A study for diagnosis of squamous cell carcinoma arising from mature cystic teratoma / 대한산부인과학회지

OBJECTIVE: To evaluate factors for diagnosis of squamous cell carcinoma arising from ovarian mature cystic teratoma and whether squamous cell carcinoma (SCC) antigen, CA125, CA19-9 and CEA is useful for detection of the malignant transformation of mature cystic teratoma of ovary. METHODS: From October 1999 to December 2008, 11 patients with malignant transformation arising from ovarian mature cystic teratoma were treated at Departments of Obstetric and Gynecology in Samsung Medical Center. Demographic characteristics, symptoms, sign, preoperative images, stage, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: The incidence of squamous cell carcinoma arising from ovarian mature cystic teratoma was 0.15% (11/7,345) in this hospital. The median age of patients was 60.8 years (range, 48~73 years). The most common preoperative diagnosis is mature cystic teratoma (n=5), followed by malignant transformation of mature cystic teratoma (n=3), colon cancer (n=2), primary epithelial ovarian cancer (n=1). SCC antigen level was elevated in five patients (45.4%) and CA125 was elevated in seven patients (63.6%). Median longitudinal diameter of ovarian tumors was 11.1 cm. All the patients were surgically staged. CONCLUSION: We should consider women, old aged and had large sized ovarian teratoma, were associated with development of malignant transformation of ovarian mature cystic teratomas, especially squamous cell carcinoma. CEA, CA19-9, and SCC antigen, in addition to CA125, should be used for tumor markers.

Comparison of fetal magnetic resonance imaging and ultrasonography for the diagnosis of fetal anomalies / 대한주산의학회잡지

PURPOSE: To compare the accuracy of fetal magnetic resonance imaging (MRI) and prenatal ultrasonography (USG) with postnatal diagnosis for the diagnosis of fetal anomalies. METHODS: Retrospective analysis of 41 fetuses who underwent fetal MRI with prenatal USG from 2005 to 2008 was performed. In 28 cases of the total population, the final neonatal diagnosis was also analyzed for the consistency of pre- and postnatal diagnoses for each diagnostic tool. Postnatal diagnosis was confirmed by physical examination, radiographic studies (USG, MRI and/or computed tomography), surgery, and/or autopsy. RESULTS: Mean gestational age at the fetal MRI performed was 26.1+/-4.7 weeks. The most common indication of the fetal MRI was central nervous system (CNS) anomalies (n=12), followed by thoracic anomalies (n=5), abdominal anomalies (n=2), genitourinary anomalies (n=3), head and neck anomalies (n=4), and others (n=2). When compared with postnatal diagnosis, the accuracy of prental MRI was superior to prenatal USG (89% vs. 71%). The cases with additional accurate diagnosis with using fetal MRI were 4 CNS, 1 genitourinary, and 1 craniofacial anomaly. Of notes, there was a case of enlarged cisterna magna in which prenatal MRI missed the diagnosis. In 2 cases (7.1%), both imaging studies made an incorrect prenatal diagnoses. CONCLUSION: Fetal MRI could confirm the USG diagnosis in most cases and provided more accurate diagnosis in some cases of CNS and thoracic, genitourinary system abnormalities. MRI is expected to be a good adjunctive for USG to improve prenatal diagnosis of fetal anomalies.