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ANTECEDENTES: El cistoadenofibroma seroso de ovario es una neoplasia epitelial benigna, relativamente infrecuente, de crecimiento lento y de causa desconocida. El diagnóstico preoperatorio es complejo debido a la ausencia de síntomas y signos específicos que permitan descartar la malignidad. OBJETIVO: Analizar retrospectivamente las características clínicas, radiológicas, histopatológicas, y la atención médica de las pacientes. MATERIALES Y MÉTODOS: Análisis retrospectivo y descriptivo de pacientes con diagnóstico histopatológico de cistoadenofibroma seroso de ovario atendidas en el Hospital General de Albacete entre los años 2010 a 2022. RESULTADOS: Se analizaron 635 piezas quirúrgicas, de las que el 57.74% correspondieron a neoplasias serosas benignas, el 17.41% a neoplasias serosas fronterizas y un 24.85% a neoplasias serosas malignas. Se identificaron 20 casos de pacientes con diagnóstico de cistoadenofibroma seroso de ovario. La edad media de esas pacientes fue de 47 años, con límites de 9 y 74 años. Un caso se asoció con un tumor proliferativo seroso atípico contralateral. El tratamiento fue quirúrgico y no se identificaron recurrencias en ninguno de los casos. CONCLUSIONES: El cistoadenofibroma seroso suele manifestarse como un quiste ovárico complejo, con componentes sólidos-quísticos y tabiques irregulares; por esto a menudo se diagnostica erróneamente como tumor maligno antes de la intervención. La biopsia por congelación ayuda a confirmar su naturaleza benigna y evita una cirugía extensa innecesaria. El tratamiento consiste, principalmente, en la extirpación quirúrgica del quiste con o sin ooforectomía. El pronóstico suele ser excelente.
Abstract BACKGROUND: Serous ovarian cystoadenofibroma is a relatively rare, slow-growing, benign epithelial neoplasm of unknown cause. Preoperative diagnosis is complex due to the absence of specific symptoms and signs to rule out malignancy. OBJECTIVE: To retrospectively analyze the clinical, radiologic, histopathologic features, and medical care of the patients. MATERIALS AND METHODS: Retrospective and descriptive analysis of patients with histopathological diagnosis of ovarian serous cystoadenofibroma attended at the General Hospital of Albacete between the years 2010 to 2022. RESULTS: 635 surgical specimens were analyzed, of which 57.74% corresponded to benign serous neoplasms, 17.41% to borderline serous neoplasms and 24.85% to malignant serous neoplasms. Twenty cases of patients with a diagnosis of ovarian serous cystoadenofibroma were identified. The mean age of these patients was 47 years, with limits of 9 and 74 years. One case was associated with a contralateral atypical serous proliferative atypical tumor. Treatment was surgical and no recurrences were identified in any of the cases. CONCLUSIONS: Serous cystoadenofibroma usually manifests as a complex ovarian cyst, with solid-cystic components and irregular septa; this is why it is often misdiagnosed as a malignant tumor before surgery. Freeze biopsy helps to confirm its benign nature and avoids unnecessary extensive surgery. Treatment consists mainly of surgical removal of the cyst with or without oophorectomy. The prognosis is usually excellent.
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Objective To investigate the clinical value of single hole laparoscopy in treatment of ovarian benign neoplasms. Methods The patients with benign ovarian tumors treated from February 2014 to August 2016 were divided into two groups, 41 cases in each. The observation group received laparoendoscopic single-site surgery, while the control group was treated with traditional porous laparoscopic gynecologic surgery. The operation effect, intraoperative and postoperative complications, postoperative ovarian function and cosmetic satisfaction were observed and recorded in the two groups. Results The operation of the two groups was smooth and there were no intraoperative or postoperative complications. The operation time and postoperative satisfaction degree of the observation group were significantly higher than that of the control group (P < 0.05). The postoperative exhaust time, postoperative hospital stay, postoperative 24 h and 72 h, VAS scores of the observation group were significantly lower than those of the control group (P < 0.05). The estradiol levels in the two groups were significantly lower than those before operation, and the levels of follicule-stimulating hormone and luteinizing hormone were significantly higher than those before operation (P < 0.05). There were no significant differences in the amount of bleeding between the two groups and the levels of estradiol, follicule-stimulating hormone and luteinizing hormone before and after the operation (P > 0.05). Conclusion The laparoendoscopic single-site surgery technique is better than the porous laparoscopic technique in the treatment of benign ovarian tumors, and it is worthy of popularization and application.
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Objective To explore the effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients. Methods From January 2015 to January 2016, 86 cases of ovarian benign tumor patients were set as study objects. All the patients were randomly divided into control group and observation group, 43 cases in each. Patients in control group were given traditional laparotomy surgery, while patients in observation group were given laparoscopic surgery. The changes of immune function related indexes before and after operation were recorded, before operation, day 1 and day 3 postoperative, number of peripheral white blood cells (WBC), neutrophil ratio (NGR), immunoglobulin (IgA, IgG, IgM) levels, C reactive protein (CRP) content and the distribution of T lymphocyte subsets (CD3+, CD4+ and CD3+/CD4+ ratio) distribution were respectively determined, and the incidence of postoperative complications was recorded, and were further statistical analyzed. Results There was no significant difference in immunoglobulin IgA, IgG and IgM between the twogroups before operation (P > 0.05). Postoperative, only the IgG content of the two groups was significantly lower than that before the operation (P 0.05), the difference between the two groups was significant (P < 0.05). The complication rate of the observation group after operation was 6.98%, the control group was 16.28%. Conclusion Clinical use of laparoscopic treatment of benign ovarian tumors relative to the traditional laparotomy can effectively reduce the immune system of patients with immune function, with high safety, contribute to the recovery of patients, it is worthy of clinical promoting.
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OBJECTIVES: The aim of this study is to confirm the clinical and histopathologic findings of ovarian tumors and determine the malignancy before operation. It will attribute to early diagnosis, determining direction of treatment and improving prognosis of malignant ovarian tumor. METHODS: Seven hundred sixty-five patients who had an operation for ovarian tumors in the department of Obstetrics and Gynecology of Gachon University Gil Medical Center from April 2007 to December 2009 were enrolled as subjects. A retrospective analysis of age, parity, menopausal status, preoperative CA 125, histology, ultrasound, and treatment method was done. RESULTS: 1. Among benign ovarian tumors, endometrial cyst (211 cases, 30.1%) was most common and had the highest preoperative CA 125 (76.07 U/mL). 2. Among borderline ovarian tumors, mucinous type (16 cases, 62.5%) was most common, but preoperative CA 125 was higher in serous type (144.38 U/mL) than mucinous type (82.59 U/mL). 3. Among malignant ovarian tumors, serous adenocarcinoma (14 cases, 29.8%) was most common, and undifferentiated carcinoma had the highest preoperative CA 125 (500.0 U/mL). 4. The preoperative CA 125 showed a tendency to increase in relation to stage in malignant ovarian tumors. 5. Age, preoperative CA 125, menopausal status and ultrasound finding were identified as discriminating factors for malignancy and relative risk of them were 7.19, 7.90, 5.56 and 61.43, respectively. CONCLUSION: Using the combination of age, menopausal status, preoperative CA 125 and ultrasound to diagnose ovarian tumors before the operation will be a help to early diagnosis and determining the treatment and improve prognosis.
Subject(s)
Female , Humans , Adenocarcinoma , CA-125 Antigen , Carcinoma , Early Diagnosis , Gynecology , Mucins , Obstetrics , Parity , Prognosis , Retrospective StudiesABSTRACT
OBJECTIVE: The purpose of our study is to investigate the feasibility of the laparoscopy and compare perioperative outcomes between laparoscopy and laparotomy in pregnant women with non-malignant ovarian tumor. METHODS: Retrospective comparative analysis of 56 pregnant women who underwent laparoscopy or laparotomy due to non-malignant ovarian tumors at Samsung Medical Center, Seoul, Korea, between October 1994 and December 2010 were performed. RESULTS: Among 56 patients, 22 and 34 pregnant women underwent laparotomy and laparoscopy, respectively. There were no statistically significant differences between the two groups about general characteristics including age, gestational age, torsion, surgeon type, pain at diagnosis and clinical outcomes including tocolytics use, operation type, operation time, the ratio of normal full-term vaginal delivery, Apgar score. However, pathological longest tumor size was larger in laparotomy group than laparoscopy group (9.0 cm vs. 5.8 cm; p=0.001) and laparoscopy was related with significantly less estimated blood loss (200 vs. 50 mL; p=0.001) and short hospital days (7 vs. 4 days; p<0.001). CONCLUSION: Laparoscopy for the treatment of non-malignant ovarian tumors in pregnant women is feasible and has benefits such as less estimated blood loss during the surgery and hospital stays when compared with laparotomy. However, laparoscopic adnexal surgery for large tumor size may be still challenging in pregnant women.
Subject(s)
Female , Humans , Pregnancy , Apgar Score , Gestational Age , Korea , Laparoscopy , Laparotomy , Length of Stay , Pregnant Women , Retrospective Studies , Tocolytic AgentsABSTRACT
Objective To study the expression and signficance of the osteopontin (OPN) in epithelial ovarian cancer tissue and serum. Methods Immunohistochemistry method and ELISA were used to detect the expression of OPN in 64 cases of epithelial ovarian cancer tissue and serum, 20 cases of ovarian benign tumors and 10 cases of ovarian nomal tissues. Results The OPN expression was associated with the clinical staging and histological grading of epithelial ovarian cancer tissue and serum (P < 0.01). The level of OPN in epithelial ovarian cancer tissue was significantly higher than that in benign ovarian tumor and normal control groups (P < 0.01). Conclusion OPN is remarkably correlated with the carcinogenesis and the development of epithelial ovarian cancer.
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OBJECTIVE: This study was designed to determine the clinical significance of serum CA 125 and CA 19-9 levels in preoperative differential diagnosis of benign ovarian tumors. METHODS: 104 patients who visited the department of Obstetrics and Gynecology of Dankook University Hospital from February 1999 to December 2001, and who were diagnosed as adnexal mass and underwent surgery, and free of other medical diseases, were enrolled as subjects. An analysis of preoperative serum CA 125, CA 19-9 levels of patients was performed in correlation with the postoperative histologic diagnoses. The histologic diagnoses were grouped as mature cystic teratoma, endometrioma, mucinous cystadenoma, serous cystadenoma, benign cystic tumor group, adnexal inflammatory disease group. Study group was defined as endometrioma, adnexal inflammatory disease in CA 125, and mature cystic teratoma, endometrioma in CA 19-9, and the others were defined as control group. Statistical analysis with Chi square test was done on the number of cases who showed CA 125 or CA 19-9 increment over cut off value between study group and control group. Study group was compared with control group in the mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value. RESULTS: The number of cases who showed serum CA 125 increment over cut off value (35 U/ml) was significantly higher in endometrioma and adnexal inflammatory disease group (p<0.05), and the number of cases who showed serum CA 19-9 increment over cut off value (37 U/ml) was significantly higher in endometrioma and mature cystic teratoma group (p<0.05). The mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value in those groups showed no significant difference in comparison with those of the other groups. CONCLUSION: In this study, increment of CA 19-9 in endometrioma and CA 125 and CA 19-9 in mature cystic teratoma showed statistically significant higher frequency than other groups. We concluded that checking the preoperative serum level of CA 125 and CA 19-9, combined with transvaginal ultrasonography, may be helpful in differential diagnosis of benign ovarian tumors and in discriminating benign ovarian tumors from malignant ovarian tumors, if any other condition that may cause serum level elevation of CA 125 and CA 19-9 is excluded.