Tumor seroso borderline de ovarios tratamiento preservador de fertilidad: caso clínico revisión de la literatura / Borderline ovarian serous tumor fertility preservative treatment. clinical case literature review

Los tumores de ovario borderline representan 10 %-20 % de los tumores malignos de ovario, y son reconocidos como una categoría independiente de los tumores epiteliales de ovario sin invasión al troma. Actualmente la cirugía laparoscópica se ha convertido en el gold standard en el tratamiento de esta afección. Paciente de 21 años de edad con tumor de ovario seroso borderline en estadio IA. Se realizó protocolo conservador de ovario por vía laparoscópica (un solo puerto umbilical). pacientes que no tienen una laparotomía clasificadora o protocolo de ovario, son asociados a una tasa mayor de recurrencia en comparación con los que sí fueron tratados con laparotomía clasificadora (11,8 % vs. 7,1 %, respectivamente). La indicación de cirugía clasificadora a pacientes sin protocolo, se mantiene controversial. La laparoscopia con portal único cada día cobra más terreno en cirugía, y la cirugía oncológica no escapa de ello. El empleo de técnicas menos invasivas, con menores efectos adversos, presentan una propuesta interesante para el tratamiento de esta patología(AU)

The borderline ovarian tumors account for 10 % - 20 % of the malignant ovarian tumors, and are recognized as a separate category of the epithelial ovarian tumors without invasion of the stroma. urrently the laparoscopic surgery has become the gold standard in the treatment of this condition. We presented a female patient of 21 years of age with diagnostic of serous borderline ovarian tumor classified as stage IA. The ovarian conservative protocol was performed laparoscopically (single umbilical port). DISCUSION: The patients, who do not have a staging surgery, are associated with a higher rate of recurrence compared with those that were treated with the staging surgery (11.8 % vs 7.1 %, respectively). Re staging surgery to this patients without protocol, remains controversial. The laparoscopy with the single port every day becomes more ground in the surgery and the oncological surgery does not escape to it. The use of the less invasive techniques, with fewer adverse effects, has an interesting proposal for the treatment of this disease(AU)

Salpingectomia "oportuna" como profilaxia do câncer de ovário / "Timely" salpingectomy for ovarian cancer prophylaxis

O câncer de ovário é o tumor ginecológico mais letal, alvo de interesse de centenas de estudos publicados anualmente, buscando melhor entendimento fisiopatológico e a possibilidade de métodos de rastreio. Trata-se da quinta causa de morte por câncer em mulheres, sendo, na maioria das vezes, encontrado em estágios avançados. Existem diversas teorias sobre a origem do câncer de ovário, sendo uma delas a de que a neoplasia ovariana teria sua origem nas tubas uterinas. Sendo assim, estudos sugerem que a exérese das tubas uterinas poderia reduzir a incidência da neoplasia maligna ovariana. A proposta do artigo é realizar uma revisão sobre a salpingectomia bilateral durante cirurgias pélvicas eletivas e suas implicações na qualidade de vida da paciente, seu potencial preventivo e possíveis complicações.(AU)

Ovarian cancer is the most lethal gynecological tumor. Hundreds of manuscripts are annually published, aiming better pathophysiological understanding and screening strategies. Ovarian cancer is the fifth of cancer death in women worldwide and, in most times, the diagnosis is performed in advanced stages. There are several theories about the origin of ovarian cancer, one of which is that the ovarian cancer would have their origin in the fallopian tubes. Thus, current research suggests that the removal of the tubes could reduce the incidence of ovarian malignancy. The purpose of the article is to review of the bilateral salpingectomy during elective pelvic surgeries and their implications for the quality of life of the patient, its preventive potential and possible complications.(AU)

Clinical management of incidental findings on pelvic adnexal masses / Manejo clínico dos achados incidentais de massas pélvicas anexiais

Summary Due to widespread use of pelvic and transvaginal ultrasound in routine gynecological evaluation, the incidental finding of adnexal masses has led to discussions about management in asymptomatic patients regarding the risk of ovarian cancer. Transvaginal ultrasonography remains the modality of choice in the evaluation of suspicious characteristics. The combined analysis of ultrasound morphological parameters with Doppler study, serum carcinona antigen 125 and investigation of a symptom index may improve diagnosis. Surgical approach should be considered whenever there are suspicious images, rapid growth of cysts, changes in the appearance compared to the initial evaluation or when the patient has symptoms. Future studies on genetic and molecular mechanisms may help explain the pathophysiology of ovarian cancer, improving early diagnosis and treatment.

Resumo Em virtude da ampla utilização da ultrassonografia pélvica e transvaginal na avaliação ginecológica de rotina, o achado incidental de massas anexiais tem ocasionado discussões sobre a conduta em pacientes assintomáticas frente ao risco de desenvolvimento do câncer de ovário. A ultrassonografia transvaginal continua a ser a modalidade de primeira escolha na avaliação de características suspeitas. A análise conjunta de parâmetros morfológicos ultrassonográficos com o estudo Doppler, a pesquisa de CA-125 e a investigação de índice de sintomas pode incrementar as taxas de diagnóstico. Abordagem cirúrgica deve ser considerada sempre que houver alterações em exames de imagem, quando houver crescimento rápido do cisto, mudanças em seu aspecto em relação à avaliação inicial ou quando a paciente apresentar sintomatologia. Uma compreensão melhor de mecanismos genéticos e moleculares pode auxiliar na elucidação da fisiopatologia do câncer ovariano, aprimorando seu diagnóstico e tratamento precoces.

Is hysterectomy needed in ovarian cancer.

Context: Hysterectomy is an integral part of ovarian cancer surgery. The authors have evaluated the uterine involvement in ovarian cancer in this study. Aims : Conventionally, removal of the uterus is considered an essential part of ovarian cancer surgery, but rationale for same in absence of its gross involvement is questionable. Aim of this study was to evaluate the microscopic involvement of uterus in ovarian cancer and whether there are any predictors of uterine involvement. Settings and Design: Retrospective study. Materials and Methods: The authors analyzed 128 patients of epithelial ovarian cancer (EOC) operated from 2004 January to 2008 June, who had not undergone hysterectomy previously. Data regarding their demographic, clinical, and pathological findings was collected and analyzed. Statistical analysis used: Chi-square test. Results: Most of our patients (n=111) presented with stage III or above. Serous carcinoma was the most common histology encountered (86.7%). Uterus was grossly involved in only 19 patients and microscopic involvement was noted in 20 patients. Only one patient with absence of gross involvement had microscopic disease in the uterus. Involvement of the uterus was found to be independent of stage, type of tumor, laterality, and preoperative chemotherapy. The grade of tumor and gross uterine involvement were only factors that showed statistically significant correlation with microscopic uterine involvement. Only one patient had synchronous endometrial cancer. Conclusions: Uterine involvement in EOC is not common. Absence of gross uterine involvement reliably predicts absence of microscopic disease.

Incidence rate of ovarian cancer in Iran in comparison with developed countries.

Background: Ovarian cancer is one of the most common gynecologic malignancies. The present study was designed to compare age-standardized incidence rate (ASR) of ovarian cancer in Iran with that in Australia and some other developed countries. Materials and Methods: Data from the Cancer Registry Program of Iran, as a base, were compared with the cancer registry reports of surveillance, epidemiology and end results program in the USA, considering the population of the USA in the year 2000 as the standard population. Results: In all the age groups, ASR of ovarian cancer was much lower in Iran. Overall rates of ovarian cancer in Iran and the USA were 3.9 and 16.2 per 100,000, respectively. Conclusion: Age-standardized ovarian cancer rate in Iran was much lower in comparison with high incidence areas in the world. Encouraging oral contraceptive use and reduction in fat intake may be effective in decreasing the rate of ovarian cancer or keeping its rate constant in Iran.

Tumores germinativos do ovário: conduta / Germ cell ovary tumors: conduct

O artigo apresenta uma revisão sobre o manejo de tumores malignos de células germinativas do ovário, com especial atenção para o tratamento cirúrgico e adjuvante. Adicionalmente, discute a repercussão desta conduta no futuro reprodutivo e endocrinológico das pacientes.

This article reviews ovary germ cells malignant tumors management with special attention to surgical and adjuvant treatments. In addition, the consequence of these procedures on patient's reproduction and endocrinology are discussed.

Quistes y tumores del ovario en la infancia / Cysts and tumor of the ovary in chilhood

Se revisa la casuística de los quistes y tumores del ovario operados en el Servicio de Cirugía Pediátrica del Hospital Juárez de México, de la Secretaría de Salud, en los últimos seis años. Se analizan la edad, el tamaño y el tipo de tumor, los signos y síntomas principales; los análisis de laboratorio, los estudios de gabinete, el diagnóstico preoperatorio y el tratamiento quirúrgico y su estadificación. Se encontraron 41 neoplasias del ovario (16 quistes funcionales y 25 tumores primarios). El 72 por ciento fueron tumores de células germinales y el 28 por ciento epiteliales benignos. El teratoma quístico benigno fue el tumor más frecuente (44 por ciento). En 93 por ciento de los casos se hizo el diagnóstico preoperatorio correcto. 28 por ciento de las pacientes tuvieron tumores malignos, que fueron tratados con cirugía y referidos a otros hospitales para su tratamiento complementario

Tumor "borderline" de ovário / Borderline tumors of the ovary

Os autores fazem uma revisäo bibliográfica sobre os tumores "borderline" de ovário, enfatizando os tipos histológicos e suas relaçöes com história natural, tratamento e prognóstico destas neoplasias ovarianas

The largest ovarian cyst in Songklanagarind Hospital: a case report.

Giant ovarian cysts (more than 12 kilogram) are now rarely seen because of the development in health care systems and education. We report a patient with an ovarian cyst weighing 64 kilogram, marked distended abdomen, tachypnea and dyspnea, pitting edema of both legs and inability to walk. The successful management required multidisciplinary team approach. Slow paracentesis of the cyst was done to relieve 20 litres of fluid before surgery to improve the respiratory function. Subtotal hysterectomy with bilateral salpingo-oophorectomy and partial omentectomy was done with about 4 litres of blood loss during operation. We replaced with 9 units of packed red cells and 25 units of fresh frozen plasma and plasma. Postoperative complications were pneumonia, urinary tract and surgical wound infection which were treated by appropriate antibiotics, dressing and physiotherapy until the patient was able to walk. She was discharged home on postoperative day 33. The pathological report of this cyst was mucinous cystadenoma. Only 4 courses of prophylactic chemotherapy were given because she was lost to follow-up.

Androblastoma de ovario; aspectos clinico-patologicos presentacion de un caso / Clinicopathologycal aspects of a case of androblastoms of ovary

Presentamos un caso de androblastoma, en una paciente de 52 anos de edad, que acudio con un cuadro clinico de amenorrea y signos de virilizacion. El objetivo de este reporte es mostrar un caso de neoplasia rara entre los tumores ovaricos y analizar las caracteristicas clinicas y patologias.

Esterilidad producida por endometiosis / Esterility due to endometiosis

Se ha tratado de interpretar las posibles causas de esterilidad por endometriosis. Se recuerda la definición de endometriosis externa y de estrogenismo sostenido. Se trata cono único tema la probable etiología de la esterilidad producida por endometriosis, dejando de lado aquellas que pueden llegar a ocasionar la endometiosis externa. Motivos de esterilidad por endometriosis externa: a) Factores ambientales, familiares y genéticos, de gran importancia etiológica, pero desafortunadamente hasta el presente estudiados en forma incompleta. b) Alteraciones hipófiso-tiroides-ovario, en particular las producidas por hipotiroidismo a nivel ovárico y endometrial. c) problemas inmunológicos demostrados en: Mucosa endometrial, placas y quistes endometriósicos, así como en la endometriosis primaria del ovario. d) Factores mecánicos y adherenciales que favorecen bloqueos: ováricos y pelvis congelada