A case of borderline clear cell fibroadenoma / 대한산부인과학회지

Clear cell tumor of borderline malignancy has been reported to account for 5 to 8% of all clear cell neoplasms, and <1% of borderline malignancies of the ovary. Borderline clear cell fibroadenoma with or without microinvasion mostly occurs in women with middle age, and the presenting symptoms associated with this tumor are non-specific. The clinico-pathologic features of borderline clear cell fibroadenoma are not well known because of its rarity. Furthermore, there is no consensus for treating the disease. Thus, we report a case of borderline clear cell fibroadenoma presenting as ovarian fibroadenoma with a review of literature.

Accuracy of frozen section diagnosis for ovarian tumors according to histologic type and malignant potential / 부인종양

OBJECTIVE: The purpose of this was to evaluate accuracy of frozen section diagnosis for ovarian tumors according to histologic type and malignant potential. METHODS: We compared the frozen section and final diagnosis of patients with ovarian tumors from April 2001 to April 2006. Of these 1138 cases, 628 cases (55.2%) were epithelial ovarian tumors. Benign, borderline, and malignant epithelial tumors were 380 (60.5%), 87 (13.9%), and 161 (25.6%) cases. The accuracy of frozen section diagnosis was analyzed according to histologic type and malignancy potential. RESULTS: The overall accuracy of frozen section diagnosis was 93.9%. The accuracy for benign, borderline, and malignant tumors were 93%, 92%, and 98%, respectively. The accuracy of frozen section diagnosis was significantly low in mucinous tumors and borderline malignant tumors. However the borderline malignancy was the only independent factor associated with the inaccuracy of frozen section diagnosis (OR: 12.2, 95% CI: 6.5-23.1). The sensitivity for immature teratoma was as low as 63.6%. CONCLUSION: Our data shows that the accuracy is low in mucinous tumors, borderline tumors, and immature teratomas and the borderline malignancy is independent factor associated with inaccuracy of frozen section diagnosis.

A case of parovarian tumor of borderline malignancy / 부인종양

Parovarian cysts, generally known as hydatid cysts of Morgagni, are small round cysts attached by a pedicle to the fimbriated end of the tube. Due to the rarity of this lesion, there are controversies concerning the origin, clinical behavior, treatment and prognosis of these tumors. Parovarian borderline malignancy mostly occur in young women, main complaints are abdominal enlargement and pelvic pain. we experienced one case of parovarian borderline malignancy and report this case with a brief review of literature.

A case of paraovarian tumor of boderline malignance / 대한산부인과학회지

Paraovarian cysts arise in the mesosalpinx, between the ovarian hilum and the fallopian tube. Clinical significance of paraovarian tumors is considerably less frequent than ovarian tumors, and malignant paraovarian lesions are exceedingly rare. Paraovarian carcinomas or borderline malignancy mostly occur in young women. Abdominal enlargement and pelvic pain are the usual complaints. Usually they have a capsule, are unilateral and are connected to the broad ligament. Little is known about the biological behavior of the paraovarian borderline malignancies, since these lesions are so rare. The appropriate therapy for this unusual lesion have not been fully defined. We had experienced a case of papillary serous adenocarcinoma of borderline malignancy and report this case with a brief review of literature.

Mucinous Borderline tumor associated with Mature Cystic Teratoma of Ovary / 부인종양

OBJECTIVE: To evaluate the clinicopathological characteristics of mucinous borderline tumor associated with mature cystic teratoma and the origin of its cell type. METHODS: Five patients who were diagnosed as mucinous borderline tumor associated with mature cystic teratoma and treated in Samsung Cheil Hospital from January 1996 to September 2004 were analyzed. In addition MEDLINE, other data bases in English as well as in Korean revealed two more cases. We analyzed the result with patient's characteristics, preoperative symptoms, mass sizes, serum CA-125, operative procedure, stages, recurrence and survival period. Histological slides of the specimens were analysed for expression of cytokeratin (CK)-7 and cytokeratin (CK)-20 by immunohistochemical staining to know the origin of the cell. RESULTS: The mean age was 45 years (25-61 years). Preoperative symptoms were palpable abdominal mass, abdominal pain and urinary frequency. The mean level of CA-125 was 46.05 U/mL and the mean tumor size was 16.75 cm (8.8-22.0 cm). Post surgical FIGO staging was; stage Ia in 6 cases, stage Ic in 1 case. Four cases were CK7(-)/CK20(+), reflecting gastrointestinal origin, and also showed pattern of pseudomyxoma peritoneii. Mean survival period was 32.7 months (6-67 months) without evidence of recurrence, except one case. CONCLUSION: Our findings suggest that mucinous borderline tumor associated with mature cystic teratoma, is diagnosed at relatively young age and early stage, associated with good prognosis.

A case of primary parovarian cystadenocarcinoma of borderline malignancy / 대한산부인과학회지

Parovarian tumors may be of mesothelial, mesonephric (Wolffian), or paramesonephric (Mullerian) origin. An estimated 10% of adnexal masses are parovarian cysts, most commonly mesothelial or paramesonephric in origin. Benign neoplasms such as cystadenomas may occasionally develop in parovarian cysts. Malignancy has been reported in 2.0% to 2.8% of parovarian cystic masses, but it seems to be even less frequent in masses smaller than 5 cm. The histologic appearance of the tumor is identical with that of tumors of ovarian origin. However, their similarity of biologic behavior is uncertain. The appropriate therapy for this unusual lesion has not been fully defined, since a minimal amount of follow-up data is available on the few cases which have been reported. We had experienced a case of papillary serous cystadenocarcinoma of borderline malignancy arising from a parovarian paramesonephric cyst and report this case with a brief review of literature.

A Case of Parovarian Serous Cystadenocarcinoma of Borderline Malignancy / 대한산부인과학회잡지

Although parovarian cysts constitute 10-20% of all adnexal masses, malignant parovarian tumors are extremely rare. Due to the rarity of this lesion, there are controversies concerning the origin, clinical behavior, and prognosis of these tumors. Currently, it is suggested that these paovarian tumors should be treated similarly to their ovarian counterparts. We experienced one case of parovarian serous cystadenocarcinoma of borderline malignancy, and report this with a brief review of the literatures.

A Clinicopathologic Characteristics and Survival Analysis of Ovarian Tumors / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to identify the clinicopathologic characteristics, treatments and overall 5-year survival and to analyze the prognostic factors affecting the survival in patient with ovarian tumors. METHODS: We reviewed retrospectively the outcome of 116 patients with ovarian cancer and 64 patients with borderline malignant ovarian tumor, who had been treated at Department of Obstetrics and Gynecology, Korea University Anam Hospital from Jan. 1991 to Dec. 2001. Univariate and multivariate analysis for survival were conducted to test the prognostic significance of several clinicopathologic factors. RESULTS: The mean age of the patients with borderline malignant ovarian tumor was 39.9 years old, and nulliparity was most common (42.2%). Mucinous tumor was the most common histologic subtype (68.8%). The FIGO stage distribution of borderline malignancy were 89.1%, 1.6%, 9.3% for stage I, II, and III, respectively. The overall 5-year survival rate of patients with borderline malignancy was 98.4%. The mean age of the patients with ovarian cancer was 50.1 years old. The incidence of ovarian cancer according to histologic type were 74.1%, 12.9%, 11.2%, 0.9%, 0.9%, in epithelial ovarian cancer, Sex-cord stromal tumor, malignant germ cell tumor, metastatic carcinoma of the ovary, and small cell carcinoma, respectively. The FIGO stage distribution of ovarian cancer were 40.5%, 12.1%, 42.2%, 5.2% for stage I, II, III, and IV, respectively. The overall 5-year survival rate of patients with ovarian cancer was 60.9%. In multivariate analysis, FIGO stage was identified as a significant independent prognostic factor in this study. CONCLUSION: In this study, patients with borderline malignancy of the ovary have good prognosis and the overall 5-year survival rate was 98.4%. Otherwise, the overall survival rate of patients with ovarian cancer was 60.9% and the stage was most important prognostic factor.

Importance of Conservative Management in Borderline Malignancy of the Ovary / 대한부인종양콜포스코피학회잡지

OBJECTIVES: To clarify the clinicopathologic features of borderline malignancy of the ovary and analyze the treatment and survival characteristics through the study of our cases. Study METHODS: 102 patients with borderline tumors of the ovary, aged from 14 to 79 years, treated between 1982 and 1999 at Seoul National University Hospital, were analyzed retrospectively for clinicopathologic features. Most informations about stage, treatment modality and prognosis were obtained by hospital record or contacting patient with telephone. RESULTS: There were 77 patients (75.5%) with stage Ia, 5 stage Ib, 11 stage Ic, 4 with stage II and 5 with stage III by the classification of FIGO. 72 patients (70.6%) were mucinous type and 28 (27.5%) were serous type, 1 endometrioid type, 1 mixed. Total abdominal hysterectomy, bilateral adnexectomy, and omentectomy were performed in 43 (42.2%) patients and fertility saving surgery in 43 patients(cystectomy in 11 patients, USO in 32 patients). Twenty two patients (21.6%) were treated with postoperative adjuvant chemotherapy. The median duration of follow up was 54.0 months (1-204 months) and 6 patients developed recurrence after several years from the primary operation. The ten-year eumulative survival rate was 92.2% and the only independent prognostic factors evaluated by Cox analysis in regards to corrected survival were the FIGO stage (p=0.0197). There was no difference in the ten-year survival rate between surgery types - conservative surgery versus full surgical staging. And there was no difference in the 10-year survival rate between treatment groups - surgery only versus surgery followed by adjuvant chemotherapy. CONCLUSIONS: FIGO stage is the only independent prognostic factor in the borderline ovarian tumors. There was no difference in the 10-year survival rate of barderline ovarian tumors between surgery alone versus surgery followed by adjuvant chemothearpy. The slow clinical course, low recurrence rate and good prognosis in our patients explained again the reason for therapeutic approach relying on surgery alone.

A Clinicopathologic Analysis of Pseudomyxoma Peritonei Originated from Mucinous Ovarian Tumors / 대한산부인과학회잡지

OBJECTIVE: The aims of this study were to analyze the natural history of patients with pseudomyxoma peritonei originated from mucinous ovarian tumor, evaluate clinical and pathologic variables, and review our experience with available therapeutic modalities. METHODS: Six patients were treated for pseudomyxoma peritonei originating from mucinous ovarian tumor at Severance Hospital between 1990 and 1998. The data were collected retrospectively and all charts were reviewed RESULTS: The mean age at diagnosis was 51 years, and most common symptoms were abdominal distension. Pseudomyxoma peritonei was found in association with five mucinous ovarian tumors of borderline malignancy, and one ovarian mucinous adenoma. All patients underwent surgical staging and cytoreduction, three patients received postoperative adjuvant chemotherapy and, of these, two developed recurrence. With respect to survival, all patients were alive, four were alive and free of disease, two were alive with disease at the end point of study. CONCLUSION: Pseudomyxoma peritonei is commonly associated with borderline mucinous ovarian tumors, and is a frequently relapsing and protracted disease. But aggressive and repeated debulking surgery is recommended for long survival.

Papillary Serous Cystadenoma of Borderline Malignancy Arising from a Paramesonephric Parovarian Cyst: A case report

Primary malignant parovarian epithelial tumors are extremely rare, with only 56 cases previously reported in the world literature. Most parovarian epithelial tumors are of paramesonephric (Mullerian) origin. In this article, we report the first case in the Korean literature of papillary serous cystadenoma of borderline malignancy from paramesonephric parovarian cyst. This case presented here is of particular interest since this neoplasm is rare. A 48-year-old female underwent a hysterectomy with bilateral adnexectomy and pelvic lymph node dissection for a cystic tumor of the right parovarian area. The tumor, measuring 13 cm in diameter, was apart from the ovaries, fallopian tubes and uterus. The cyst wall had well-developed smooth muscle layers. The cyst was lined with mildly atypical ciliated and non-ciliated low columnar cells compatible with those of paramesonephric origin. From the inner surface of the cyst several cauliflower-like structures projected into the lumen. They were of a predominantly papillary architecture covered by atypical epithelial cells with piling-up and occasional glandular growth. No destructive stromal invasion was identified.

A Case of Ovarian Mucinous Cystadenoma, Borderline Malignancy in Pediatric Patient

Ovarian tumors of an epithelial origin in pediatric age are uncommon and mucinous cystadenoma, borderline malignancy is extremely rare. We experienced a case of ovarian mucinous cystadenoma, borderline malignancy in a 14-year-old girl. She was admitted due to huge abdominal distension for 2 months. Her past history and family history were normal. The physical examination was normal except tense and distended abdomen. All laboratory findings were normal. On abdominal ultrasonography and CT scan, a huge cystic tumor filled with fluid and inner multiseptation was noted. Unilateral salphingo- oophorectomy was done and pathologic findings were compatible with ovarian borderline malignancy of mucionous cystadenoma. The postoperative course was uneventful.

A Case of Ovarian Mullerian Mucinous Papillary Cystadenoma of Borderline Malignancy / 대한암학회지

Ovarian mucinous cystadenoma of borderline malignancy was consisted of intestinal mucinous cystadenomas of borderline malignancy and Mullerian mucinous papillary borderline tumors. Mullerian mucinous papillary tumors was lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors. These tumors have clinical and pathologic differences from those of intestinal mucinous cystadenomas of borderline malignancy.We report a case of ovarian Mullerian mucinous papillary cystadenomas of borderline malignancy with review of literature.

A Serous Papillary Cystadenoma of Low Malignant Potential in Paratesticular Tissue

The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

A Case of Huge Ovarian Tumor / 대한부인종양콜포스코피학회잡지

We experienced a huge ovarian tumor of 16kg, measured 29 x 25 x 30cm in 85 years old woman. Pathologic diagnosis was mucinous cystadenoma, borderline malignancy of right ovary. We present this case with brief review of literatures.

A Case of Huge Ovarian Tumor / 대한부인종양콜포스코피학회잡지

We experienced a huge ovarian tumor of 16kg, measured 29 x 25 x 30cm in 85 years old woman. Pathologic diagnosis was mucinous cystadenoma, borderline malignancy of right ovary. We present this case with brief review of literatures.