Epidemiology of ovarian cancer.

Worldwide, ovarian cancer (OC) is the seventh most common type of malignant neoplasm in women and the eighth cause of mortality in them. The classification of OC is made by the possible origin of one of the three main components of the ovary: epithelium, stroma, and germinal cells. Due to this the main malignant tumors arising from the ovary are epithelial carcinoma, germ cell tumor, sex cord-stromal tumor, and Krukenberg's tumor. The most common are the epithelial carcinomas, in which the most prevalent is serous ovarian carcinoma. Nevertheless, the subtype of OC varies according to the age of appearance. The global incidence of OC has been stable during the last decades, but, it´s still a disease that has contributed to a considerable number of deaths around the world. The epidemiology of this cancer shows differences between races and countries due to several factors including genetic and economic. The detection of this cancer has been problematic as there is no screening public program for its early detection and as a consequence, most OCs are detected in an advanced stage where most of the time it has already spread to other parts different from the ovary. The purpose of this article is to present a comprehensive review of the general epidemiology, incidence rates, prevalence rates, mortality, and survival of the different types of OC worldwide and in certain regions.

ACROMEGALY AND A GIANT RETROPERITONEAL LIPOSARCOMA PRODUCING IGF-1.

OBJECTIVE: Liposarcoma is the most common histotype of retroperitoneal sarcomas, representing up to 45% of all cases. We report a rare combination of acromegaly and liposarcoma in the same individual. METHODS: Laboratory and imaging studies including an oral glucose tolerance test, measurements of growth hormone (GH) and insulin-like growth factor-1 (IGF-1), and a computed tomography scan were performed. RESULTS: The patient was a 60-year-old male with a history of acromegaly diagnosed on the basis of elevated IGF-1 at 1,373 ng/mL (age-appropriate reference range is 87 to 225 ng/mL) and macroadenoma treated with transsphenoidal surgery. He presented 8 years later with a history of abdominal distension and weight loss. Physical examination was notable for a right-sided abdominal mass that was tense and non-fluctuant. Two years earlier, he had a post oral glucose tolerance test GH level <0.25 ng/mL and IGF-1 level of 256 ng/mL (age-appropriate reference range is 55 to 206 ng/mL). Pituitary magnetic resonance imaging reported a 3.7 × 2.0-mm left-sided parasagittal lesion. Computed tomography scan showed a 25.0 × 22.0 × 32.3-cm heterogeneous giant mass in the right abdomen corresponding to a liposarcoma causing displacement of kidney, liver, and bowel loops. The patient was treated with a complete en bloc resection of the liposarcoma with the right kidney (45 × 33 × 17 cm) and tumor (9,400 g). Immunohistochemical examination revealed positive IGF-1 and GH staining. The patient suffered postoperative gastrointestinal bleeding that resulted in hemorrhagic shock and died on the 29th postoperative day after a cardiorespiratory arrest. CONCLUSION: Acromegalic patients are at increased risk of developing various types of neoplasms. This is the first documented coexistence of liposarcoma and history of acromegaly.