Struma ovarii: presentación de 37 casos y actualización de la evidencia disponible / Struma ovarii: 37 cases and an update of the current evidence

Objetivo: Determinar aquellos datos clínicos que puedan comportarse como factores de riesgo de mal pronóstico en el struma ovarii, así como establecer las directrices que nos ayuden a un precoz diagnóstico en esta rara entidad, comparando nuestros resultados con la evidencia científica publicada hasta el momento. Método: Estudio observacional retrospectivo de pacientes intervenidas por masa anexial con diagnóstico de «struma ovarii» en el Hospital Virgen del Rocío durante el periodo comprendido entre los años 2000-2016. Resultados: Se estudiaron un total de 37 casos. La edad media fue de 43,11 años con IMC medio de 30,43kg/m2, 11 casos (29,73%) eran pacientes menopáusicas y 26 (70,27%) estaban en edad fértil. En el 91,9% de los casos el comportamiento fue benigno y solo el 8,1%, presentaron malignidad. Clínicamente el dolor fue el motivo más frecuente de consulta (27,02%). En 22 casos se realizó anexectomía, en 11 marsupialización y en 4 se realizó histerectomía y doble anexectomía. Tras el estudio anatomopatolo??gico postoperatorio 3 resultaron struma ovarii maligno (8,1%): un carcinoma tiroideo folicular, otro papilar y un tumor carcinoide estrumal. Conclusiones: El struma ovarii es una rara entidad cuyo tratamiento no está establecido. La cirugía conservadora se recomienda en tumores benignos y puede ser una opción terapéutica en casos malignos seleccionados asociando la tiroidectomía total profiláctica y radioablación con 131I

Objective: To determine the medical data that could behave as risk factors for poor prognosis in the struma ovarii, as well as establishing the criteria that could be of help for an early diagnosis, comparing the results obtained, with the scientific evidence that has been published to date. Method: A retrospective observational study conducted on patients operated for adnexal mass with a struma ovarii diagnosis in the Hospital Virgen del Rocío during the period 2000-2016. Results: A total of 37 cases were analysed. The mean age was 43.11 years, and the mean BMI 30.43kg/ m2. Of the 37 cases, 11 (29.73%) were patients with menopause, and 26 (70.27%) were of fertile age. The behaviour was benign in 91.9% of the cases, and was malignant in only 8.1% of cases. As regards clinical symptoms, the pain (27.02%) was the most frequent reason for consulting a doctor. Adnexectomy was performed in 22 cases, marsupialisation in 11, and hysterectomy with bilateral adnexectomy in 4 cases. After the post-operative histology study, three (8.1%) of them were reported as malignant struma ovarii, with one follicular carcinoma of the thyroid, one papillary carcinoma of the thyroid, and one carcinoid stromal tumour. Conclusions: Struma ovarii is a rare condition for which there is no established treatment. Conservative surgery is recommended in benign tumours, and could be a therapeutic option for specific malignant tumours combined with a prophylactic total thyroidectomy and radio-ablation therapy with 131I

Clinical and pathologic features of patients with non-epithelial ovarian cancer: retrospective analysis of a single institution 15-year experience

Purpose. Non-epithelial ovarian cancers (NEOCs) are rare diseases. Despite their overall good prognosis, the best management and current prognostic factors remain unclear. The objective of our study was to assess the clinical and pathological features of NEOC patients treated in our institution in the last 15 years and to explore risk factors for relapse and survival. Methods/patients. All patients with a pathological diagnosis of NEOC referred to the medical oncology department at Hospital Universitario Virgen del Rocio between 1999 and 2014 were included. Demographics, tumor characteristics, treatment procedures, and clinical follow-up were retrospectively collected. Risk factors for disease-free survival (DFS) and overall survival (OS) were assessed. Results. Fifty-seven patients were included, 33 (58 %) had a sex cord-stromal tumor (SCST) and 24 (42 %) had a germ-cell tumor (GCT). Median age, non-conservative surgery rates and DFS were lower in the GCT cohort; however, salvage chemotherapy led to a high proportion of complete responses in this group translating into a 90 % 3-year OS rate in both NEOC subtypes. The only identified risk factors statistically significant were stage and tumour relapse that associated, respectively, with DFS (HR = 8.84; 95 % CI 1.85-42) and OS (HR = 11.02; 95 % CI 1.76-68.7). Conclusions. Despite their rarity, NEOCs remain a highly curable group of neoplasm. In our series, a more conservative treatment approach in ovarian GCTs revealed comparable OS outcomes to SCST. No new risk factors that would help in patient stratification were identified (AU)

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Clinical and pathologic features of patients with non-epithelial ovarian cancer: retrospective analysis of a single institution 15-year experience.

PURPOSE: Non-epithelial ovarian cancers (NEOCs) are rare diseases. Despite their overall good prognosis, the best management and current prognostic factors remain unclear. The objective of our study was to assess the clinical and pathological features of NEOC patients treated in our institution in the last 15 years and to explore risk factors for relapse and survival. METHODS/PATIENTS: All patients with a pathological diagnosis of NEOC referred to the medical oncology department at Hospital Universitario Virgen del Rocio between 1999 and 2014 were included. Demographics, tumor characteristics, treatment procedures, and clinical follow-up were retrospectively collected. Risk factors for disease-free survival (DFS) and overall survival (OS) were assessed. RESULTS: Fifty-seven patients were included, 33 (58 %) had a sex cord-stromal tumor (SCST) and 24 (42 %) had a germ-cell tumor (GCT). Median age, non-conservative surgery rates and DFS were lower in the GCT cohort; however, salvage chemotherapy led to a high proportion of complete responses in this group translating into a 90 % 3-year OS rate in both NEOC subtypes. The only identified risk factors statistically significant were stage and tumour relapse that associated, respectively, with DFS (HR = 8.84; 95 % CI 1.85-42) and OS (HR = 11.02; 95 % CI 1.76-68.7). CONCLUSIONS: Despite their rarity, NEOCs remain a highly curable group of neoplasm. In our series, a more conservative treatment approach in ovarian GCTs revealed comparable OS outcomes to SCST. No new risk factors that would help in patient stratification were identified.