Serum copper, ceruloplasmin and thiobarbituric acid reactive substance status in patients with ovarian cancer.

Serum copper, ceruloplasmin and thiobarbituric acid reactive substances (TBARS) were estimated in 30 patients of ovarian cancer. The copper to ceruloplasmin ratio was moderately increased (P<0.05) but the copper (P<0.01) and ceruloplasmin (P<0.001) levels were significantly increased in ovarian cancer patients as compared to controls. TBARS levels were also found to be highly significant (P<0.001). Trace elements and free radicals have been implicated in the etiology of cancer. Hence the estimation of antioxidants like ceruloplasmin and TBARS along with the trace element like copper may be of value in the early diagnosis of cancer.

Granulosa-theca cell tumour of the ovaries. A late metastasizing tumour

Granulosa-theca cell tumours are ovarian neoplasms of low malignancy with hormone secreting potential, accounting for 2-3 percent of all ovarian cancers. They have an uncertain clinical course and a potential for late recurrence aftet surgical removal. Clincal features of a patient presenting with pulmonary metastases 21 years after removal of the primary tumour are described, along with a review of the management options.(AU)

Sertoliform variant of endometrioid carcinoma of the ovary

Although endometrioid carcinoma constitutes the second most common type of primary ovarian adenocarcinoma, the sertoliform variant is rarely encountered. We describe a case of this rare ovarian carcinoma which mimics a Sertoli cell tumour in its pathological appearance (AU)

Co-existing leiomyoma and benign cystic teratoma of the ovary

A case of benign cystic teratoma and a leiomyoma in the same ovary is described. The leiomyoma was confirmed by immunohistochemical methods. The occurrence of leimyoma and a teratoma within the same ovary is very rare.

Successful pregnancy after conservative surgery for ovarian papillary serous cystadenocarcinoma of low malignant potential

Conserative surgery was performed on a 28-year-old patient with an ovarian serous cystadenocarcinoma of low malignant potential who became pregnant one year later. The good prognosis of these tumours makes conservative surgical management the treatment of choice when preservation of child-bearing potential is deemed appropriate. (AU)

Accurate pre-operative diagnosis of ovarian cancer by a combination of clinical criteria, ultrasonography and CA 125 - abstract

Early pre-operative treatment of ovarian cancer is hindered by a lack of reliable criteria for its early diagnosis. This study was undertaken to assess the value of clinical criteria, ultrasonography and serum CA 125 values in the differential diagnosis of benign and malignant pelvic masses. Thirty-six consecutive patients who had elective surgery for investigation and management of an adnexal mass were enrolled in the study from May to October, 1988. All patients had a clinical examination, serum CA 125 measurement and ultrasound pre-operatively, and their menopausal status determined. Based on these findings, a scoring system was devised (Table). Twenty patients had serum CA 125 values < 35 U/ml and histology confirmed a benign ovarian lesion. The remaining 16 patients had serum CA 125 levels > 35 U/ml, and their tumours were confirmed to be malignant histologically. There were significant differences in age (p<0.01), menopausal status (p=0.01), clinical impression score (p<0.01), ultrasound score (p<0.001) and serum CA 125 level (p<0.001) in patients with benign as compared to malignant lesions. The most useful single diagnostic criterion was serum CA 125 levels, and diagnostic accuracy was increased by adding menopausal status and ultrasound findings (sensitivity > 90 per cent; specificty 95.2 per cent) (AU)

Role of ultrasound in the management of ovarian carcinoma - abstract

It is generally accepted that ultrasound (US) has only a limited role (assessment of the primary site and possible extensions) in the initial or preoperative management of ovarian cancer. Ultrasound is of value in monitoring response to therapy and in detecting and staging tumour recurrence. The accuracy of US in Stage III and IV ovarian cancer was tested in a group of 85 patients who were scanned at intervals from the time of primary surgery until just prior to second-look laparotomy. Results show that high values of accuracy were obtained for US of the pelvis (90 per cent) and liver (91 per cent), but US was insensitive to peritoneal disease unless ascites was present (Table). Ultrasound is a useful complement to laparoscopy in the follow-up of patients with ovarian cancer (AU)

An unusual malignancy arising in a benign cystic teratoma of the ovary

Mucinous epithelial neoplasms and benign cystic teratomas (dermoid cysts) of the ovary have been reported as coexisting inseparably in 5 percent of cases. Though some mucinous tumours may arise from germ cells as monophyletic teratomas, neoplastic transformation within the cystic teratoma is another possibility. Mucinous ovarian neoplasms with "sarcoma-like" mural nodules were first described by Prat and Scully in 1979. This report describes the first such tumour arising in a dermoid cyst of the ovary (AU)

A clinico-pathologic study of ovarian neoplasm

A series of 96 patients who were diagnosed with 120 ovarian neoplasms at surgery have been reviewed. Nine types of benign ovarian cysts were encountered. Benign cystic teratoma with an incidence of 30 percent was the commonest tumor. The majority of these were in the 20 - 30 year age range. The mean age of the patients with mucinous cyst adenoma and benign cystic teratoma was significantly less (p< 0.05) than those with serous cyst adenoma. The incidence of ovarian malignancies of 8.3 percent was low, and none of the malignancies was bilateral. There was a high incidence of 8.3 percent of milignant change in benign cystic teratomas. Abdominal pain and swelling were the symptoms most frequently experienced in patients with benign ovarian neoplasms. (AU)

Splenic metastases in ovarian carcinoma

We report two cases of ovarian carcinoma with splenic metastases detected by ultrasound and discuss their sonographic appearances. The importance of routinely including this organ during staging and follow-up studies in ovarian carcinoma using diagnostic imaging methods is emphasized (AU)

A five-year study of benign and malignant ovarian neoplasms - abstract

The few recorded series of the more common benign ovarian neoplasms are at considerable variance with one another with regard to basic information about these tumours. We have therefore reviewed ovarian neoplasms in order to determine the incidence, mean age, age range, race and parity of the patients with the various benign ovarian tumours, the frequency of bilateral occurrence, the ratio of benign to malignant tumours and the complications and presentation of these ovarian neoplasms in Trinidad. The 120 tumours, which were found in surgical patients admitted to Mt. Hope Women's Hospital between November 1981 and October 1986, were classified as recommended by Novak. Functional ovarian tumours less than 5 cm in diameter were excluded from our study. Nine types of benign ovarian tumours were encountered, with dermoid cysts being (33 percent) the commonest. The incidence of malignancy in ovarian neoplasms was 7 percent. The benign to malignant ratio in dermoid and serous cysts was 13.3 to 1 and 2.3 to 1 while wiht mucinous cysts it was 4.0 to 1. The presenting complaints of abdominal pain, swelling and abdominal mass were commonest. Torsion of benign simple cysts and haemorrhage into corpus luteum cysts were the most frequent complications. This review reveals that our incidence of malignancy in ovarian neoplasms is lower, the malignant change in dermoid cysts is higher, and the bilaterality of primary ovarian carcinoma is lower than that reported in the literature (AU)

Primary nongestational choriocarcinoma of the ovary

Primary choriocarcinoma of the ovary arising, presumably, from a germ cell is extremely rare. The patient, a 16 year old girl who presented with dysuria and frequency of micturition developed fatal haemoperitoneum due to rupture of a pure primary nongestational ovarian choriocarcinoma.(AU)

Endometriosis in Jamaica: report on a 15-year study at the University Hospital of the West Indies (1968-1982)

A clinical and pathological study on 108 cases of endometriosis observed at the University Hospital of the West Indies during a 15-year period (1968-1982) is reported. A low incidence was found when compared with similar studies conducted elsewhere. The peak age at occurence was 36 years. Common clinical manifestations were pelvic pain, infertility, dysmenorrhoea, menorrhagia and dyspareunia. A preoperative diagnosis of endometriosis was made very infrequently. A high index of suspicion, careful clinical examination, including family history, pelvic examinatiuon and laparoscopy are required to improve the accuracy of the clinical diagnosis. The ovaries and the pelvic peritoneum were the commonest sites affected. There was a relatively high frequency of involvement of the fallopian tubes, laparotomy scars, umbilicus, uterine cervix and the vagina (AU)

Aspects of primary ovarian cancer in Jamaica

Analysis of 280 cases of primary ovarian cancer occurring in the parishes of Kingston and St. Andrew during the 18-year period, 1958-1975, showed that the crude average annual incidence was 6.0 per 100,000. It is the second most common female genital cancer, next to that of the uterine cervix. The age range of the patients was 4 months to 86 years with a peak age at occurrence of 45-64 years. The maximum age-specific incidence was 70-74 years. Age-adjusted and age-specific comparisons have been made with other countries. Serous cystadenocarcinoma was the commonest type (41 percent). There was a remarkably low proportion of cases of mucinous cystadenocarcinoma (6 percent) and a relatively higher percentage of germ cell tumours (8 percent) than other series. A more detailed clinical investigation on 77 cases showed that they were of low parity. The chief presenting symptom was abdominal swelling. The overall 5-year survival was 19.1 percent. A review of the literature revealed a similarly poor prognosis in other series. The significant prognostic markers were the age of the patient, the histological type and the clinical stage at presentation. (AU)

Pathological considerations of primary ovarian cancer in Jamaica - abstract

The need for a proper classification of primary ovarian cancer has prompted this study which deals with the experience with 101 cases encountered over a 17-year period (1953-1969) at the University Hospital in Jamaica. Pathological data on all cases of primary ovarian malignancies seen at this hospital since its inception have been reviewed in detail. In 94 cases, the tumours were removed at operation and in 7, all of which were admitted with terminal cancer, only autopsy material was available for study. The tumours were classified into four broad groups according to the criteria established at a symposium held by the Patients Care Committee of the Inter-national Union Against Cancer (1968): (a) Tumours of Mullerian origin, (b) Sex cord - Mesenchyme tumours, (c) Tumours of germinal origin and (d) Lipoidic cell tumours. Tumours related to the Mullerian epithelium constitued 67 per cent of the total and of these 47 cases were papillary serous cystadenocarcinomas, of 1361 cases collected over a 38-year period (1921-1959). A striking aspect of the present series was the relatively high increase of sex cord mesenchyme tumours (22 per cent) as compared with Kottmeier's figure of 8 per cent. Twenty-one of the 22 cases were granulosa-theca cell tumours and the other a Sertoli-Leydig cell turmour. There were also twice as many germ cell tumours in the present study than those reported by Kottmeier and these, except for one case of choriocarcinoma, were divided roughly equally among the dysgerminoma, malignant teratoma and the endodermal sinus tumour. Mucinous cystadenocarcinomas, in contrast to the papillary serous tumours, were uncommon accounting for only 3 per cent of the total. There were 10 per cent of endometrioid carcinomas which is half the incidence reported in Kottmeier's series (AU)

Feminizing mesenchymal tumour of the ovary

The clinical and pathological features of 17 cases of feminizing mesenchymal tumours of the ovary observed over a 14-year period have been reviewed. (1) This group of neoplasms accounts for 3.4 percent of all primary ovarian tumours. (2) One case was observed before puberty and the others equally divided between women in the reproductive and the post-menopausal age groups. Most of the thecomas were observed in the reproductive period. (3) The tumours occurred in nulliparous patients and in those of low parity. (4) Vaginal bleeding and swelling of the abdomen were the most frequent presenting symptoms. The former symptom was, however, notably absent in the cases with pure granulosa cell growths. (5) All cases were treated surgically, the extent of the operation depending on the age of the patient and the presence of association uterine pathology. (6) The very large tumours were almost entirely cystic and all these cases died within 5 years. The thecomas were all benign. (7) Follow-up of these patients for life is essential as late recurrences of the tumours are a prominent feature (AU)

Dysgerminoma of the ovary

The first case of ovarian dysgerminoma studied at the University Hospital of the West Indies is presented and the condition briefly reviewed. The patient was 38 years old at the time of presentation; she was treated by surgery and radiotherapy, and remains free of tumour six months after (AU)