Recurrence and Metachronous Disease in Children with Benign Ovarian Tumors: A Systematic Review of the Literature

Aim The majority of ovarian tumors in children are benign, with good prognosis following complete resection. Little is published on the incidence of tumor recurrence and metachronous disease, and follow-up management of children with benign ovarian tumors (BOTs) remains a matter of debate. This systematic review aimed to evaluate the incidence and timing of recurrence and metachronous disease in children with BOTs in pediatric literature. Methods Comprehensive literature searches of the English literature (PubMed, OVID, EMBASE databases) from inception to present according to the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Outcomes for tumor recurrence and metachronous disease were synthesized. Results Nineteen studies comprising 1,069 patients with BOTs were included in the analysis. All studies were retrospective cohort studies of children less than 18 years old. A total of 56 events of recurrence or metachronous disease were reported in these patients. The overall risk of recurrence/metachronous event occurrence was 5.2%/2.9%. Seventy-five percent of events occurred within the first 4 years following resection. Conclusion Although the studies identified are few and heterogeneous, they demonstrate a significant risk of tumor recurrence and metachronous disease for children following resection of a BOT.Especially following total unilateral oophorectomy, these children are at risk of losing the contralateral ovary in case of metachronous disease.Immediate discharge from follow-up, therefore, does not appear safe. The majority of events occurred within the first 4 years following resection. Follow-up for children following resection of a BOT should, therefore, be continued for a minimum of 4 years following surgery. Larger, long-term prospective studies are required to more accurately determine the true incidence and long-term outcomes for children and adolescents with these tumors.

Lipid profile an important risk factor in patients with ovarian tumors: a meta-analysis

Introduction: In the literature ovarian tumors are knowed to be one of the most deadliest gynecological malignancies [1-4]. In US this type of malignancy represents 2.3 % of all cancer-related death and about 4 % of all new cancer cases among women. There are several studies that have reported the role of lipid profiles and it’s role in ovarian tumorigenesis. Fatty acids are essential for cancer cells progression[4-8]. In our study we investigated the true differance in circulating lipid profiles (total cholesterol TC, triglyceride TG, high-density lipoprotein cholesterol HDL, low density lipoprotein cholesterol LDL) among patients with and without ovarian tumors (OT) using a meta-analytical approach. Mehods: The meta-analysis was conducted using the MOOSE guidelines. PubMed, EMBASE and Cochrane Library were extensively searched ( with a period of publication restriction between 2007 and 2019) to indetify published studies using the following keywords: “ total cholesterol ”, “high-density lipoprotein”, “ triglycerides ”, “ low-density lipoprotein ”, “ ovarian cancer”, “ ovarian tumor ”, “ lipid profile ”. The search methodology is shown in Fig. 1 and all references of retrieved articles were searched manually. Results: Seven studies, involving 1542 OT cases and 2195 non-cases of OT were included in this meta-analysis and I² statistics ranged between 97 and 99%. Mean circulating TC and HDL were significantly lower among OT cases compared to non-OT cases (P<0.04 and P<0.005). Conclusion: There is a modest significant association between circulating HDL and risk of ovarian tumor but it is crucial to elucidate the implications of HDL in tumor manifestations and growth.

Lipid Profile an Important Risk Factor in Patients with Ovarian Tumors: A-Meta-Analysis

Introduction In the literature ovarian tumors are know to be one of the deadliest gynecological malignancies [1-4]. In US this type of malignancy represents 2.3 % of all cancer-related death and about 4 % of all new cancer cases among women. There are several studies that have reported the role of lipid profiles and it’s role in ovarian tumorigenesis. Fatty acids are essential for cancer cells progression[4-8]. In our study we investigated the true differance in circulating lipid profiles (total cholesterol TC, triglyceride TG, high-density lipoprotein cholesterol HDL, low density lipoprotein cholesterol LDL) among patients with and without ovarian tumors (OT) using a meta-analytical approach. Methods The meta-analysis was conducted using the MOOSE guidelines. PubMed, EMBASE and Cochrane Library were extensively searched (with a period of publication restriction between 2007 and 2019) to indentify published studies using the following keywords: “ total cholesterol ”, “high-density lipoprotein”, “ triglycerides ”, “ low-density lipoprotein ”, “ ovarian cancer”, “ ovarian tumor ”, “ lipid profile ”. The search methodology is shown in Fig. 1 and all references of retrieved articles were searched manually. Results Seven studies, involving 1542 OT cases and 2195 non-cases of OT were included in this meta-analysis and I² statistics ranged between 97 and 99%. Mean circulating TC and HDL were significantly lower among OT cases compared to non-OT cases (P<0.04 and P<0.005). Conclusion There is a modest significant association between circulating HDL and risk of ovarian tumor but it is crucial to elucidate the implications of HDL in tumor manifestations and growth.

Mimics and Pitfalls of Primary Ovarian Malignancy Imaging

The complex anatomy and similarity of imaging features of various pathologies in the pelvis can make accurate radiology interpretation difficult. While prompt recognition of ovarian cancer remains essential, awareness of processes that mimic ovarian tumors can avoid potential misdiagnosis and unnecessary surgery. This article details the female pelvic anatomy and highlights relevant imaging features that mimic extra-ovarian tumors, to help the radiologists accurately build a differential diagnosis of a lesion occupying the adnexa.

Expression of TIMPs and MMPs in Ovarian Tumors, Ascites, Ascites-Derived Cells, and Cancer Cell Lines: Characteristic Modulatory Response Before and After Chemotherapy Treatment

BackgroundThe tissue inhibitors of metalloproteinase (TIMPs) and their associated metalloproteinase (MMPs) are essential regulators of tissue homeostasis and are essential for cancer progression. This study analyzed the expression of TIMP-1,-2,-3 and the associated MMPs (MMP-2,-9,-11,-14) in different Stages, Grades and World Health Organization (WHO) classifications of serous ovarian tumors, ascites, ascites-derived cells from chemo-naïve (CN) and relapsed (CR) patients, and in ovarian cancer cell lines. The status of TIMPs and associated MMPs in response to chemotherapy treatment was assessed in cancer cell lines; TCGA data was interrogated to gauge TIMPs and associated MMPs as prognostic and platinum-response indicators.MethodsThe levels of TIMP-1, -2 and -3 were assessed by immunohistochemistry. The mRNA expression of TIMPs and MMPs was quantified by real time PCR (qRT-PCR). The chemosensitivity (IC50 values) to Cisplatin or Paclitaxel in cell lines was evaluated by MTT assay. The levels of TIMPs in ascites and cell lysates were analyzed by an ELISA assay.ResultsThe expression of TIMP-2 was significantly upregulated in Type 2 compared to Type 1 tumors and normal/benign ovarian tissues. TIMP-3 expression was significantly enhanced in Stage III, Grade 3 and Type 2 tumors compared to normal/benign ovarian tissues. The mRNA expression of MMP-9,-11 and -14 was significantly upregulated in Stage IV compared to normal/benign ovarian tissues. The expression of TIMP-1 was highest, followed by TIMP-2 and then TIMP-3 in CN ascites. At the cellular level, TIMP-2 mRNA expression was significantly higher in CN compared to CR epithelial cells in patients. The expression of TIMP-1 and -2, MMPs and cancer stem cells (CSCs) were upregulated in response to chemotherapy treatments in cancer cell lines. Interrogation of the TCGA dataset suggests shifts in platinum responses in patients consistent with genetic alterations in TIMP-2, -3 and MMP-2, -11 genes in tumors; and decreased overall survival (OS) and progression-free survival (PFS) in patients with altered MMP-14 genes.ConclusionsTIMPs and related MMPs are differentially expressed in serous ovarian tumors, ascites, ascites-derived cells and ovarian cancer cell lines. Chemotherapy treatment modulates expression of TIMPs and MMPs in association with increased expression of genes related to cancer stem cells.

Histomorphological spectrum of ovarian tumors - A tertiary care center experience

Background: Ovarian tumors are a heterogeneous group of neoplasms with variable clinical, morphological, and histological features. Ovarian cancer is the leading cause of death in females. Aims and Objectives: (1) To study and characterize the ovarian tumors based on gross and histopathological features. (2) To study prevalence and age distribution of various ovarian tumors. (3) To study the clinical features in patients with ovarian tumors. (4)To compare the frequency of benign and malignant neoplasms of the ovary with other studies. Materials and Methods: This is a prospective study conducted in Upgraded Department of Pathology, Modern Government maternity hospital, and Osmania General Hospital, Hyderabad, Telangana from March 2018 to February 2021. A total of 200 ovarian tumors were studied. Results: Out of 200 ovarian tumors, 132 were benign, seven were borderline and 61 were malignant. The surface epithelial tumors were the most common tumors accounting for 159cases (79.5%), germ cell tumors were seen in 27 cases (13.5%), sex-cord stromal tumors formed 10 cases (5%), and metastasis in 4 cases (2%). Conclusion: Ovary is a common site of tumors in the female genital tract and usually presents with a variety of clinocomorphological and histological features. Benign are the most common, of these surface epithelial tumors are the commonest, affects mainly reproductive age group.

Laparoscopy in diagnosis and complex treatm ent of malignant ovarian tumors

To study the possibilities of laparoscopy in diagnosis of malignant ovarian tumors 635 patients at different stages of the disease were examined. High informing characteristics make it possible to recommend laparoscopy as a method of improved diagnostics of tumors in smallpelvic with the aim of early revealingof malignant tumors, morphologic verification and evaluation of tumor extensiveness, diagnosis of preclinical recurrent tumors in case of diverse results of non-invasive monitoring methods.