. Ovarian tumor diagnosis is based on clinical symptomatology followed by radiological confirmation. Tumor markers are considered just adjunct. Management of ovarian mass is surgical and intra -op frozen section aids in understanding the nature of the mass but histopathology is definitive. Ovarian torsion affects 2.5 to 7.4% of all ovarian tumors. The present case will highlight the destructive changes brought about by torsion which could ultimately result in missed tissue diagnosis.

Frequency of Overweight Women and Ovarian Enlargement among Females Presented with Pelvic Pain Complains

Objective: To determine the frequency of overweight females and ovarian enlargement among women presenting with pelvic pain complaints at rural Health facilities of district Tando Muhammad Khan. Methodology: This descriptive study was conducted at physiology department of Sindh University with the collaboration of different rural health facilities of Tando Muhammad Khan, Sindh. All the females presented with pelvic pain and age more than 18 and up to 45 years were included. Body mass index (BMI) was assessed by the ratio of the individual's weight in kilograms divided by the height in meters squared (BMI = kg/m2). All the patients underwent ultrasound examination. Data collection was done by structured study proforma. Analysis of the data was done by the SPSS version 20. Results: A total of 239 women with pelvic pain complaints were studied, their mean age was 32.79+4.31 years. Neoplastic ovarian lesions were seen amogn12.54% of the cases. Cystic ovarian lesions were among 30.54% of the females, 5.01% had ovarian mass and 21.33% females had mixed pathologies. BMI was normal among 62.76% cases, while 20.08% women were overweight, 03.34% were obese and 13.8%females were underweight. Conclusion: Overweight females and ovarian enlargement were observed to be highly frequent among females presented with pelvic pain complaints. Cystic enlargement was observed to be the commonest cause of ovarian enlargement.

Autoamputated ovarian mass causing a partial bowel obstruction in an infant with literature review

An autoamputated ovary (AO) is an extremely rare circumstance with a few reports in the literature. We present a case of a 3-month-old girl with a history of vague abdominal symptoms as well as a known ovarian mass, which was initially suspected to be benign and regressing. On laparoscopy for pain and obstructive symptoms, she was found to have an AO. The pathology was consistent with necrotic and torsed ovarian tissue with superimposed infection and possibly a cystic non-malignant teratoma. AOs are thought to originate from a torsion and are typically diagnosed incidentally. This is an interesting case of an AO causing a partial small bowel obstruction.

Case Report: Gastric Cancer Combined With Bilateral Ovarian Metastasis In Pregnancy

Background: The early manifestations of gastric cancer during pregnancy are non-specific. Ovarian mass and ascites are the main manifestations of late ovarian metastasis. Case presentation: A case of late gastric cancer with bilateral ovarian metastasis in pregnancy was reported in our study. Cesarean section and full staging of ovarian malignant tumors were performed at 28+5 weeks of pregnancy, and the prognosis was poor. We performed Cesarean delivery and extracted a vital male newborn of 35 cm, 1020 g, Ap score 3. The newborn is alive and grows normally. Three months later the mother died. The key to improving the prognosis is early diagnosis, and the pre-pregnancy health checkup must be emphasized. Conclusions: During pregnancy, ultrasound, gastroscopy, MRI and other related examinations should be performed to confirm the diagnosis, and individualized treatment plans should be formulated to maximize the protection of the mother and child's interests.