Hormone-receptor expression status of epithelial ovarian cancer in Ibadan, South-western Nigeria.

INTRODUCTION: Epidemiological evidence strongly suggests that steroid hormones are implicated in the pathogenesis of ovarian cancer. Estrogen receptor (ER) and Progesterone receptor (PR) are prognostic indicators for a number of epithelial tumors and may play the same role in ovarian cancers. This study aims to evaluate the expression of ER and PR in epithelial ovarian cancer (EOC) in an African population and compare it with other prognostic factors such as age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype. METHODS: Ninety cases of histologically confirmed EOC were reviewed. Immunohistochemistry was used to assess their ER and PR expression status and was then compared with other demographic variables using statistical methods, with level of significance set at p < 0.05. RESULTS: 30.2% and 8.3% of serous and mucinous carcinomas respectively were ER positive while 41.2% and 22.5% of both tumour types were PR positive. One of the two endometrioid carcinomas showed PR expression but neither were positive for ER. The only case of Brenner tumour in the series was ER positive but negative for PR. There was a significant association between ER and the histological subtypes (p = 0.042) while no significant association was found between PR expression and histological subtypes (p = 0.650). No significant association was found between hormone receptor status, age and stage of the EOC. CONCLUSION: The study showed a lower ER expression in serous carcinoma compared to large cohorts from developed countries. Future translational studies could be used to determine response of EOC to endocrine therapy.

Malignant Brenner tumors of the ovary; a population-based analysis.

OBJECTIVE: Malignant Brenner Tumor (MBT) is a tumor with an extremely low incidence that morphologically resembles to urothelium. Given the paucity of evidence on the epidemiology and prognosis of MBT, the aim of this retrospective population-based study was to elucidate the demographic and clinico-pathological characteristics of patients with ovarian MBT. METHODS: A cohort of patients diagnosed between 1988 and 2012 was drawn from the National Cancer Institute Surveillance and Epidemiology End Results database. For surgically treated patients, Observed and Disease Specific Survival were calculated following generation of Kaplan-Meier curves. Comparisons were made using the log-rank test. RESULTS: A total of 207 patients were identified. Median patient age was 65years and the majority presented with unilateral, high grade tumors with a median size of 10cm. Stage I, II, III and IV disease was noted for 55.4%, 14.4%, 18%, and 12.2% of patients respectively. Only 5.1% had positive lymph nodes for metastatic disease. Five-year disease-specific survival (DSS) of patients with tumors confined to the ovary was 94.5% compared to 51.3% for those with extra-ovarian spread (p<0.001). Lymphadenectomy was not associated with an improved DSS (p=0.2). CONCLUSIONS: MBTs are typically unilateral high grade tumors localized to the ovary. Regional lymphatic spread is uncommon and lymphadenectomy does not confer any improvement on survival. Patients with tumors confined to the ovary have an excellent prognosis while extra-ovarian spread is associated with a poor outcome.

[Diagnosis and treatment of the epithelial ovarian cancer at the West African Cancer Center of Dakar]. / Prise en charge diagnostique et thérapeutique des tumeurs épithéliales malignes de l'ovaire dans le Centre Ouest-Africain de lutte Contre le Cancer de Dakar.

INTRODUCTION: Epithelial ovarian cancer are the most frequent of ovarian cancer, their prognosis is very bad. The aim of this study is to describe the diagnosis, the treatment and to assess the survival rate of the patients. METHODS: It was a retrospective study realized at the Cancer Institute of Dakar from December 2000 to January 2007. We have collected 117 patients with epithelial ovarian cancer. The mean age was 49 years. Patients were comprised: 22 stage I, 32 stage II, 35 stage III and 26 stage IV. Primary surgery was performed to 34 patients and the other patients were treated with chemotherapy and surgery. The survival rate was assessed by Kaplan-Meier method and the Logrank test had allowed to compare the survival among age and optimal surgery. RESULTS: Optimal surgery R0 was done in 20 cases and surgical resection R2 was performed in 45 cases. Pathological exam had found 65 serous cystadenocarcinoma, 28 mucinous cystadenocarcinoma and 21 endometrioid cystadenocarcinoma, one malignant tumor of Brenner. Overall survival at five years was 13.3%. The survival among optimal surgery was 16.3 and 2.3% for suboptimal surgery. There was no significant difference of the survival among patients who were less than 40 years old (P = 0.334). CONCLUSION: Prognosis of epithelial ovarian cancer is worse in Senegal as like as in the world. To improve the survival of our patients, we must detect the early diagnosis of these tumors and to introduce the neoadjuvant chemotherapy before optimal surgery.

Ovarian mucinous cystadenoma coexisting with benign Brenner tumor: MR imaging findings.

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.

[Borderline ovarian tumors and global radiation in relation with climate change impact]. / Tumorile ovariene cu potential malign scazut si radiatia globala.

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.

[Ovarian tumors of low malignant potential (borderline ovarian tumors)]. / Tumorile ovariene cu potential malign scazut (tumorile ovariene borderline).

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%.

[Proliferating Brenner tumor: case report]. / Tumeur de Brenner proliférante: à propos d'un cas.

Brenner tumors account for only 1 to 2% of ovarian tumors. Proliferating Brenner tumors are characterized by an epithelial proliferation, resembling superficial well-differentiated urothelial carcinomas. A single 29-year-old patient was operated for an ovarian tumor. On gross examination, the tumor, which originated in the left ovary, was cystic multilocular and presented polyoid excrescences. Definitive histological exam showed a papillary proliferation lined by transitional cells without stroma infiltration. Mucinous cells lined some cavities. The diagnosis of proliferating Brenner tumor was made. Clinical and pathological characteristics of this rare entity will be discussed.

[Clinico-pathological study of elderly women with malignant ovarian tumors].

Twenty-five elderly women (those 70 years or older) with borderline and malignant ovarian tumors during the past 20 years were reviewed clinico-pathologically in comparison with 160 younger women (those 69 years or younger). The following results were obtained: 1) The incidence rate of elderly women for all patients of borderline and malignant ovarian tumors was 13.5%, and did not tend to increase in the past several years. 2) The rate that the elderly woman visited first at the other department excepting the department of obstetrics and gynecology was 36%, and which was statistically higher than that of the younger woman (p less than 0.01). 3) Fifty-two % of elderly patients had some complications and the incidence was significantly higher than that (23.1%) of younger patients (p less than 0.005). 4) Histopathologically in elderly patients, 9 patients (36%) were of serous cystadenocarcinoma and 17 patients (68%) were of malignant epithelial tumor (primary ovarian cancer and malignant Brenner tumor). 5) Of elderly patients, 8 (47.1%) were in Stage III and IV, and it was higher incidence than that (33.3%) of younger patients. In advanced cases, the histological grades became more poorly. 6) The survival rate of elderly patients in Stage III and IV was significantly lower than that in Stage I and II. The various treatment for Stage III and IV patients did not demonstrate the correlation in prognosis. In contrast, the survival rate for the group treated surgically in Stage I and II was significantly higher than that of non-surgical group (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)