RESUMO
OBJECTIVE: To evaluate the prevalence of appendiceal tumors in patients diagnosed with mucinous ovarian tumors and to determine factors associated with coexisting appendiceal tumors. MATERIALS AND METHODS: Retrospective review of all patients who were diagnosed with mucinous ovarian tumors and underwent an appendectomy during surgery between January 2002 and June 2017 was performed. Univariate and multivariate logistic regression analyses were used to identify risk factors for coexisting appendiceal tumors. RESULTS: A total of 303 patients with mucinous ovarian tumors who underwent appendectomy were identified, including 77 (25.4%) mucinous cystadenoma and 226 (74.6%) mucinous borderline tumor or carcinoma. Twenty-one (6.9%) had coexisting appendiceal tumors including 8 that were primary appendiceal mucinous adenocarcinomas, 6 low-grade appendiceal mucinous neoplasms, 6 secondary appendiceal metastasis from the ovary, and one hyperplastic polyp. None of mucinous cystadenoma had coexisting appendiceal tumors. Multivariate analysis revealed advanced age ≥50 years, previous rupture of ovarian tumors, abdominal extension of tumors, and grossly abnormal appendix were independent factors for coexisting appendiceal tumors. CONCLUSION: Prevalence of coexisting appendiceal tumors in mucinous ovarian tumors was not uncommon. The risk factors were grossly abnormal appendix, abdominal extension of tumor, previous rupture of ovarian tumors, and advanced age.
Assuntos
Neoplasias do Apêndice , Cistadenoma Mucinoso , Neoplasias Ovarianas , Neoplasias do Apêndice/epidemiologia , Neoplasias do Apêndice/cirurgia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/cirurgia , Centros de Atenção Terciária , Tailândia/epidemiologiaRESUMO
RESEARCH QUESTION: What are ovarian stimulation cycle outcomes and acceptance rates of an oocyte accumulation programme in young women with benign ovarian tumour (BOT)? DESIGN: Retrospective cohort study conducted at the Academic Assisted Reproductive Technology and Fertility Preservation Centre, Lille University Hospital, between January 2016 and December 2019. The number of metaphase II oocytes per cycle and per patient after accumulation were evaluated. Two groups were identified for the analysis: endometrioma ('endometrioma') and dermoid, mucinous or serous cyst ('other cysts'). RESULTS: A total of 113 fertility-preservation cycles were analysed in 70 women aged 27.9 ± 4.8 years. Almost all women had undergone previous ovarian surgery before fertility preservation (89%). Mean anti-Müllerian hormone levels before ovarian stimulation was 12.5 ± 8.7 pmol/l. A total of 6.4 ± 3.4 oocytes were retrieved, and 4.3 ± 3.4 metaphase II (MII) oocytes were vitrified per cycle. All agreed to the oocyte accumulation programme and all underwent at least one cycle. To date, 36 (51%) patients achieved two or three fertility- preservation cycles. After accumulation, 7.0 ± 5.23 MII oocytes were vitrified per patient. No difference was found in ovarian response and oocyte cohort between the 'endometrioma' and 'other cysts' groups. Questionnaires completed after oocyte retrieval revealed abdominal bloating and pelvic pain in most patients, with no difference according to the type of cyst. No serious adverse events occurred. CONCLUSIONS: Oocyte accumulation should be systematically offered to young women with BOT irrespective of histological type, as it seems to be well-tolerated. Long-term follow-up is needed to assess the efficiency of oocyte accumulation to optimize the chances of subsequent pregnancies.
Assuntos
Preservação da Fertilidade/métodos , Procedimentos Cirúrgicos em Ginecologia/reabilitação , Cistos Ovarianos , Neoplasias Ovarianas , Indução da Ovulação , Adulto , Estudos de Coortes , Criopreservação/métodos , Cistadenoma Mucinoso/complicações , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/patologia , Cistadenoma Mucinoso/terapia , Cistadenoma Seroso/complicações , Cistadenoma Seroso/epidemiologia , Cistadenoma Seroso/patologia , Cistadenoma Seroso/terapia , Endometriose/complicações , Endometriose/epidemiologia , Endometriose/patologia , Endometriose/terapia , Feminino , Preservação da Fertilidade/estatística & dados numéricos , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Humanos , Recuperação de Oócitos/métodos , Recuperação de Oócitos/estatística & dados numéricos , Cistos Ovarianos/complicações , Cistos Ovarianos/epidemiologia , Cistos Ovarianos/patologia , Cistos Ovarianos/terapia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Reserva Ovariana/fisiologia , Ovário/cirurgia , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Gravidez , Estudos Retrospectivos , Teratoma/complicações , Teratoma/epidemiologia , Teratoma/patologia , Teratoma/terapia , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: A prospective survey to evaluate the diagnostic workup of cystic pancreatic neoplasms (CPNs) according to the Italian guidelines. METHODS: An online data sheet was built. RESULTS: Fifteen of the 1385 patients (1.1%) had non cystic neoplastic lesions. Forty percent (518/1295) had at least one 1st degree relative affected by a solid tumor of the digestive and extra-digestive organs. Symptoms/signs associated with the cystic lesion were present in 24.5% of the patients. The cysts were localized in the head of the pancreas in 38.5% of patients. Of the 2370 examinations (1.7 examinations per patient) which were carried out for the diagnosis, magnetic resonance imaging was performed as a single test in 48.4% of patients and in combination with endoscopic ultrasound in 27% of the cases. Of the 1370 patients having CPNs, 89.9% had an intraductal papillary mucinous neoplasm (IPMN) (70.1% a branch duct IPMN, 6.2% a mixed type IPMN and 4.6% a main duct IPMN), 12.7% had a serous cystadenoma, 2.8% a mucinous cystadenoma, 1.5% a non-functioning cystic neuroendocrine neoplasm, 0.7% a solid-pseudopapillary cystic neoplasm, 0.3% a cystic adenocarcinoma, and 1.2% an undetermined cystic neoplasm. Seventy-eight (5.7%) patients were operated upon after the initial work-up. CONCLUSIONS: This prospective study offers a reliable real-life picture of the diagnostic work-up CPN.
Assuntos
Cistadenoma Mucinoso/epidemiologia , Cistadenoma Seroso/epidemiologia , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , Neoplasias Pancreáticas/epidemiologia , Adenocarcinoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Endossonografia , Feminino , Humanos , Itália/epidemiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/epidemiologia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Inquéritos e Questionários , Adulto JovemRESUMO
Mucinous neoplasms of the ovary account for 10%-15% of ovarian neoplasms. They may be benign, borderline, or malignant. The large majority are benign or borderline, accounting for 80% and 16%-17%, respectively. Mucinous neoplasms of the ovary most commonly affect women in their 20s to 40s. The clinical manifestation is nonspecific, but most mucinous ovarian neoplasms manifest as large unilateral pelvic masses. At gross pathologic analysis, mucinous ovarian neoplasms appear as large multiloculated cystic masses. The contents of the cyst loculi vary on the basis of differences in internal mucin content. At histologic analysis, mucinous ovarian neoplasms are composed of multiple cysts lined by mucinous epithelium, often resembling gastrointestinal-type epithelium. Imaging evaluation most commonly includes US and/or MRI. The imaging findings parallel the gross pathologic features and include a large, unilateral, multiloculated cystic mass. The cyst loculi vary in echogenicity, attenuation, and signal intensity depending on the mucin content. Mucinous neoplasms of the ovary are staged surgically using the FIGO (International Federation of Gynecology and Obstetrics) staging system. Primary treatment is surgical, with adjuvant chemotherapy considered in the uncommon case of mucinous carcinoma with extraovarian disease. Since most mucinous ovarian neoplasms are benign or borderline, the overall prognosis is excellent.
Assuntos
Adenocarcinoma Mucinoso/diagnóstico por imagem , Cistadenoma Mucinoso/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos , Adenocarcinoma Mucinoso/epidemiologia , Adenocarcinoma Mucinoso/patologia , Adenofibroma/diagnóstico por imagem , Adenofibroma/patologia , Adulto , Idoso , Neoplasias do Apêndice/diagnóstico por imagem , Tumor de Brenner/diagnóstico por imagem , Tumor de Brenner/patologia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/patologia , Diagnóstico Diferencial , Epitélio/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/patologia , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Carga Tumoral , Adulto JovemRESUMO
Fundamento: los tumores mucinosos representan alrededor del 8 porciento de las neoplasias apendiculares y originan dilatación quística del apéndice debido a la acumulación de material gelatinoso. El cistoadenoma mucinoso del apéndice es una rara enfermedad, que cursa de manera asintomática y se diagnostica de manera incidental mediante estudios imagenológicos o intra operatorio y representa de un 0,2 porciento a 0,6 porciento de las apendicectomías. Objetivo: presentar el caso inusual de una joven operada por apendicitis aguda que tenía además un cistoadenoma mucinoso del apéndice. Caso clínico: paciente nuligesta, de 19 años de edad con antecedentes de pérdida de peso en un período de seis meses y cuadros recurrentes de dolor en epigastrio que aliviaban con analgésicos, acudió por dolor en el cuadrante inferior derecho del abdomen de 48 horas de evolución, acompañado de náuseas y pérdida del apetito. Al examen físico se constató taquicardia y dolor abdominal a la palpación en la fosa iliaca derecha, con maniobra de Blumberg positiva, el tacto vaginal y rectal resultaron dolorosos. En el acto quirúrgico se constató apéndice cecal engrosado en el tercio proximal, turgente, con una tumoración dura en tercio distal y se realizó apendicectomía sin complicaciones. La evolución fue favorable y fue dada de alta. Conclusiones: a pesar de lo raro de esta afección, el cirujano debe conocer que en un cuadro apendicular puede estar presente este tipo de tumor aún en pacientes jóvenes a fin de tomar la conducta quirúrgica adecuada y evitar complicaciones al enfermo(AU)
Background: mucinous tumors represent about 8 percent of appendix neoplasms and cause cystic dilatation of the appendix due to the accumulation of gelatinous material. Mucinous cystadenoma of the appendix is a rare disease, which occurs asymptomatically and is diagnosed incidentally through imaging studies or intra-operatively and accounts for 0.2percent to 0.6percent of appendectomies. Objective: to present the unusual case of a 19-year-old girl operated on for acute appendicitis who also had a mucinous cystadenoma of the appendix.Clinical case: patient without previous pregnancy, with a history of weight loss in a period of 6 months and recurrent pain in the epigastrium that relieved with analgesics, came for pain in the lower right quadrant of the abdomen of 48 hours of evolution, accompanied by nausea and loss of appetite. Physical examination revealed tachycardia and abdominal pain on palpation in the right iliac fossa, with a positive Blumberg maneuver; vaginal and rectal examinations were painful. In the surgical act, a cecal appendix was found thickened in the proximal third, turgid, with a hard mass in the distal third and an appendectomy was performed without complications. The evolution was favorable and the patient was discharged. Conclusions: despite the rareness of this condition, the surgeon must know that this type of tumor may be present in an appendicular frame even in young patients in order to take the appropriate surgical behavior and avoid complications to the patient(AU)
Assuntos
Humanos , Adulto Jovem , Cistadenoma Mucinoso/diagnóstico , Cistadenoma Mucinoso/epidemiologia , Apendicectomia , Apêndice/cirurgia , Apendicite/cirurgiaRESUMO
El cistoadenoma mucinoso de ovario representa aproximadamente 15 % de las lesiones neoplásicas benignas de ovario y en 5 % de los casos pueden ser bilaterales. Suele manifestarse en edades medias de la vida y son poco frecuentes en la edad pediátrica y en la adolescencia. El objetivo del trabajo es profundizar en el diagnóstico y la conducta terapéutica de esta enfermedad. Se realizó una revisión del tema y se presentó un caso relevante por las dimensiones del quiste. Se presenta una adolescente de 16 años de edad que presentó un cuadro de distensión abdominal y dolor en hemiabdomen derecho de un mes de evolución. Se le realizó cirugía y se encontró un tumor gigante de ovario izquierdo con 10 kilogramos de peso, se corroboró el diagnóstico histológico de cistoadenoma mucinoso de ovario. La paciente evolucionó satisfactoriamente.
Ovarian mucinous cystadenoma accounts for approximately 15 % of benign ovarian neoplastic lesions and in 5 % of cases may be bilateral. It usually manifests in middle ages of life and they are rare in pediatric age and adolescence. The objective of this paper work is to deepen on the diagnosis and therapeutic state of this disease. A review of the topic was made and a case was presented because of the significant dimensions of the cyst. We present a 16-year-old girl who presented abdominal distension and pain in the right hemiabdomen for a month of evolution. Surgery was performed and a giant tumor on the left ovary was found. It weighed 10 kilograms, corroborating the histological diagnosis of mucinous ovarian cystadenoma. The patient evolved satisfactorily.
Assuntos
Humanos , Feminino , Adolescente , Cistadenoma Mucinoso/patologia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso , Revisão , Laparotomia/métodosRESUMO
El cistoadenoma mucinoso de ovario representa aproximadamente 15 por ciento de las lesiones neoplásicas benignas de ovario y en 5 por ciento de los casos pueden ser bilaterales. Suele manifestarse en edades medias de la vida y son poco frecuentes en la edad pediátrica y en la adolescencia. El objetivo del trabajo es profundizar en el diagnóstico y la conducta terapéutica de esta enfermedad. Se realizó una revisión del tema y se presentó un caso relevante por las dimensiones del quiste. Se presenta una adolescente de 16 años de edad que presentó un cuadro de distensión abdominal y dolor en hemiabdomen derecho de un mes de evolución. Se le realizó cirugía y se encontró un tumor gigante de ovario izquierdo con 10 kilogramos de peso, se corroboró el diagnóstico histológico de cistoadenoma mucinoso de ovario. La paciente evolucionó satisfactoriamente(AU)
Ovarian mucinous cystadenoma accounts for approximately 15 percent of benign ovarian neoplastic lesions and in 5 percent of cases may be bilateral. It usually manifests in middle ages of life and they are rare in pediatric age and adolescence. The objective of this paper work is to deepen on the diagnosis and therapeutic state of this disease. A review of the topic was made and a case was presented because of the significant dimensions of the cyst. We present a 16-year-old girl who presented abdominal distension and pain in the right hemiabdomen for a month of evolution. Surgery was performed and a giant tumor on the left ovary was found. It weighed 10 kilograms, corroborating the histological diagnosis of mucinous ovarian cystadenoma. The patient evolved satisfactorily(AU)
Assuntos
Humanos , Feminino , Adolescente , Cistadenoma Mucinoso/patologia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/diagnóstico por imagem , Laparotomia/métodosRESUMO
La prevalencia real de las lesiones quísticas de páncreas sigue siendo una incógnita. El potencial de malignidad de algunas de estas lesiones supone una causa de preocupación significativa en la práctica clínica diaria. Por lo tanto, es necesario determinar una estrategia para poder discriminar claramente los quistes potencialmente malignos de aquellos que no suponen ningún tipo de riesgo. Los tumores papilares mucinosos intraductales y los cistoadenomas mucinosos son neoplasias quísticas mucinosas potencialmente malignas que han ido ganando mayor importancia y reconocimiento en los últimos años. Sin embargo, pese a los múltiples estudios que se han realizado hasta la fecha, su diagnóstico diferencial respecto a otros subtipos de quistes, así como su manejo terapéutico, continúan suponiendo un reto. Este manuscrito contiene una revisión crítica de las recomendaciones actuales y de las estrategias en el manejo de los tumores papilares mucinosos intraductales y los cistoadenomas mucinosos, así como hace hincapié en las limitaciones de las guías actuales (AU)
The real prevalence of pancreatic cystic lesions remains unknown. The malignant potential of some of these lesions remains a cause for significant concern. Thus, it is mandatory to develop a strategy to clearly discriminate those cysts with a potential for malignant transformation from those that do not carry any significant risk. Intraductal papillary mucinous neoplasms and mucinous cystadenomas are mucinous cystic neoplasms with a known malignant potential that have gained greater recognition in recent years. However, despite the numerous studies that have been carried out, their differential diagnosis among other cysts subtypes and their therapeutic approach continue to be a challenge for clinicians. This review contains a critical approach of the current recommendations and management strategies regarding intraductal papillary mucinous neoplasms and mucinous cystadenomas, as well as highlighting the limitations exposed in current guidelines (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cistadenoma Mucinoso/epidemiologia , Pâncreas/lesões , Neoplasias Ductais, Lobulares e Medulares/epidemiologia , Neoplasias Pancreáticas/epidemiologia , Diagnóstico Diferencial , Cistadenoma Mucinoso , Cistadenoma Mucinoso/classificação , Pâncreas/patologia , PâncreasRESUMO
INTRODUCTION: Primary retroperitoneal mucinous cystic neoplasm (PRMCN) is a rare retroperitoneal tumor with female predilection. It is classified into 3 types: benign mucinous cystadenoma (MCA), borderline mucinous cystadenoma (MCAb), malignant mucinous cystadenocarcinoma (MCAc). This study retrospectively evaluates the prevalence of PRMCN among retroperitoneal neoplasms resected between June 2006 and January 2015 at a referral center. Authors' experience with PRMCN is reviewed, and a new case of PRMCN, incidentally diagnosed during pregnancy is reported. A literature review using PubMed is also presented, discussing several issues concerning clinicopathologic features, treatment options, and long-term outcome of PRMCN. CASE REPORT: A 36-year-old woman was incidentally diagnosed with a 12-cm retroperitoneal cyst discovered by ultrasound at 36 weeks of gestation. Eight months later the patient was referred to the department of surgery, the Tel Aviv Sourasky Medical Center. By that time, the patient has sensed local discomfort. Physical examination revealed a right abdomen mass with mild tenderness. Computed tomographic scan depicted the cyst, located along the right paracolic gutter, displacing the right colon medially. The patient underwent complete laparoscopic resection of a 15-cm cyst, without its disruption. The cyst was drained inside an endobag and retrieved. The patient was discharged home on postoperative day 1. The pathology was MCA. Long-term result was no evidence of disease for 9 months. DISCUSSION: The prevalence of PRMCN among resected retroperitoneal neoplasms was 1.95% (3/154 neoplasms). The treatment of choice is complete tumor resection. Surgical technique should be chosen depending on the surgeon's expertise and tumor factors affecting safe resection. Surgery timing during pregnancy should be dictated by both risk of malignancy and obstetric considerations. As for malignant PRMCN, radical surgery does not seem justified, especially in reproductive females. Adjuvant chemotherapy should probably be reserved for metastatic disease, recurrence, and tumor rupture. Long-term follow-up is lacking, although it is important to better define the prognosis of PRMCN.
Assuntos
Cistadenocarcinoma Mucinoso/epidemiologia , Cistadenocarcinoma Mucinoso/cirurgia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/cirurgia , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Neoplasias Retroperitoneais/epidemiologia , Neoplasias Retroperitoneais/cirurgia , Adulto , Idoso , Cistadenocarcinoma Mucinoso/diagnóstico , Cistadenoma Mucinoso/diagnóstico por imagem , Feminino , Humanos , Achados Incidentais , Gravidez , Prevalência , Neoplasias Retroperitoneais/diagnóstico por imagem , Estudos Retrospectivos , UltrassonografiaRESUMO
IMPORTANCE: The role of interval appendectomy after conservative management of perforated appendicitis remains controversial. Determining the etiology of perforated appendicitis is one reason to perform interval appendectomies. OBJECTIVE: To determine whether adult patients undergoing interval appendectomy experience an increased rate of neoplasms. DESIGN: Retrospective study. SETTING: A single tertiary care institution. PARTICIPANTS: All patients 18 years or older who underwent appendectomy for presumed appendicitis from January 1, 2006, through December 31, 2010. EXPOSURES Appendectomy for presumed appendicitis. MAIN OUTCOMES AND MEASURES: Underlying neoplasm as the cause of presentation for presumed appendicitis. Demographic data, clinicopathologic characteristics, interval resection rate, and complication data were collected and analyzed. RESULTS: During the study period, 376 patients underwent appendectomies. Interval appendectomy was performed in 17 patients (4.5%). Neoplasms were identified in 14 patients (3.7%); 5 of those tumors occurred in patients who had undergone interval appendectomy (29.4%). Nine neoplasms were mucinous tumors (64.3%), including all neoplasms associated with interval appendectomies. The mean age of all patients with appendiceal tumors was 49 years (range, 35-74 years). CONCLUSIONS AND RELEVANCE: Mucinous neoplasms of the appendix were found in 5 of 17 patients (29.4%) undergoing interval appendectomy. Interval appendectomies should be considered in all adult patients, especially those 40 years or older, to determine the underlying cause of appendicitis. A multi-institutional study to determine the generalizability of these findings is warranted.
Assuntos
Adenocarcinoma Mucinoso/epidemiologia , Apendicectomia , Neoplasias do Apêndice/epidemiologia , Neoplasias do Apêndice/patologia , Apendicite/cirurgia , Cistadenoma Mucinoso/epidemiologia , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/cirurgia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Apêndice/cirurgia , Apendicite/etiologia , Apendicite/patologia , Tumor Carcinoide/epidemiologia , Tumor Carcinoide/patologia , Tumor Carcinoide/cirurgia , Cistadenoma Mucinoso/patologia , Cistadenoma Mucinoso/cirurgia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
PURPOSE: The purpose of this study was to describe the MR imaging findings of ovarian mucinous cystadenomas coexisting with benign Brenner tumors. MATERIALS AND METHODS: MR images with a 1.5-T unit obtained in five consecutive patients (age range, 51-72 years; mean age, 61 years) with surgically confirmed ovarian mucinous cystadenomas coexisting with benign Brenner tumors were retrospectively reviewed for the presence, configuration, and signal intensity of cystic and solid components of the lesions. RESULTS: Tumors ranged in size from 7.5 to 22.1 cm (mean, 13.5 cm). In four patients (80%), the size of mucinous cystadenoma (range 6.4-22.1 cm; mean, 12.5 cm) was larger than that of Brenner tumor (range 0.2-9.1 cm; mean, 2.8 cm). All patients (100%) had cystic, and three (60%) had solid components. Four patients (80%) showed multilocular cystic, and one (20%) showed unilocular cystic appearance. MR imaging findings were classified into three patterns: (1) a bulky solid mass adjacent to the cystic component, (2) a mural nodule at the periphery of the cystic component, and (3) a cystic component without a detectable solid component. All four multilocular cystic areas exhibited "stained glass" appearances on both T1- and T2-weighted images, and all three solid areas showed homogeneous hypointensity on T2-weighted images. CONCLUSION: Mucinous cystadenomas were often larger than the coexisting benign Brenner tumors. Mucinous cystadenomas coexisting with benign Brenner tumors should be considered when multilocular or unilocular cystic components are accompanied by homogeneously hypointense solid components on T2-weighted images.
Assuntos
Tumor de Brenner/patologia , Cistadenoma Mucinoso/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Ovarianas/patologia , Idoso , Tumor de Brenner/epidemiologia , Comorbidade , Cistadenoma Mucinoso/epidemiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Ovarianas/epidemiologiaAssuntos
Carcinoma Ductal Pancreático/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Carcinoma Ductal Pancreático/epidemiologia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/epidemiologia , Carcinoma Papilar/parasitologia , Transformação Celular Neoplásica/patologia , Estudos Transversais , Cistadenoma Mucinoso/diagnóstico , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/patologia , Cistadenoma Seroso/diagnóstico , Cistadenoma Seroso/epidemiologia , Cistadenoma Seroso/patologia , Diagnóstico Diferencial , Alemanha , Humanos , Achados Incidentais , Estadiamento de Neoplasias , Pâncreas/patologia , Cisto Pancreático/diagnóstico , Cisto Pancreático/epidemiologia , Neoplasias Pancreáticas/epidemiologia , RiscoRESUMO
UNLABELLED: There is limited information on borderline ovarian tumor detected intra-surgically and its most favorable treatment in relation with global radiation and climate changes. AIM: To study the pre-surgery and intra-surgery differentiation criteria of borderline ovarian tumors from invasive carcinoma, and to make a very complex analysis of the frequency, distribution, and variation in time of global radiation, temperature, and precipitation in North-East Romania. MATERIAL AND METHOD: The 54 patients (age range 20-78 years, mean age 46 years) included in this study had borderline ovarian tumors surgically treated during the last 22 years (January 1988 - December 2009) at the 4th Gynecological Clinic at Iasi, and representing 4.87% of the total 1107 ovarian tumors detected and treated during this interval. The histological types were: serous (18 cases), mucinous (27 cases), mixed (8 cases), and Brenner tumor (1 case). In order to analyze the impact of climate changes on borderline ovarian tumors a thorough study on the frequency of global radiation in relation with climate changes based on data recorded in the last 55 years was also carried out. RESULTS: The distribution of these cases depending on when surgery was performed was analyzed. In our study the frequency of ovarian borderline tumors (4.87%) is lower than in similar reports in the literature being due, in our opinion, to the influence of global radiation in relation with climate changes. CONCLUSIONS: In our study global radiation is probably responsible for a progression to invasive carcinoma in 0.7% of the borderline ovarian tumors.
Assuntos
Tumor de Brenner/etiologia , Mudança Climática , Radiação Cósmica/efeitos adversos , Cistadenoma Mucinoso/etiologia , Cistadenoma Seroso/etiologia , Neoplasias Ovarianas/etiologia , Adulto , Idoso , Tumor de Brenner/epidemiologia , Tumor de Brenner/patologia , Tumor de Brenner/cirurgia , Transformação Celular Neoplásica , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/patologia , Cistadenoma Mucinoso/cirurgia , Cistadenoma Seroso/epidemiologia , Cistadenoma Seroso/patologia , Cistadenoma Seroso/cirurgia , Diagnóstico Diferencial , Progressão da Doença , Feminino , Aquecimento Global , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Prognóstico , Estudos Retrospectivos , Romênia/epidemiologia , Resultado do TratamentoRESUMO
Ovarian tumors represent approximately 30% of genital tumors, being the most frequent the germ and the epithelial tumors. During pregnancy the incidence of ovarian cysts is less than 5%, and they are almost always benign. Giant cysts have a frequency of less than 1%. A giant cyst in a primigravida 20 years, 15 weeks pregnant and the evolution of the same case is reported.
Assuntos
Cistadenoma Mucinoso/cirurgia , Neoplasias Ovarianas/cirurgia , Complicações Neoplásicas na Gravidez/cirurgia , Abdome Agudo/etiologia , Cesárea , Cistadenoma Mucinoso/complicações , Cistadenoma Mucinoso/diagnóstico , Cistadenoma Mucinoso/epidemiologia , Feminino , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro , Laparotomia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Adulto JovemRESUMO
OBJECTIVES: The aim of this study was to further evaluate the pathologic features of epithelial ovarian neoplasms and their relative frequency among all ovarian tumors in the adolescent population. DESIGN: We conducted a retrospective pathologic study of all cases of epithelial ovarian neoplasms in adolescents (aged 11-19 years) diagnosed in the pathology laboratory of our hospital over the past 25 years. RESULTS: A total of 86 ovarian tumors were identified, including 23 epithelium-derived ovarian neoplasms (26.7%), 53 germ cell tumors (61.6%), 9 sex-cord stromal tumors (10.5%) and 1 benign Brenner tumor (1.2%). Most cases of epithelial tumors were found in patients 17 years of age or older (14/23 cases, 60.9%). All tumors were unilateral, and their size ranged from 2.5-21 cm (mean 11.7 cm). Epithelial tumors were further histologically subtyped into 21 benign cystadenomas (14 serous and 7 mucinous) and 2 mucinous borderline tumors. CONCLUSIONS: A relatively high frequency of epithelial ovarian neoplasms among all ovarian tumors in a purely adolescent population was found in our study. Age-related selection bias may account at least in part for the discrepancy between our data and most previous reports. The most common subtype of epithelial ovarian tumor in our series was the benign serous cystadenoma.
Assuntos
Cistadenoma Mucinoso/patologia , Cistadenoma Seroso/patologia , Neoplasias Ovarianas/patologia , Dor Abdominal/etiologia , Adolescente , Adulto , Doenças Assintomáticas , Viés , Criança , Cistadenoma Mucinoso/complicações , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Seroso/complicações , Cistadenoma Seroso/epidemiologia , Feminino , Humanos , Distúrbios Menstruais/etiologia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/epidemiologia , Estudos Retrospectivos , Adulto JovemRESUMO
Women with congenital adrenal hyperplasia (CAH) caused by steroid 21-hydroxylase deficiency show reduced fertility, especially with the salt-wasting form. A 27-year-old pregnant woman with this disease underwent laparotomy and oophorectomy to remove a multilocular ovarian tumor at 14 weeks of pregnancy. This proved to be a mucinous cystadenoma. Toward the third trimester, she presented with marked elevations of 17α-hydroxyprogesterone and plasma renin activity. Careful management of endocrine and body fluid homeostasis allowed her to give birth to a healthy female infant with normal external genitalia. This case illustrates endocrinological parameters during pregnancy in a woman with classical salt-wasting CAH.
Assuntos
Hiperplasia Suprarrenal Congênita/epidemiologia , Cistadenoma Mucinoso/diagnóstico por imagem , Cistadenoma Mucinoso/epidemiologia , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/epidemiologia , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/epidemiologia , 17-alfa-Hidroxiprogesterona/sangue , Hiperplasia Suprarrenal Congênita/sangue , Adulto , Comorbidade , Cistadenoma Mucinoso/cirurgia , Feminino , Humanos , Laparoscopia , Neoplasias Ovarianas/cirurgia , Ovariectomia , Gravidez , Complicações Neoplásicas na Gravidez/cirurgia , Resultado da Gravidez , Primeiro Trimestre da Gravidez , Renina/sangue , Resultado do Tratamento , UltrassonografiaRESUMO
UNLABELLED: Ovarian borderline tumors are rare, their good prognosis depending on their stage at the time of diagnosis, and the presence of invasive implants. There is little information on tumor type identified intra-surgically, as well as on the most favorable treatment in borderline ovarian tumors. AIM: To determine the criteria of identification and presurgery and intra-surgery differentiation of the ovarian borderline tumors from the invasive carcinoma and benign ovarian tumors. MATERIAL AND METHODS: This study included 54 patients with TPMS (ovarian borderline tumors) surgically treated in the past 22 years (January 1988-December 2009) at the 4th Gynecological Clinic of the lasi "Gr. T. Popa" University of Medicine and Pharmacy. In this interval 1,107 ovarian tumors: 575 benign, 478 malignant, and 54 TPMS (4.87%) were recorded. The age of the patients with borderline tumors ranged between 20 and 78 years, mean age 46 years, and the histological types were: mucinous (27 cases), serous (18 cases), mixed (8 cases), and Brenner tumor (1 case). RESULTS: We have analyzed the distribution of these cases according to the time when surgical treatment was performed. The frequency of borderline ovarian tumors in our study is 4.87%, lower than in the literature. We believe that this low percentage in our study is due to missing the microscopic data in some macroscopic benign tumors. CONCLUSIONS: By this research we aimed at elaborating a therapeutic strategy for each case using with discernment the modern treatment (surgery, chemotherapy, radiotherapy), as well as new chemical drugs with the goal of obtaining better results and longer survival. There are no tumor markers which could predict the progression of a borderline ovarian tumor to invasive tumors, but the invasive course is only 0.7%.
Assuntos
Tumor de Brenner/patologia , Cistadenoma Mucinoso/patologia , Cistadenoma Seroso/patologia , Neoplasias Ovarianas/patologia , Adulto , Idoso , Tumor de Brenner/epidemiologia , Tumor de Brenner/terapia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/terapia , Cistadenoma Seroso/epidemiologia , Cistadenoma Seroso/terapia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/terapia , Estudos Retrospectivos , Romênia/epidemiologiaRESUMO
OBJECTIVE: To determine the risk of malignancy in septated cystic ovarian tumors. MATERIALS: 1319 (4.4%) of 29,829 women were identified by transvaginal sonography (TVS) as having a complex cystic ovarian tumor with septations without solid areas or papillary projections and were placed on long-term ultrasound surveillance for ovarian malignancy. RESULTS: These 1319 patients had a total of 2870 septated cystic ovarian tumors. 2288 tumors (79.7%) had a septal width <2 mm and 582 (20.3%) had a septal width >or=2 mm. 2286 tumors (79.6%) were <5 cm in diameter and 584 (20.4%) were>or=5 cm in diameter. 1114 septated cystic tumors (38.8%) resolved spontaneously (mean duration to resolution-12 months) and 1756 (61.2%) tumors persisted. 128 patients underwent surgical tumor removal within 3 months of ultrasound. Most common histopathology was: serous cystadenoma (75), mucinous cystadenoma (13), and endometrioma (10). One patient had an ovarian tumor of borderline malignancy (Stage IB). There were no cases of ovarian cancer. Patients were followed from 4 to 252 months (mean-77 months). One patient developed papillary morphology in the contralateral ovary 3.2 years after detection of a septated ovarian cyst and had epithelial ovarian cancer in that ovary and in the omentum (Stage IIIC disease). The remaining patients are all free of ovarian neoplasia after a total of 7642 follow-up years. CONCLUSIONS: Septated cystic ovarian tumors without solid areas or papillary projections have a low risk of malignancy and can be followed sonographically without surgery.
Assuntos
Cistos Ovarianos/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistadenocarcinoma Seroso/epidemiologia , Cistadenocarcinoma Seroso/patologia , Cistadenoma Mucinoso/epidemiologia , Cistadenoma Mucinoso/patologia , Endometriose/epidemiologia , Endometriose/patologia , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Cistos Ovarianos/epidemiologia , Cistos Ovarianos/patologia , Neoplasias Ovarianas/epidemiologia , Fatores de Risco , Ultrassonografia , Estados Unidos/epidemiologiaRESUMO
A 53-year-old woman was wheelchair-dependent and unable to work due to an extreme increase in abdominal circumference. Closer investigation revealed an ovarian tumour. A mucinous cystadenoma of the ovary weighing more than 20 kg was removed with laparotomy. A 63-year-old woman presented with postmenopausal haemorrhage. Morbid obesity and agoraphobia had prevented her from visiting a doctor earlier. She was eventually diagnosed with stage 1C grade III endometrial carcinoma, which was treated with surgery and vaginal brachytherapy. The incidence of gynaecological tumours is increased in patients with a high BMI. This association is stronger for endometrial carcinoma than for ovarian carcinoma. Obesity has a favourable influence on the histological grade of endometrial carcinoma, and is associated with lower-stage ovarian cancer. Surgery-related complications are more common in obese patients. Determining the optimal dose of adjuvant therapy is also problematic in obese patients.