Female ; Humans ; Kidney Neoplasms ; complications ; pathology ; Ovarian Neoplasms ; pathology ; Wilms Tumor ; complications ; pathology ; Young Adult

Female ; Humans ; Luteoma ; pathology ; Ovarian Neoplasms ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology

Adolescent ; Diagnosis, Differential ; Endometriosis ; pathology ; Female ; Humans ; Melanoma ; pathology ; Melanosis ; complications ; pathology ; surgery ; Ovarian Neoplasms ; complications ; Peritoneal Diseases ; complications ; pathology ; surgery ; Teratoma ; complications

A 60 year-old female complained with abdominal distension for one month. Stage IIIc, grade 2 clear cell carcinoma of the ovary was diagnosed after laparotomy. Weekly paclitaxel combined with carboplatin as adjuvant chemotherapy was given after optimal cytoreductive surgery. An acute cerebral infarction after first chemotherapy cycle was developed. The patient presented with dyspnoea after the third chemotherapy cycle and the symptom could be relieved at rest. Such symptom worsened and relieved alternatively for 3 days. A sudden dyspnoea occurred to the patient again when she got up one night, and died of respiratory and circulatory failure on the way to the hospital. Autopsy revealed ovarian clear cell carcinoma with metastasis to the whole pelvic and abdominal cavity and massive pulmonary arterial embolism (the length of embolus is 20 cm) with cerebral infarction. A conclusive remarks was made during the conference that patients who underwent operation and chemotherapy were at high risk for venous thrombosis (VT) and pulmonary embolism (PE). It was important to analyze a patient's individual risk for VT and PE. Appropriate thrombosis prophylaxis ought to be considered highly for high risk patients.
Adenocarcinoma, Clear Cell ; complications ; pathology ; Death, Sudden ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; complications ; pathology ; Pulmonary Embolism ; etiology

OBJECTIVETo summarize the clinicopathological features and prognosis of malignant ovarian neoplasms complicating pregnancy and explore the rational treatment.

METHODSThe clinical data of 38 patients with malignant ovarian neoplasms complicating pregnancy were retrospectively analyzed,and the intra-surgical pathological sections were reviewed. International Federation of Gynecology and Obstetrics (FIGO) staging system (1988) was applied.

RESULTSOf these 38 patients,the malignancies included epithelial ovarian cancer (n=9, 23.7%), epithelial borderline ovarian tumor (n=13, 34.2%),ovarian malignant germ cell tumors (n=11, 28.9%), sex cord stromal tumors (n=3, 7.9%), and metastatic tumor from gastrointestinal tracts (n=2, 5.3%). Twenty-seven patients (71.1%) were at stage I. The pregnancy outcomes included termination in the first trimester (n=8), full-term vaginal delivery (n=6), full-term Cesarean section (n=15), and therapeutical Cesarean section for premature birth (n=9). One newborn died,and the remaining 29 survived in a healthy status. All patients underwent surgical treatment,among whom two patients received surgeries during pregnancy. Patients were followed up for (40.5±38.5) months,during which one patient was lost to follow-up, 7 died, 1 survived with tumor, and 29 (76.3%) survived free of tumors.

CONCLUSIONSThe management of ovarian malignancies complicating pregnancy should be individualized. Both surgical treatment and chemotherapy are relatively safe in the second and third trimesters. Satisfactory prognosis can be expected after appropriate treatment.

Adult ; Female ; Humans ; Ovarian Neoplasms ; pathology ; therapy ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Young Adult

To investigate the immunophenotypings of malignant epithelial mesothelioma (MEM), and to seek the valuable markers in distinguishing peritoneal MEM from peritoneal metastatic ovarian adenocarcinoma (OA) and colorectal adenocarcinoma (CA), immunohistochemical SP method was used to detect expressions of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 in paraffin-embedded tissues of 18 cases of MEM, 20 OA and 20 CA. The results showed that there was a significant difference in the expressions of E-cadherin, CA19-9 and MOC-31 between MEM and OA group (P<0.05). Similarly, the difference in the expression of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 between MEM and CA groups is significant (P<0.05). These results indicate that HBME-1 could be used as a positive marker in distinguishing MEM from CA. E-cadherin, CA19-9 and MOC-31 are considered to be useful negative markers in diagnostic distinction between MEM and metastatic adenocarcinomas, including OA and CA. CK7 is the best positive marker in distinguishing MEM from CA, but this marker appears to be valueless in discriminating MEM from OA.
Adenocarcinoma ; diagnosis ; pathology ; Colorectal Neoplasms ; complications ; diagnosis ; pathology ; Cystadenocarcinoma, Mucinous ; diagnosis ; pathology ; Cystadenocarcinoma, Serous ; diagnosis ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunophenotyping ; Male ; Mesothelioma ; diagnosis ; etiology ; pathology ; Ovarian Neoplasms ; complications ; diagnosis ; pathology ; Peritoneal Neoplasms ; diagnosis ; etiology ; pathology

We report here on the multiple genital tract neoplasms in a 41-yr-old Korean woman with Peutz-Jeghers Syndrome (PJS). The patient presented with lower abdominal pain. Her previous medical history was PJS and breast cancer. Pelvic ultrasound showed a multilocular cyst at the right adnexal region, diagnosed as bilateral ovarian mucinous borderline tumors. An ovarian sex cord tumor with annular tubules was incidentally diagnosed together with a minimal deviation adenocarcinoma of the uterine cervix and mucinous metaplasia of both the Fallopian tubal mucosa and the endometrium. Although the cases of multiple genital tract tumors with PJS has rarely been reported, the present case appears to be the first in Korea in which the PJS syndrome was complicated by multiple genital tract tumors and infiltrating carcinoma of the breast. The clinical significance of the multiple genital tract tumors and breast cancer associated with PJS is reviewed.
Uterine Cervical Neoplasms/complications/*pathology ; Sex Cord-Gonadal Stromal Tumors/complications/pathology ; Peutz-Jeghers Syndrome/complications/*pathology ; Ovarian Neoplasms/complications/*pathology ; Metaplasia ; Korea ; Humans ; Female ; Fallopian Tubes/pathology ; Endometrium/pathology ; Carcinoma, Ductal, Breast/complications/pathology ; Breast Neoplasms/complications/*pathology ; Adult ; Adenocarcinoma/complications/pathology

Acupuncture Therapy ; Edema ; etiology ; immunology ; therapy ; Female ; Humans ; Lower Extremity ; pathology ; Middle Aged ; Ovarian Neoplasms ; surgery ; Postoperative Complications ; etiology ; therapy

Objective To investigate the clinical characteristics of preadolescent and adolescent female patients with ovarian mass combined with dysplasia of secondary sexual characteristics. Methods This study retrospectively analyzed 18 cases of ovarian mass combined with dysplasia of secondary sexual characteristics aged 0-19 years admitted to Peking Union Medical College Hospital from January 2012 to November 2019.By analyzing the clinical manifestations,surgical methods,postoperative pathology,therapies and prognosis of the cases,we summarized the diagnosis and treatment ideas. Results Among the 18 cases,7(7/18,38.9%)developed secondary sex signs before puberty,including 5 cases showing precocity(including 2 cases of juvenile granulosa cell tumor,1 case of gonadoblastoma,1 case of ovarian follicular cyst,and 1 case of 46,XY simple gonadal dysplasia combined with dysgerminoma)and 2 cases presenting masculine manifestations(1 case of steroid cell tumor and 1 case of sclerosing stromal tumor).The rest 11(11/18,61.1%)cases showed abnormal development of secondary sexual characteristics during puberty,including 8 cases with masculine manifestations or abnormal menstruation after menarche(7 cases with sex cord stromal cell tumor and 1 case with cystic granulosa cell tumor),2 cases with primary amenorrhea(1 case with androgen insensitivity syndrome combined with testicular sertoli cell tumor and 1 case with endometriosis cyst combined with reproductive tract malformation),and 1 case diagnosed as 46,XX gonadal dysplasia with serous cystadenoma and no secondary sexual development during puberty. Conclusions Sex hormone levels should be actively tested in the case of prepubertal secondary sexual characteristics appearing early,pubertal secondary sexual characteristics being abnormal(underdevelopment),and/or menstrual abnormalities.Imaging examination should be performed to exclude ovarian organic lesions,and chromosome karyotype analysis should be performed if necessary.The diagnosis of ovarian mass in preadolescent and adolescent females with related symptoms should first be alerted to cord stromal cell tumor.It is recommended to rule out the possibility of combined reproductive tract malformation in the adolescent patients with primary amenorrhea.Chromosome examination should be conducted to rule out the possibility of gonadal dysplasia in the adolescent patients with primary amenorrhea and/or no development of secondary sexual characteristics.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Hyperplasia/complications* ; Infant ; Infant, Newborn ; Ovarian Neoplasms/pathology* ; Retrospective Studies ; Young Adult

To evaluate the outcomes of controlled ovarian hyperstimulation (COH)-in vitro fertilization (IVF) such as clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) for infertile patients with borderline ovarian tumor (BOT) after conservative treatment, 10 IVF cycles in five patients from January 1999 to July 2005 were analyzed. At the time of diagnosis with BOT, the mean age of patients was 30.0 yr (range, 22-40). For 8 cycles out of 10 attempted IVF cycles, except for 2 cancellation cycles, the mean number of oocytes retrieved was 5.6 (range, 2-16) with a mean fertilization rate of 74.4%. The CPR, IR, and LBR were 50.0% (4/8 cycles), 31.6% (6/19) and 50.0% (4/8 cycles) respectively. The mean follow-up period after COH-IVF initiation was 29.6 (range, 14-61) months. A gynecological oncologist followed all patients every 3 months during the first year and every 6 months thereafter. There was no recurrence during the follow-up period. Our results suggest that COH-IVF may be acceptable for infertile patients with BOT, especially in patients with early-stage BOT after conservative treatment.
Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female/*complications/*therapy ; Ovarian Neoplasms/*complications/pathology/*surgery ; Ovulation Induction/methods ; Pregnancy ; Pregnancy Complications, Neoplastic ; Prognosis ; Treatment Outcome