Borderline tumors of the ovary: a separate entity
|
|
- Rosalyn Hensley
- 5 years ago
- Views:
Transcription
1 Borderline tumors of the ovary: a separate entity Authors Key words A.Ph. Makar Excellent prognosis, conservative surgery, adjuvant therapy Summary Borderline ovarian tumors (BOT) account for 10% to 20% of all epithelial ovarian tumors. BOT represent a separate entity with pathologic features and biologic behaviour intermediate between distinctly benign and frankly malignant. The misunderstanding of such entity results in over-treatment of BOT both surgically and pharmaceutically. BOT present in the majority of cases as FIGO stage I and are associated with an excellent prognosis. Treatment is mainly surgical and adjuvant therapy is not beneficial. (BJMO 2009;Vol 3;1:28-xx) Introduction Epithelial ovarian tumors with histopathologic features and biologic behaviour intermediate between clearly benign and frankly malignant have been identified as a separate group. In 1971, this group of tumors was classified by the International Federation of Gynaecology and Obstetrics (FIGO) as carcinoma of low malignant potential, and in 1973 by the World Health Organization (WHO) as BOT. 1,2 The histologic diagnosis of BOT is based on the following criteria as established by Hart and Norris and detailed by Scully: epithelial cellular proliferation (stratification of the epithelial lining of the papillae, multi-layering of the epithelium, mitotic activity and nuclear atypia) without stromal invasion. As opposed to women with invasive carcinoma, those with BOT tend to present at an earlier stage and at a younger age. 4,5 Women with BOT have a better prognosis than those with invasive carcinoma, and the 5-year survival for stage I disease exceeds 95%. 1-5 Incidence BOT account for 10% to 20% of all epithelial ovarian tumors. The median age at presentation is 45 years which is 10 years younger than the median age seen with invasive tumors. 2,3 About 27% will present during the reproductive age. In over 80% of cases, the tumor is limited to one or both ovaries. Intra-abdominal spread occurs in less than 10%. 1-3 This is the opposite as the situation seen in invasive tumors which present with advanced stage in more than 75% of the cases. Etiology Unlike invasive tumors of the ovary there is no genetic predisposition seen with BOT. 2 The use of oral contraceptives seems to have a protective effect. 1,2 Histologic subtypes Serous BOT account for approximately 55% of all BOT cases. 1-3 They present as a cystic mass with intra-and extra-cystic vegetations (Figure 1). Bilaterality exists in about 40% of the cases. Unlike invasive counterparts, the presence of extracystic vegetations or bilaterality does not imply bad prognosis. The outcome of serous BOT correlates with the FIGO stage. Stage I has a 15-year survival of 99%. In stage III, however, the 15-year mortality rate varies from 0% to 50%. 1-5 The survival rate depends on the extent of extra-ovarian spread. Peritoneal implants at the time of diagnosis have been reported in 35% of the cases. It is a matter of discus- 28
2 Figure 1. Bilateral serous BOT showing external vegetations. Figure 2. Mucious BOT with smooth capsule. sion whether these implants are true implantation metastases or rather manifestations of multifocal in situ lesions of the peritoneum. Some of these implants will progress to infiltrating cancer, while the majority will remain either stationary or regress after removal of the main ovarian tumor. The survival would only be affected by true conversion to invasive disease. 5 Invasive implants must be differentiated from foci of endosalpingiosis and noninvasive implants that arise from benign glandular elements of the peritoneal serosa (potential for Müllerian differentiation). Mucinous BOT account for 40% of all BOT cases. They present as uni-or multilocular cystic mass with smooth capsule (Figure 2). Mucinous BOT cannot be macroscopically distinguished from benign cystadenomas or cystadenocarcinomas. 5 Mucinous BOT present in 85% of the cases as stage I and are associated with excellent 15-year survival (97%). In Stage III, the reported mortality rate was 64%. 2-5 Extra-ovarian spread at the time of diagnosis is rare. However 10-15% of the cases are associated with pseudomyxoma peritonei. The impact of pseudomyxoma on survival is controversial. The mucinous BOT can be separated into the endocervical (Müllerian) and intestinal types. Pseudomyxoma is only present in the intestinal type. Mucinous tumors of the appendix coexist in 8% of these cases. It is controversial whether a patient with a mucinous BOT in the ovary and in the appendix has two primaries or has a primary appendiceal lesion and a metastatic ovarian lesion. 5 About 5% of the BOT cases are non-serous, mucinous tumors (endometrioid 2%, mixed 2%, clear cell < 1%, and Brenner < 1%). The clear cell type has the worst prognosis. 5 DNA ploidy state Different studies showed that tumor ploidy state is the most powerful indicator for risk of relapse and for survival. 3 Hormonal receptor state Unlike invasive tumors, the majority of BOT contain positive hormonal receptors both for oestrogen and progesterone. 2 Staging and re-tagging Staging is pathological according to the FIGO classification of Surgical staging for BOT follows the same guidelines as those for invasive tumors. However, the prognostic significance of external vegetations or capsular rupture is not so evident in BOT as it is in invasive tumors. Diagnosis of BOT in young women often occurs postoperatively on pathological examination following removal of a presumed benign cyst. Different studies stressed on the significance of re-staging in such cases especially in case of serous BOT. Stage upgrading has been reported in up to 15% and suboptimal staging is associated with worse survival. Omentectomy is recommended especially with serous BOT as it is the potential site for disease recurrence in about 50% of the relapses. Appendectomy is recommended for mucinous tumors. 1,5,6 Lymph node metastases are rare in case of mucinous BOT but occur in 10-15% of serous BOT cases, especially when they are associated with invasive implants. Lymph node metastases need to be differentiated from endosalpingosis. 1,5,6 Surgical cytoreduction to 0 cm implies excellent 29
3 Table 1. Guidelines for fertility conserving surgery Laparotomy through vertical incision Cytologic examination of peritoneal washing Careful evaluation of abdominal cavity and biopsy of all suspicious areas Avoid capsular rupture Unilateral ovariectomy or cystectomy in case of bilateral tumors Omentectomy Appendectomy with mucinous tumors Resection of all peritoneal implants The presence of pseudomyxoma is not a contraindication for conservative approach Lymphadenectomy only with serous tumors associated with invasive implants Endometrial curettage in case of BOT of the endometrioid type prognosis in patients with advanced stage. Some reports suggested that laparoscopic surgery is less safe as it is associated with more peritoneal recurrences. 1,7 Fertility conserving surgery About one third of BOT will present during the reproductive age. In over 80% of the cases, the tumor is limited to one or both ovaries (FIGO stage I). Fertility conserving approach must therefore be an option (Table 1). A thorough surgical staging is mandatory and is preferably performed by a gynaecologic oncologist. Definitive surgery should be recommended after family planning. 5-8 About 40% of serous BOT are bilateral and partial ovariectomy (cystectomy) can be performed. Positive resection margins after cystectomy are associated with a recurrence rate up to 15%. Generous sampling of the resection margins of ovarian cysts is therefore very important. Blind wedge biopsies of a macroscopically normal contralateral ovary are still controversial even in case of serous BOT. 1,5,8 Fertility conserving surgery does not worsen the obstetrical or the prenatal outcomes. Also, the use of fertility inducing drugs (if necessary), does not seem to be associated with increased risk of disease relapse. The recurrence rate for conservatively operated stage IA patients is 0% to 30%. Survival is not affected if the patients are re-operated at recurrence. The corresponding recurrence rate is below 5% for serous BOT who have received relapse treatment. 5 Conservatively treated patients need close follow-up and definitive surgery must be recommended after family planning. 1,5,8 Follow-up must include vaginal sonography. In contrast to invasive tumors, CA125 is only elevated in less than 25% of the relapses. 9 Adjuvant therapy There is no evidence that adjuvant chemo- or radiotherapy improves survival in early stage BOT. On the contrary, a review of randomized trials showed that adjuvant therapy was even associated with high morbidity without therapeutic benefits. 2-4 In patients with extra-ovarian spread, adjuvant platinum based chemotherapy is especially used with the presence of invasive peritoneal implants. However, there is no therapeutic evidence for this. Non invasive implants have been reported to regress spontaneously following removal of the primary tumor. 1,5 Disease recurrence BOT has an excellent prognosis with a 10 years survival over 95%, both for serous and mucinous types. The risk of local recurrence is high in case of suboptimal staging and with the presence of invasive peritoneal implants, especially when surgical cytoreduction is not completed. Local recurrence in case of fertility conserving surgery is also high after cystectomy with positive resection margins. 1,5,8 Unlike invasive tumors, serum CA125 is not elevated in the majority of BOT recurrences, this is especially the case in the non-invasive ones. 9 Surgical resection is the preferred treatment for recurrent disease. Almost all recurrences are inside the abdominal cavity and distant spread is an exception. 30
4 Table 2. Significant differences between BOT and invasive counterparts BOT is not associated with an increased genetic risk. About two thirds of BOT are diagnosed as FIGO stage I compared to only one fourth of invasive tumors. Mucinous tumors are more frequently observed with BOT. Median age at presentation is 45 years with BOT compared to less than 55 years in case of invasive tumors. Fertility conserving surgery is recommended in young women with BOT even in case of advanced stage. The prognostic significance of external vegetations or capsular rupture in early stage is not evident with BOT. Serum CA125 level is not trustable in follow-up of BOT independent on histologic subtype. Adjuvant chemotherapy does not improve survival in women with BOT. Disease recurrence can occur up to years later and long follow-up is necessary in case of BOT. Surgery is the recommended treatment for BOT recurrences because chemotherapy has not been proven to prolong long-term survival. Platinum based chemotherapy in case of invasive recurrence was successfully used in retrospective series including limited number of patients. 2 The majority of BOT contain positive hormonal receptors and this deserves more attention in the clinical practice. Patients with pseudomyxoma peritonei recur more often, and may present with bowel obstructions. The treatment for this condition is surgery; even repeated laparotomies with removal of the mucus material are indicated. Chemotherapy does not seem to be effective, whether administered intravenously or as an intraperitoneal instillation. 5 Conclusions As opposed to invasive carcinoma, BOT tend to present at an earlier stage and at a younger age and fertility conserving surgery should be an option. BOT have very good prognosis and the 5-year survival for stage I exceeds 95%. Nevertheless, the 10-year survival figures show that some women may eventually die from their tumor. Biologic, epidemiologic, and pathologic aspects show distinct differences between BOT and invasive ovarian tumors (Table 2). References 1. Makar A, Declercq S. Epitheliale borderlinetumoren van het ovarium: een aparte entiteit.tijdschr voor Geneeskunde 2006;62(18): Burger CW, Prinsen HM, Baak JPA, Wagenaar N, Kennemans P. The management of borderline epithelial tumors of the ovary. Int J Gynecol Cancer 2000:10; Kaern J, Trope CG, Kristensen GB, Abeler VM, Pettersen EO. DNA ploidy: the most important prognostic factor in patients with BOT of the ovary. Int J Cancer 1993;6: Trope G, Kaern J, Vergote IB, Kristensen G, Abeler V. Are BOT of the ovary overtreated both surgically and systemically? A review of four prospective randomized trials including 253 patients with BOT. Gynecol Oncol 1993;51: Tropé CG, Kristensen G, Makar AP. Surgery for borderline tumor of the ovary. Seminars in Surgical Oncology 2000;19: Key messages for clinical practice 1. BOT present at an earlier stage and at a younger age than invasive carcinoma and fertility conserving surgery should be an option. 2. BOT have very good prognosis and the 5-year survival for stage I exceeds 95%. 3. However, 10-year survival figures show that some women may eventually die from their tumor. 4. Treatment is mainly surgical and adjuvant therapy is not beneficial. 31
5 6. Camtte S, Morice P, Thoury A. Impact of surgical staging in patients with macroscopic "stage I" ovarian borderline tumors: analysis of a continuous series of 101 cases. Eur J Cancer 2004:40; Maneo A, Vignali M, Chiari S, Colombo A, Mangioni C, Landoni F. Are BOT of the ovary safely treated by laparoscopy? Gynecol Oncol 2004:94; Morice P, Leblanc E, Rey A.Conservative treatment in epithelial ovarian cancer: results of a multicentre study of the GCCLCC (Groupe des Chirurgiens de Centre de Lutte Contre le Cancer) and SFOG (Societe Francaise d'oncologie Gynecologique). Hum Reprod 2005;20: Makar AP, Kaern J, Kristensen GB, Vergote I, Bormer O, Tropé CG. Evaluation of serum CA 25 level as a tumor marker in borderline tumors of the ovary. Int J Gynecol Cancer 1993;3: C o r r e s p o n d e n c e a d d r e s s Author: A. Ph. Makar Department of Gynaecologic Oncology, University Hospital Ghent, Belgium Department of Gynaecologic Oncology, ZNA Middelheim, Antwerp, Belgium Please send all correspondence to: Prof. Dr. A. Ph. Makar De Pintelaan 185 B-9000 Ghent Belgium Tel: amin.makar@pandora.be amin.makar@zna.be Conflicts of interest: the author has nothing to disclose and indicates no potential conflicts of interest. Geen tijd om bij elke grote internationale bijeenkomst aanwezig te zijn? Toch behoefte om het nieuws van de recentste ontwikkelingen direct tot u te nemen? Meldt u dan nu aan voor onze digitale congresmailing Oncologie, een nieuwe service van het Nederlands Tijdschrift voor Oncologie. Digitale Congresmailing Oncologie U kunt zich aanmelden via Voor meer informatie kunt u zich wenden tot Ariez Medical Publishing,
Survival Analysis and Prognosis for Patients with Serous and Mucinous Borderline Ovarian Tumors: 14-Year Experience from a Tertiary Center in Iran
ORIGINAL ARTICLE Survival Analysis and Prognosis for Patients with Serous and Mucinous Borderline Ovarian Tumors: 14-Year Experience from a Tertiary Center in Iran Katayoun Ziari, Ebrahim Soleymani, and
More informationMucinous Tumors of the Ovary Beirut, Lebanon. Anaís Malpica, M.D. Professor Department of Pathology
Mucinous Tumors of the Ovary Beirut, Lebanon Anaís Malpica, M.D. Professor Department of Pathology Primary Mucinous Tumors of the Ovary Cystadenoma Borderline (Tumor of Low Malignant Potential/Atypical
More informationBorderline Ovarian Tumours. Andreas Obermair Brisbane
Borderline Ovarian Tumours Andreas Obermair Brisbane Definition First described in 1929 Cellular features of malignancy Cellular atypia Mitotic activity No stromal invasion An entity per se??? (or precursor
More informationManagement of an Appendiceal Mass - Approach to acute presentation of appendiceal neoplasms
Management of an Appendiceal Mass - Approach to acute presentation of appendiceal neoplasms Dr. Claudia LY WONG, Department of Surgery, Kwong Wah Hospital Joint Hospital Surgical Grand Round Presentation,
More informationLow-grade serous neoplasia. Robert A. Soslow, MD
Low-grade serous neoplasia Robert A. Soslow, MD soslowr@mskcc.org Outline Orientation Ovarian tumor overview Non serous borderline tumors Serous borderline tumors Clinical summary Morphologic description
More informationJoseph Misdraji, M.D. GI pathology Unit Massachusetts General Hospital
Joseph Misdraji, M.D. GI pathology Unit Massachusetts General Hospital jmisdraji@partners.org Low-grade appendiceal mucinous neoplasm (LAMN) High-grade appendiceal mucinous neoplasm (HAMN) Adenocarcinoma
More informationClinical outcome of cystectomy compared with unilateral salpingo-oophorectomy as fertility-sparing treatment of borderline ovarian tumors
REPRODUCTIVE SURGERY Clinical outcome of cystectomy compared with unilateral salpingo-oophorectomy as fertility-sparing treatment of borderline ovarian tumors Yoav Yinon, M.D., Mario E. Beiner, M.D., Walter
More informationGestione dei tumori borderline iniziali e avanzati nelle donne in età fertile
Gestione dei tumori borderline iniziali e avanzati nelle donne in età fertile Pierandrea De Iaco pierandrea.deiaco@aosp.bo.it SSD ONCOLOGIA GINECOLOGICA AOU SANT ORSOLA-MALPIGHI BOLOGNA Borderline ovarian
More information3 cell types in the normal ovary
Ovarian tumors 3 cell types in the normal ovary Surface (coelomic epithelium) the origin of the great majority of ovarian tumors (neoplasms) 90% of malignant ovarian tumors Totipotent germ cells Sex cord-stromal
More informationIndex. B Bilateral salpingo-oophorectomy (BSO), 69
A Advanced stage endometrial cancer diagnosis, 92 lymph node metastasis, 92 multivariate analysis, 92 myometrial invasion, 92 prognostic factors FIGO stage, 94 histological grade, 94, 95 histologic cell
More informationHitting the High Points Gynecologic Oncology Review
Hitting the High Points is designed to cover exam-based material, from preinvasive neoplasms of the female genital tract to the presentation, diagnosis and treatment, including surgery, chemotherapy, and
More informationA Serous Borderline Tumor of the Fallopian Tube Detected Incidentally
A Serous Borderline Tumor of the Fallopian Tube Detected Incidentally Imrana Tanvir, Ghania Ali, Haseeb Ahmed Khan and Ahmed Nasir Hanifi* Dept. of Histopathology, FMH College of Medicine & Dentistry,
More informationClinical guideline Published: 27 April 2011 nice.org.uk/guidance/cg122
Ovarian cancer: recognition and initial management Clinical guideline Published: 27 April 2011 nice.org.uk/guidance/cg122 NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationChapter 2: Initial treatment for endometrial cancer (including histologic variant type)
Chapter 2: Initial treatment for endometrial cancer (including histologic variant type) CQ01 Which surgical techniques for hysterectomy are recommended for patients considered to be stage I preoperatively?
More informationStaging. Carcinoma confined to the corpus. Carcinoma confined to the endometrium. Less than ½ myometrial invasion. Greater than ½ myometrial invasion
5 th of June 2009 Background Most common gynaecological carcinoma in developed countries Most cases are post-menopausal Increasing incidence in certain age groups Increasing death rates in the USA 5-year
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/24096
More informationChapter 8 Adenocarcinoma
Page 80 Chapter 8 Adenocarcinoma Overview In Japan, the proportion of squamous cell carcinoma among all cervical cancers has been declining every year. In a recent survey, non-squamous cell carcinoma accounted
More information3 cell types in the normal ovary
Ovarian tumors 3 cell types in the normal ovary Surface (coelomic epithelium) the origin of the great majority of ovarian tumors 90% of malignant ovarian tumors Totipotent germ cells Sex cord-stromal cells
More informationAdjuvant Therapies in Endometrial Cancer. Emma Hudson
Adjuvant Therapies in Endometrial Cancer Emma Hudson Endometrial Cancer Most common gynaecological cancer Incidence increasing in Western world 1-2% cancer deaths 75% patients postmenopausal 97% epithelial
More informationThe impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients ( 40 years old) with borderline ovarian tumors
Fang et al. BMC Cancer (2018) 18:1147 https://doi.org/10.1186/s12885-018-4932-2 RESEARCH ARTICLE Open Access The impact of clinicopathologic and surgical factors on relapse and pregnancy in young patients
More informationA Survay on Appendiceal Involvement in Ovarian Mucinous Tumors
http://www.ijwhr.net Open Access doi 10.15296/ijwhr.2018.33 Original Article International Journal of Women s Health and Reproduction Sciences Vol. 6, No. 2, April 2018, 199 203 ISSN 2330-4456 A Survay
More informationMPH Quiz. 1. How many primaries are present based on this pathology report? 2. What rule is this based on?
MPH Quiz Case 1 Surgical Pathology from hysterectomy performed July 11, 2007 Final Diagnosis: Uterus, resection: Endometrioid adenocarcinoma, Grade 1 involving most of endometrium, myometrial invasion
More informationPlease complete prior to the webinar. HOSPITAL REGISTRY WEBINAR FEMALE REPRODUCTIVE SYSTEM EXERCISES CASE 1: FEMALE REPRODUCTIVE
Please complete prior to the webinar. HOSPITAL REGISTRY WEBINAR FEMALE REPRODUCTIVE SYSTEM EXERCISES PHYSICAL EXAMINATION CASE 1: FEMALE REPRODUCTIVE 3/5 Patient presents through the emergency room with
More informationCase 1. Pathology of gynecological cancer. What do we need to know (Case 1) Luca Mazzucchelli Istituto cantonale di patologia Locarno
Case 1 Pathology of gynecological cancer. What do we need to know (Case 1) Luca Mazzucchelli Istituto cantonale di patologia Locarno SAMO Interdisciplinary Workshop on Gynecological Tumors Lucern, October
More informationPublished Ahead of Print on September 28, 2012 as /theoncologist
The Oncologist Gynecologic Oncology Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors DANIELA FISCHEROVA, a MICHAL ZIKAN, a PAVEL DUNDR, b DAVID CIBULA a a Gynecological Oncology Center,
More informationGeneral history. Basic Data : Age :62y/o Date of admitted: Married status : Married
General history Basic Data : Age :62y/o Date of admitted:940510 Married status : Married General history Chief Complain : bilateral ovarian cyst incidentally being found out during pap smear. Present Illness
More informationKey Words. Borderline ovarian tumor Prognostic parameter Ultrasound Fertility Conservative surgery Recurrence
The Oncologist Gynecologic Oncology Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors DANIELA FISCHEROVA, a MICHAL ZIKAN, a PAVEL DUNDR, b DAVID CIBULA a a Gynecological Oncology Center,
More informationLAPAROSCOPY and OVARIAN CANCER
LAPAROSCOPY and OVARIAN CANCER J. DAUPLAT Clermont-Ferrand France UNIVERSITÉ D'AUVERGNE CLERMONT 1 1 - PROPHYLACTIC OOPHORECTOMY 2 - DIAGNOSIS 3 - EARLY STAGES : STAGING 4 - ADVANCED STAGES - ASSESSMENT
More informationProf. Dr. Aydın ÖZSARAN
Prof. Dr. Aydın ÖZSARAN Adenocarcinomas of the endometrium Most common gynecologic malignancy in developed countries Second most common in developing countries. Adenocarcinomas, grade 1 and 2 endometrioid
More informationMousa. Najat kayed &Renad Al-Awamleh. Nizar Alkhlaifat
6 Mousa Najat kayed &Renad Al-Awamleh Nizar Alkhlaifat P a g e 1 This sheet written based on record 13 on website Cover slide( 95-117 ) No need to go back to slide FALLOPIAN TUBE PATHOLOGY In general fallopian
More informationSurgery of borderline tumors of the ovary: retrospective comparison of short-term outcome after laparoscopy or laparotomy
Acta Obstetricia et Gynecologica. 2007; 86: 620 626 ORIGINAL ARTICLE Surgery of borderline tumors of the ovary: retrospective comparison of short-term outcome after laparoscopy or laparotomy ELIN ØDEGAARD
More informationPathology of the female genital tract
Pathology of the female genital tract Common illnesses of the female genital tract Before menarche Developmental anomalies Tumors (ovarial teratoma) Amenorrhea Fertile years PCOS, ovarian cysts Endometriosis
More informationSEROUS TUMORS. Dr. Jaime Prat. Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona
SEROUS TUMORS Dr. Jaime Prat Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona Serous Borderline Tumors (SBTs) Somatic genetics Clonality studies have attempted to dilucidate whether
More informationInternational Society of Gynecological Pathologists Symposium 2007
International Society of Gynecological Pathologists Symposium 2007 Anais Malpica, M.D. Department of Pathology The University of Texas M.D. Anderson Cancer Center Grading of Ovarian Cancer Histologic grade
More informationInvited Re vie W. Molecular genetics of ovarian carcinomas. Histology and Histo pathology
Histol Histopathol (1 999) 14: 269-277 http://www.ehu.es/histol-histopathol Histology and Histo pathology Invited Re vie W Molecular genetics of ovarian carcinomas J. Diebold Pathological Institute, Ludwig-Maximilians-University
More informationof 20 to 80 and subsequently declines [2].
- - According to the 2014 World Health Organization (WHO) classification and tumor morphology, primary ovarian tumors are subdivided into three categories: epithelial (60%), germ cell (30%), and sex-cord
More informationL/O/G/O. Ovarian Tumor. Xiaoyu Niu Obstetrics and Gynecology Department Sichuan University West China Second Hospital
L/O/G/O Ovarian Tumor Xiaoyu Niu Obstetrics and Gynecology Department Sichuan University West China Second Hospital Essentials classification of ovarian tumor clinical manifestation of ovarian tumor metastatic
More informationNew Cancer Cases By Site Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3%
Uterine Malignancy New Cancer Cases By Site 2010 Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3% Cancer Deaths By Site 2010 Lung 26% Breast 15% Colo-Rectal 9% Pancreas 7%
More informationFertility Preservation Is Safe for Serous Borderline Ovarian Tumors
ORIGINAL STUDY Fertility Preservation Is Safe for Serous Borderline Ovarian Tumors Eveline Vancraeynest, MD,* Philippe Moerman, MD, PhD,Þ Karin Leunen, MD, PhD,* Frédéric Amant, MD, PhD,* Patrick Neven,
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX Site Group: Gynecology Cervix Author: Dr. Stephane Laframboise 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING AND
More informationNAACCR Webinar Series 1 Q&A. Fabulous Prizes. Collecting Cancer Data: Ovary 11/3/2011. Collecting Cancer Data: Ovary
NAACCR 2011 2012 Webinar Series Collecting Cancer Data: Ovary Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching this webinar
More informationProposed All Wales Vulval Cancer Guidelines. Dr Amanda Tristram
Proposed All Wales Vulval Cancer Guidelines Dr Amanda Tristram Previous FIGO staging FIGO Stage Features TNM Ia Lesion confined to vulva with
More informationRecurrence of sex cord tumor with annular tubules in young patient with Peutz-Jeghers syndrome
Slimane et al. 74 CASE REPORT PEER REVIEWED OPEN ACCESS Recurrence of sex cord tumor with annular tubules in young patient with Peutz-Jeghers syndrome Meher Slimane, Selma Gadria, Manel Hadidane, Houyem
More informationUnilateral salpingo-oophorectomy as fertility-sparing surgery for borderline ovarian tumors
Available online at www.sciencedirect.com Journal of the Chinese Medical Association 74 (2011) 250e254 Original Article Unilateral salpingo-oophorectomy as fertility-sparing surgery for borderline ovarian
More informationWinship Cancer Institute of Emory University Optimizing First Line Treatment of Advanced Ovarian Cancer
Winship Cancer Institute of Emory University Optimizing First Line Treatment of Advanced Ovarian Cancer Ira R. Horowitz, MD, SM, FACOG, FACS John D. Thompson Professor and Chairman Department of Gynecology
More informationCytoreductive surgery and perioperative intraperitoneal chemotherapy for Rare Peritoneal Disease. Results of the French multicentric database
Cytoreductive surgery and perioperative intraperitoneal chemotherapy for Rare Peritoneal Disease Results of the French multicentric database Université Lyon 1 Centre Hospitalo-Universitaire Lyon-Sud EA
More informationMody. AIS vs. Invasive Adenocarcinoma of the Cervix
Common Problems in Gynecologic Pathology Michael T. Deavers, M.D. Houston Methodist Hospital, Houston, Texas Common Problems in Gynecologic Pathology Adenocarcinoma in-situ (AIS) of the Cervix vs. Invasive
More informationGynecologic Oncologist. Surgery Chemotherapy Radiation Therapy Hormonal Therapy Immunotherapy. Cervical cancer
Gynecologic Oncology Pre invasive vulvar, vaginal, & cervical disease Vulvar Cervical Endometrial Uterine Sarcoma Fallopian Tube Ovarian GTD Gynecologic Oncologist Surgery Chemotherapy Radiation Therapy
More informationINTRODUCTION Ovarian cancer is the leading cause of mortality from gynecologic malignancies in the industrialized countries and is responsible for
INTRODUCTION Ovarian cancer is the leading cause of mortality from gynecologic malignancies in the industrialized countries and is responsible for more deaths than both cervical and endometrial tumours.
More informationOne of the commonest gynecological cancers,especially in white Americans.
Gynaecology Dr. Rozhan Lecture 6 CARCINOMA OF THE ENDOMETRIUM One of the commonest gynecological cancers,especially in white Americans. It is a disease of postmenopausal women with a peak incidence in
More informationOvarian Tumors. Andrea Hayes-Jordan MD FACS, FAAP Section Chief, Pediatric Surgery/Surgical Onc. UT MD Anderson Cancer Center
Ovarian Tumors Andrea Hayes-Jordan MD FACS, FAAP Section Chief, Pediatric Surgery/Surgical Onc. UT MD Anderson Cancer Center Case 13yo female with abdominal pain Ultrasound shows huge ovarian mass Surgeon
More informationUTERINE SARCOMAS CURRENT THERAPEUTIC OPTIONS
Review Journal of Translational Medicine and Research, volume 19, no. 1-2, 2014 UTERINE SARCOMAS CURRENT THERAPEUTIC OPTIONS N. Bacalbaæa 1, A. Traistaru 2, I. Bãlescu 3 1 Carol Davila University of Medicine
More informationCurrent Concept in Ovarian Carcinoma: Pathology Perspectives
Current Concept in Ovarian Carcinoma: Pathology Perspectives Rouba Ali-Fehmi, MD Professor of Pathology The Karmanos Cancer Institute, Wayne State University School of Medicine Current Concept in Ovarian
More informationC ORPUS UTERI C ARCINOMA STAGING FORM (Carcinosarcomas should be staged as carcinomas)
C ORPUS UTERI C ARCINOMA STAGING FORM CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery Tis * T1 I T1a IA NX N0 N1 N2
More informationEndometrial cancer. Szabolcs Máté MD. I. St. Department of Obstetrics and Gyneacology.
Endometrial cancer Szabolcs Máté MD. I. St. Department of Obstetrics and Gyneacology dr.mate.szabolcs@gmail.com Epidemiology Developing countries Cervical cancer is the most common gyn. malignant tumor
More informationC ORPUS UTERI C ARCINOMA STAGING FORM (Carcinosarcomas should be staged as carcinomas)
CLINICAL C ORPUS UTERI C ARCINOMA STAGING FORM PATHOLOGIC Extent of disease before S TAGE C ATEGORY D EFINITIONS Extent of disease through any treatment completion of definitive surgery y clinical staging
More informationDavid Nunns on behalf of the Gynae Guidelines Group Date:
Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Borderline tumours of the ovary management and follow-up Author: Contact Name and Job Title Directorate & Speciality
More informationPre-operative assessment of patients for cytoreduction and HIPEC
Pre-operative assessment of patients for cytoreduction and HIPEC Washington Hospital Center Washington, DC, USA Ovarian Cancer Surgery New Strategies Bergamo, Italy May 5, 2011 Background Cytoreductive
More informationThe Influence of Cyst Emptying, Lymph Node Resection and Chemotherapy on Survival in Stage IA and IC1 Epithelial Ovarian Cancer
doi:10.21873/anticanres.11111 The Influence of Cyst Emptying, Lymph Node Resection and Chemotherapy on Survival in Stage IA and IC1 Epithelial Ovarian Cancer MIKKEL ROSENDAHL, BERIT JUL MOSGAARD and CLAUS
More informationSee the latest estimates for new cases of ovarian cancer and deaths in the US and what research is currently being done.
About Ovarian Cancer Overview and Types If you have been diagnosed with ovarian cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to start. What Is
More informationRole of peritoneal washing cytology in ovarian malignancies: correlation with histopathological parameters
Naz et al. World Journal of Surgical Oncology (2015) 13:315 DOI 10.1186/s12957-015-0732-1 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Role of peritoneal washing in ovarian malignancies: correlation
More informationSection 1. Biology of gynaecological cancers: our current understanding
Section 1 Biology of gynaecological cancers: our current understanding Chapter 1 Morphological sub-types of ovarian carcinoma: new developments and pathogenesis W Glenn McCluggage 1 Introduction In most
More informationFERTILITY SPARING IN ENDOMETRIAL CANCER
FERTILITY SPARING IN ENDOMETRIAL CANCER Prof. Dr. Bülent Özçelik Erciyes University Medical Faculty Department of Obstetrics and Gynecology Gynecologic Oncology Unit Endometrial Cancer Most frequent gynecologic
More informationSignificance of Ovarian Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma
ORIGINAL STUDY Significance of Ovarian Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma Jeong-Yeol Park, MD, PhD, Dae-Yeon Kim, MD, PhD, Dae-Shik Suh, MD, PhD, Jong-Hyeok Kim, MD, PhD, Yong-Man
More informationH&E, IHC anti- Cytokeratin
Cat No: OVC2281 - Ovary cancer tissue array Lot# Cores Size Cut Format QA/QC OVC228101 228 1.1mm 4um 12X19 H&E, IHC anti- Cytokeratin Recommended applications: For Research use only. RNA or protein ovary
More informationCase # 4 Low-Grade Serous Carcinoma (Macropapillary) of the Ovary Arising in an Atypical Proliferative Serous Tumor
Case # 4 Low-Grade Serous Carcinoma (Macropapillary) of the Ovary Arising in an Atypical Proliferative Serous Tumor Robert J Kurman, M.D. Johns Hopkins University School of Medicine Case History A 53 year
More informationPathology of Ovarian Tumours. Dr. Jyothi Ranganathan MD ( Path) AFMC Pune PDCC (Cytopathology) PGI Chandigarh
Pathology of Ovarian Tumours Dr. Jyothi Ranganathan MD ( Path) AFMC Pune PDCC (Cytopathology) PGI Chandigarh Outline Incidence Risk factors Classification Pathology of tumours Tumour markers Prevention
More informationOVARIES. MLS Basic histological diagnosis MLS HIST 422 Semester 8- batch 7 L13 Dr: Ali Eltayb.
OVARIES MLS Basic histological diagnosis MLS HIST 422 Semester 8- batch 7 L13 Dr: Ali Eltayb. OBJECTIVES Recognize different disease of ovaries Classify ovarian cyst Describe the pathogenesis, morphology
More informationInstitute of Pathology First Faculty of Medicine Charles University. Ovary
Ovary Barrett esophagus ph in vagina between 3.8 and 4.5 ph of stomach varies from 1-2 (hydrochloric acid) up to 4-5 BE probably results from upward migration of columnar cells from gastroesophageal junction
More informationStaging and Treatment Update for Gynecologic Malignancies
Staging and Treatment Update for Gynecologic Malignancies Bunja Rungruang, MD Medical College of Georgia No disclosures 4 th most common new cases of cancer in women 5 th and 6 th leading cancer deaths
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Cancer of the Ovary
North of Scotland Cancer Network Cancer of the Ovary Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by NOSCAN Gynaecology Cancer
More informationLaparoscopic versus laparotomic surgery for adnexal masses: role in elderly
Pulcinelli et al. World Journal of Surgical Oncology (2016) 14:105 DOI 10.1186/s12957-016-0861-1 RESEARCH Open Access Laparoscopic versus laparotomic surgery for adnexal masses: role in elderly F. M. Pulcinelli
More informationPatient Presentation. 32 y.o. female complains of lower abdominal mass CEA = 433, CA125 = 201
Patient Presentation 32 y.o. female complains of lower abdominal mass CEA = 433, CA125 = 201 CT shows: Thickening of the right hemidiaphragm CT shows: Fluid in the right paracolic sulcus CT shows: Large
More informationBREAST PATHOLOGY. Fibrocystic Changes
BREAST PATHOLOGY Lesions of the breast are very common, and they present as palpable, sometimes painful, nodules or masses. Most of these lesions are benign. Breast cancer is the 2 nd most common cause
More informationEndometrial Cancer. Incidence. Types 3/25/2019
Endometrial Cancer J. Anthony Rakowski DO, FACOOG MSU SCS Board Review Coarse Incidence 53,630 new cases yearly 8,590 deaths yearly 4 th most common malignancy in women worldwide Most common GYN malignancy
More informationFeasibility, safety, and efficacy of conservative laparoscopic treatment of borderline ovarian tumors
Feasibility, safety, and efficacy of conservative laparoscopic treatment of borderline ovarian tumors Raffaele Tinelli, M.D., a Mario Malzoni, M.D., a Francesco Cosentino, M.D., a Ciro Perone, M.D., a
More informationGynaecological Malignancies
Gynaecological Malignancies Dr Rodney Itaki Lecturer Anatomical Pathology Discipline University of Papua New Guinea Division of Pathology School of Medicine & Health Sciences Overview Genital tract tumors
More informationis time consuming and expensive. An intra-operative assessment is not going to be helpful if there is no more tissue that can be taken to improve the
My name is Barry Feig. I am a Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center in Houston, Texas. I am going to talk to you today about the role for surgery in the treatment
More informationبسم هللا الرحمن الرحيم. Prof soha Talaat
بسم هللا الرحمن الرحيم Ovarian tumors The leading indication for gynecologic surgery. Preoperative characterization of complex solid and cystic adnexal masses is crucial for informing patients about possible
More informationRecurrence, new primary and bilateral breast cancer. José Palacios Calvo Servicio de Anatomía Patológica
Recurrence, new primary and bilateral breast cancer José Palacios Calvo Servicio de Anatomía Patológica Ipsilateral Breast Tumor Relapse (IBTR) IBTR can occur in approximately 5 20% of women after breast-conserving
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer
THIS DOCUMENT North of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT
More informationFDG-PET/CT in Gynaecologic Cancers
Friday, August 31, 2012 Session 6, 9:00-9:30 FDG-PET/CT in Gynaecologic Cancers (Uterine) cervical cancer Endometrial cancer & Uterine sarcomas Ovarian cancer Little mermaid (Edvard Eriksen 1913) honoring
More informationSarah Burton. Lead Gynae Oncology Nurse Specialist Cancer Care Cymru
Sarah Burton Lead Gynae Oncology Nurse Specialist Cancer Care Cymru Gynaecological Cancers Cervical Cancers Risk factors Presentation Early sexual activity Multiple sexual partners Smoking Human Papiloma
More informationOriginal contribution
Human Pathology (2012) 43, 747 752 www.elsevier.com/locate/humpath Original contribution The presence and location of epithelial implants and implants with epithelial proliferation may predict a higher
More informationHJOG. Fertility sparing options for women with ovarian neoplasms. Review. Abstract
HJOG An Obstetrics and Gynecology International Journal Review Fertility sparing options for women with ovarian neoplasms Zygouris Dimitrios 1, Panagopoulos Perikles 1, Christodoulaki Chrysi 1, Vrachnis
More informationShina Oranratanaphan, Tarinee Manchana*, Nakarin Sirisabya
Comparison of Synchronous Endometrial and Ovarian Cancers versus Primary with Metastasis RESEARCH COMMUNICATION Clinicopathologic Variables and Survival Comparison of Patients with Synchronous Endometrial
More informationSpecialised Services Policy: CP02 Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Cytoreductive Surgery for treatment of Pseudomyxoma Peritonei
Specialised Services Policy: CP02 Hyperthermic Intraperitoneal Chemotherapy (HIPEC) of Pseudomyxoma Peritonei Document Author: Assistant Medical Director Executive Lead: Medical Director Approved by: Management
More informationGYNECOLOGIC MALIGNANCIES: Ovarian Cancer
GYNECOLOGIC MALIGNANCIES: Ovarian Cancer KRISTEN STARBUCK, MD ROSWELL PARK CANCER INSTITUTE DEPARTMENT OF SURGERY DIVISION OF GYNECOLOGIC ONCOLOGY APRIL 19 TH, 2018 Objectives Basic Cancer Statistics Discuss
More informationEndosalpingiosis. Case report
Case report Endosalpingiosis Michael D. Holmes, M.D. Howard S. Levin M.D. Department of Pathology Lester A. Ballard, Jr., M.D. Department of Gynecology Endosalpingiosis, a term referring to tuballike epithelium
More informationVilloglandular adenocarcinoma of cervix a tumour with bland cytological features: report of a case missed on cytology
Malaysian J Pathol 2003; 25(2) : CERVICAL 139 143 VILLOGLANDULAR ADENOCARCINOMA CYTOLOGY CASE REPORT Villoglandular adenocarcinoma of cervix a tumour with bland cytological features: report of a case missed
More informationThe role of neoadjuvant chemotherapy in patients with advanced (stage IIIC) epithelial ovarian cancer
Radiology and Oncology Ljubljana Slovenia www.radioloncol.com research article 341 The role of neoadjuvant chemotherapy in patients with advanced (stage IIIC) epithelial ovarian cancer Erik Škof 1, Sebastjan
More informationHistopathological analysis of neoplastic and non neoplastic lesions of ovary: A study of one hundred cases
Orginal Article Histopathological analysis of neoplastic and non neoplastic lesions of ovary: A study of one hundred cases 2 G Prathima, Srikanth Shastry 2 Consultant Pathologist, Image Diagnostics, Kadapa,
More informationBorderline Ovarian Mucinous Tumors: Consensus Points and Persistent Controversies Regarding Nomenclature, Diagnostic Criteria, and Behavior
Borderline Ovarian Mucinous Tumors: Consensus Points and Persistent Controversies Regarding Nomenclature, Diagnostic Criteria, and Behavior Brigitte M. Ronnett, M.D.; C. Blake Gilks, M.D., Maria J. Merino,
More informationBorderline tumors. Borderline tumors. Serous borderline tumor are NOT benign. Low grade serous carcinoma: pathogenesis. Serous carcinoma: pathogenesis
Serous borderline tumor are NOT benign Robert A. Soslow, MD Memorial Sloan-Kettering Cancer Center soslowr@mskcc.org Borderline tumors Serous BTs and seromucinous BTs are both histopathologically borderline
More informationPregnancy With Huge Ovarian Cyst
BMH Med. J. 2018;5(3):74-78 Case Report Pregnancy With Huge Ovarian Cyst Suja Ann Ranji, Usha Payyodi, Ani Praveen, Rajesh MC, Jini Chandran Baby Memorial Hospital, Kozhikode 673004 Address for Correspondence:
More informationEndometrial Cancer. Saudi Gynecology Oncology Group (SGOG) Gynecological Cancer Treatment Guidelines
Saudi Gynecology Oncology Group (SGOG) Gynecological Cancer Treatment Guidelines Endometrial Cancer Emad R. Sagr, MBBS, FRCSC Consultant Gynecology Oncology Security forces Hospital, Riyadh Epidemiology
More informationRegional Therapy for Management of Peritoneal Carcinomatosis from Gastrointestinal Malignancies
Regional Therapy for Management of Peritoneal Carcinomatosis from Gastrointestinal Malignancies Byrne Lee, MD FACS Chief, Mixed Tumor Surgery Service City of Hope Division of Surgical Oncology September
More information3/25/2019. Rare uterine cancers ~3% Leiomyosarcoma Carcinosarcoma (MMMT) Endometrial Stromal Sarcomas Aggressive tumors High Mortality Rates
J. Anthony Rakowski D.O., F.A.C.O.O.G. MSU SCS Board Review Coarse Rare uterine cancers ~3% Leiomyosarcoma Carcinosarcoma (MMMT) Endometrial Stromal Sarcomas Aggressive tumors High Mortality Rates Signs
More informationSquamous cell carcinoma arising in a dermoid cyst of the ovary: a case series
DOI: 10.1111/j.1471-0528.2007.01478.x www.blackwellpublishing.com/bjog Gynaecological oncology Squamous cell carcinoma arising in a dermoid cyst of the ovary: a case series JL Hurwitz, a A Fenton, a WG
More informationImpact of Surgery Extent on Survival and Recurrence Rate of Stage ⅠEndometrial Adenocarcinoma
Hou et al. / Cancer Cell Research 3 (2014) 65-69 Cancer Cell Research Available at http:// http://www.cancercellresearch.org/ ISSN 2161-2609 Impact of Surgery Extent on Survival and Recurrence Rate of
More information