Gynecology Oncology
Fariba Behnamfar; Safoura Rouholamin; Taj Sadat Allameh; Fahimeh Sabet; Leila Mousavi Seresht; Maryam Nazemi
Volume 7, Issue 1 , September and October 2021, , Pages 32-37
Abstract
Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated ...
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Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during 2020 and 2021. The laparoscopic predictive index value (PIV) score (range: 0-14) was calculated for all patients. In patients with PIV scores <8, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥8 were candidates for neoadjuvant chemotherapy (NACT). In the PCS group, laparotomy scoring and surgical findings for each anatomical area were registered for all patients, and concordance between laparoscopy and laparotomy findings was compared. Residual disease following PCS was documented for all patients.Results: A total of 27 patients underwent laparoscopic scoring surgery; 25 patients (92/5%) had a PIV score <8, and two patients (7/5%) had a PIV score ≥8. There was 92% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel 76%, mesenteric 92%, liver 96%, omental 92%, diaphragm 96%, stomach 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 84% at predicting R0 at PCS.Conclusion: Laparoscopic scoring is a precise approach in the management of patients with advanced ovarian cancer. Laparoscopic scoring is a screening method of selecting patients for primary surgery or NACT and improved R0 resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.
Gynecology Oncology
Hemant Kumar Sharma
Volume 6, Issue 4 , August 2021, , Pages 224-227
Abstract
Malignant pericardial effusion presenting with cardiac tamponade is a rare manifestation of metastatic gynecological cancer. Our patient, a 62-year-old female was presented with papillary serous adenocarcinoma of the right ovary in 2016. She was treated with interval cytoreduction surgery and platinum-based ...
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Malignant pericardial effusion presenting with cardiac tamponade is a rare manifestation of metastatic gynecological cancer. Our patient, a 62-year-old female was presented with papillary serous adenocarcinoma of the right ovary in 2016. She was treated with interval cytoreduction surgery and platinum-based chemotherapy until 2018. Now, she presented with sudden onset dyspnea, tachypnea, tachycardia with hypotension, and distended jugular venous pressure. Echocardiography confirmed a large pericardial effusion with mild bilateral pleural effusion. She underwent an emergent pericardiocentesis which yielded 350 mL of hemorrhagic fluid and cytological examination of smears confirmed the presence of metastatic adenocarcinoma cells. The patient was managed conservatively and discharged after one week of hospitalization with a referral to the oncology center for further treatment. With increasing longevity and improved chemotherapeutic regimens, cases of malignant pericardial effusion with cardiac tamponade are on the rise, and therefore, clinicians need to be familiar with the prompt diagnosis and management of this life-threatening disease process.
Obstetrics and Gynecology
Tahereh Ashrafganjoei; Atyeh Bahman; Somayyeh Noei Teymoordash; Soheila Aminimoghaddam; Abdolali Ebrahimi; Maryam Talayeh
Volume 6, Issue 3 , June 2021, , Pages 105-109
Abstract
Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, ...
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Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, a complete surgical staging in endometrial cancer includes oophorectomy since 1988. There has been some research to assess whether an oophorectomy should be performed and in which cases, ovaries can be preserved.Materials & Methods: Aim of this study was to evaluate the coexistence of ovarian involvement in endometrioid endometrial carcinoma. In this study, we evaluated 180 patients with endometrioid endometrial cancer patients who were surgically staged at Imam Hossein Hospital between 2004 and 2017.Results: Mean age of subjects of the study was 56.78 ±10.59. Forty-six of patients (25.6 %) were less than 50 years old and 74.4 % (134) were older than 50. Twenty out of 180 (11.1 %) of them had ovarian involvement (one of them had simultaneous ovarian tumor) and 11 (55%) of these cases were less than 50 years old. In 55 % (11) patients, the involved ovaries were less than 5 cm with grossly normal appearance, lymph nodes metastases were detected in 3 out of 20 (15 %) of them although their ovarian size were 4, 4.5 and 6.5 cm. In 10 (50 %) of them, deep myometrial invasion was detected.Conclusion: In endometrial cancer staging, ovarian preservation could be a challenging decision and a real controversy which needs more researches.
Shirin Haghighat
Volume 4, Issue 4 , September and October 2019, , Pages 131-134
Abstract
Epithelial ovarian cancer is one of the most common gynecological malignancies worldwide with an incidence of 225000 cases annually. For most patients, multimodality treatment including cytoreductive surgery and combination chemotherapy is an accepted standard of care. Despite the relatively favorable ...
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Epithelial ovarian cancer is one of the most common gynecological malignancies worldwide with an incidence of 225000 cases annually. For most patients, multimodality treatment including cytoreductive surgery and combination chemotherapy is an accepted standard of care. Despite the relatively favorable response to initial treatment, relapse free survival and overall survival are disappointing in patients with advanced ovarian cancer. Therefore, new treatment approaches have been proposed in recent years. The present review aims to describe the most relevant data published during the last four years on new approach to advanced ovarian cancer. Therefore, relevant studies were searched through Pubmed, Cochrane library and Scopus database published online until 2019. The most important changes studied in recent years have included the addition of new chemotherapy or targeted agent to first-line chemotherapy. Although combination of intravenous paclitaxel and carboplatin is currently accepted as the standard of care for treatment of advanced ovarian cancer, discussion around the intraperitoneal chemotherapy is still an important challenge. Additionally, much efforts have been dedicated to design an appropriate maintenance treatment as a goal of diminish the risk of recurrence. This review summarizes the results of most recent phase 3 trials surrounding optimal first-line chemotherapy, addition of a targeted agent including bevacizumab and maintenance treatment.
Zohreh Yousefi; Shohreh Saied; Amir Hosein Jafarian; Jelveh Jalili
Volume 1, Issue 2 , September and October 2016
Abstract
Introduction: Peritoneal tuberculosis (PTB) and ovarian cancer have overlapping nonspecific symptoms and signs. No pathognomonic clinical features or imaging findings can help to distinguish definite diagnosis of extra pulmonary TB. Peritoneal TB can be easily confused with peritoneal carcinomatosis ...
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Introduction: Peritoneal tuberculosis (PTB) and ovarian cancer have overlapping nonspecific symptoms and signs. No pathognomonic clinical features or imaging findings can help to distinguish definite diagnosis of extra pulmonary TB. Peritoneal TB can be easily confused with peritoneal carcinomatosis or advanced ovarian carcinoma; therefore, it is difficult to distinguish these two entities. The current study described two cases of peritoneal tuberculosis mimicking advanced ovarian cancer.
Case Presentation: In the first case, the initial manifestation was lower abdominal pain. The imaging indicated ovarian mass, ascites and hepatic surface nodularity, omental and peritoneal thickening. Also, titer of tumor marker CA-125 was more than 600 units. In laparoscopy, disseminated peritoneal seeding was observed. Frozen section of sampling these lesions reported tuberculosis. Biopsy of ovarian mass reported fibrothecoma. Concurrent with this patient, the second case referred to the same center, Department of Gynecology Oncology at Ghaem Hospital, Mashhad University, Iran, in 2015. Her presentation was fever and remarkable weight loss during the last three months. She had a multiloculated pelvic mass with septation in sonography and peritoneal seeding with pleural effusion in computed tomography (CT) scan. Peritoneal tuberculosis was recognized through laparotomy and both patients received anti-TB treatment and now they are in good health status.
Conclusions: Peritoneal tuberculosis should always be considered in differential diagnosis of patients with evidences suggesting advanced ovarian cancer..
