Diagnosis and treatment characteristics of mucinous ovarian tumors

Ovarian tumors occupy a special place in gynecological pathology due to their great diversity, diagnostic difficulties, specifying their evolutionary nature, establishing the prognosis and treatment. Ovarian mucinous tumors are a group of rare formations, with a cell of as yet undefined origin, but with an apparent progression from benign to borderline and carcinoma. The treatment of a benign ovarian tumor is surgical. Material and methods. The research in question was performed on a group of 50 patients, who were treated in the gynecology department of the IMSP Oncological Institute of the Republic of Moldova, with the diagnosis of mucinous ovarian tumors. Results. The study analyzed data on the diagnosis and treatment of mucinous ovarian tumors. The clinical diagnosis showed a unilateral ovarian involvement in 41 cases (82%) compared to the bilateral one registered in 9 patients (18%). All tumors were large and irregularly shaped. In the case of laboratory diagnosis in assessing the benign or malignant tumor potential, the tumor marker CA-125 was performed, in 41 patients the index was within the norm range from 0-35U / ml and only in 9 cases were there insignificant increases of 50-100U / ml. Ultrasonographic diagnosis is an important method in detecting mucinous ovarian tumors. The treatment of patients is surgical and, depending on the appearance of the tumor intraoperatively and age, they had a radical or less radical character. Conclusions. The most common clinical signs were fullness in the pelvis, dysuria, pain in the lumbar or sacral region. As usual, the mucous ovarian tumors are large. The CA-125 tumor marker was in most cases within the normal range. Imaging investigations are informative and some of them applied to all patients in the study. Endoscopic diagnostic methods are less informative in mucinous ovarian tumors due to bulky formations and the risk of effusion of the mucin into the abdominal cavity.

Primary mucinous ovarian tumors vs. ovarian metastases from gastrointestinal tract, pancreas and biliary tree: a review of current problematics

Background Making the distinction between primary mucinous and metastatic ovarian tumors is often difficult, especially in tumors with a primary source from the gastrointestinal tract, pancreas and biliary tree. The aim of the following paper is to provide an overview of the problematics, with a focus on the possibilities of the differential diagnosis at the macroscopic, microscopic and immunohistochemical level. Main body The three main aspects of mucinous ovarian tumors are described in detail, including the comparison of the available diagnostic algorithms based on the evaluation of mostly macroscopic features, characterization of the spectrum of microscopic features, and a detailed analysis of the immunophenotype comparing 20 antibodies with the assessment of their statistical significance for differential diagnosis purposes. Specific features, including Krukenberg tumor and pseudomyxoma peritonei, are also discussed. Conclusion Despite the growing knowledge of the macroscopic and microscopic features of ovarian mucinous tumors and the availability of a wide range of immunohistochemical antibodies useful in this setting, there still remains a group of tumors which cannot be precisely classified without close clinical-pathological cooperation.

Lymphadenectomy for early-stage mucinous ovarian carcinoma

ObjectivesThere is evidence to suggest that the rate of lymph node metastases in patients with ovarian mucinous tumors is rare. The objective of this study was to investigate the prevalence of regional lymph node metastases among patients with apparent stage IA and IC mucinous ovarian carcinoma.MethodsA retrospective cohort study was performed and included patients from the National Cancer Database with apparent stage IA and IC mucinous ovarian tumors who underwent surgery between January 1, 2004 and December 31, 2015. Data collected included demographics, surgical procedures, and pathologic characteristics. The primary outcome was the effect of tumor stage, grade, and size on the risk of lymph node metastases. Categorical and continuous variables were compared using the χ2 and Mann–Whitney U tests, respectively.ResultsA total of 4379 patients were identified: 3088 and 1213 with stage IA and IC disease, respectively, with an additional 78 patients who were stage I Not Otherwise Specified (NOS). Lymphadenectomy was performed in 70.6% of patients with stage IA and 70.3% of patients with stage IC cancers. Stratifying by grade, 68.4%, 71.3%, and 72.8% of patients with grades 1, 2, and 3 tumors underwent a lymphadenectomy, respectively. Furthermore, lymphadenectomy was performed in 64.9% of patients with tumors <10 cm and 72.4% with tumors >10 cm. Lymph node metastases were identified in 1.2% and 1.6% of patients with stage IA and IC disease, respectively (p=0.063). Additionally, metastases were present in 0.6% of patients with grade 1 tumors, 1.1% of patients with grade 2 tumors, and 5.3% of patients with grade 3 tumors (p<0.001). Lastly, 0.9% of patients with tumors <10 cm and 1.4% of patients with tumors >10 cm had lymph node metastases (p=0.19).ConclusionsAmong patients with mucinous ovarian carcinoma, lymph node metastases are rare. However, metastases are significantly more common in patients with higher grade tumors. These factors may be considered when making decisions regarding the need for lymphadenectomy in early-stage mucinous ovarian tumors.

Collision tumor of ovary: a case report on bilateral dermoid cyst with co-existing unilateral mucinous cystadenoma

A collision tumor is the coexistence of two adjacent, but histologically distinct tumors without histological admixture in the same tissue or organ. Such tumors have often been reported in various organs, but location in the ovary is rare. The juxtaposition with dermoid cysts has been reported as comprising approximately 5% of benign mucinous ovarian tumors and rare examples of proliferating mucinous tumors. Authors are reporting a case of collision tumor which included benign mucinous cystadenoma and benign cystic teratoma. The gynecologists and pathologists should be aware of such combination of tumors. The case was diagnosed post-operatively. It is important to correctly diagnose the component of tumor for further management and favourable prognosis. Frozen section intra-operatively plays an important role in diagnosing such tumors.

Retrospective Study of the Epidemiology, Pathology, and Therapeutic Management in Patients With Mucinous Ovarian Tumors

Aim: We sought to determine the epidemiology of mucinous ovarian tumors, the correlation between serum biomarkers and tumor status, and the outcomes of the management in different subtypes of mucinous ovarian tumors in a Chinese surgical cohort. Methods: A total of 513 patients were enrolled from January 2009 to May 2017. The number of patients who had benign mucinous ovarian tumor, borderline mucinous ovarian tumor, or malignant mucinous ovarian tumor was pathologically quantified. All patients underwent surgery with or without postoperative adjuvant therapy. Prognosis was analyzed based on clinicopathological characteristics and the type of treatment received. Hyperthermic intraperitoneal chemotherapy efficacy and adverse effects in patients were also explored. Results: In all, 383 (75%) patients were diagnosed as having benign mucinous ovarian tumor, 76 (14%) patients with borderline mucinous ovarian tumor, and 54 (5%) patients with malignant mucinous ovarian tumor. Levels of serum biomarkers increased as the tumors became more malignant. Patients with stage IA and IC (unilateral) malignant mucinous ovarian tumor who underwent fertility conserving surgery did not experience poorer prognoses when compared to those who received non-fertility conserving surgery. Hyperthermic intraperitoneal chemotherapy followed by chemotherapy significantly influenced survival rates in patients with a ruptured malignant mucinous ovarian tumor. Conclusions: Levels of serum tumor markers, carbohydrate antigen 125, carbohydrate antigen 199, carbohydrate antigen 242, and carcinoembryonic antigen may be useful in monitoring for malignant transformation. Fertility conserving surgery might be a preferable surgical procedure for patients with malignant mucinous ovarian tumor at early stage (IA and IC [unilateral]). Hyperthermic intraperitoneal chemotherapy appears to be a well-tolerated and promising postoperative adjuvant.