ABSTRACT
STUDY OBJECTIVE: To evaluate the accuracy and usefulness of intraoperative diagnosis of ovarian tumor during laparoscopic surgery. DESIGN: Retrospective cohort study (Canadian Task Force classification II-3). SETTING: Tertiary care university hospital. PATIENTS: We reviewed the cases of 262 patients who underwent laparoscopic surgery at our institution between January 2005 and December 2011 in whom a benign ovarian tumor was diagnosed intraoperatively. INTERVENTIONS: Intraoperative pathologic assessment of frozen sections. MEASUREMENTS AND MAIN RESULTS: Intraoperative diagnosis of ovarian tumors demonstrated sensitivity of 80%, specificity of 99.6%, positive predictive value of 80%, and diagnostic accuracy of 99.2%. Mucinous tumors diagnosed intraoperatively showed differing intraoperative and final pathologic diagnoses significantly more frequently than did other types of tumors. CONCLUSION: Intraoperative pathologic assessment of benign ovarian tumors during laparoscopic surgery is reliable. However, clinicians should recognize that it is possible to make an incorrect diagnosis in some situations and should exercise caution accordingly.
Subject(s)
Carcinoma, Endometrioid/pathology , Cystadenocarcinoma/pathology , Cystadenoma/pathology , Endometriosis/pathology , Intraoperative Care , Ovarian Neoplasms/pathology , Teratoma/pathology , Adolescent , Adult , Aged , Canada , Carcinoma, Endometrioid/surgery , Child , Cohort Studies , Cystadenocarcinoma/surgery , Cystadenoma/surgery , Endometriosis/surgery , Female , Frozen Sections , Humans , Laparoscopy , Middle Aged , Ovarian Diseases/pathology , Ovarian Diseases/surgery , Ovarian Neoplasms/surgery , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Teratoma/surgery , Young AdultABSTRACT
Desmoplastic small round cell tumor (DSRCT) is a rare intra-abdominal tumor of uncertain histogenesis that occurs predominantly in young males. We report two cases of DSRCT in young women that presented clinically as ovarian tumor with extensive pelvic and abdominal dissemination. Both patients underwent debulking surgery and combined chemotherapy. After primary therapy, the tumors recurred and both women died of the disease. The clinical presentation and differential diagnosis, as well as the treatment, including surgical debulking and combined chemotherapy are discussed.
Subject(s)
Ovarian Neoplasms/pathology , Sarcoma, Small Cell/pathology , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Diagnosis, Differential , Fatal Outcome , Female , Humans , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgery , Ovary/pathology , Sarcoma, Small Cell/drug therapy , Sarcoma, Small Cell/surgery , Treatment OutcomeABSTRACT
Primary ovarian carcinoid tumors are rare. It has been reported that constipation was a presenting symptom in some patients with ovarian carcinoid. A case of strumal carcinoid of the ovary with contralateral clear cell adenocarcinoma of the ovary discovered with a complaint of constipation is described. Constipation was dramatically improved by resectioning the tumor. The tumor cells were positive for peptide YY (PYY) in the carcinoid component, but not in any other components. The present case could provide evidence of the correlation between constipation and PYY that has been reported elsewhere. Interestingly, the constipation caused by PYY also helped in discovering epithelial ovarian cancer.
Subject(s)
Adenocarcinoma, Clear Cell/complications , Carcinoid Tumor/metabolism , Constipation/etiology , Ovarian Neoplasms/metabolism , Peptide YY/metabolism , Adenocarcinoma, Clear Cell/pathology , Carcinoid Tumor/complications , Carcinoid Tumor/pathology , Constipation/metabolism , Female , Humans , Middle Aged , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/metabolism , Neoplasms, Multiple Primary/pathology , Ovarian Neoplasms/complications , Ovarian Neoplasms/pathology , Ovary/pathologyABSTRACT
Spiral chaos appears in the two-dimensional Aliev-Panfilov model. The generation mechanism of the spiral chaos is related to the breathing instability of pulse trains. The spiral chaos can be eliminated by applying periodic force uniformly. The elimination of the spiral chaos is most effective when the frequency of the periodic force is close to that of the breathing motion.
