A 20 year-old woman presented with features of a twisted ovarian cyst and had an emergency laparotomy Intraoperative findings revealed bilateral, solid ovarian tumors and a left oophorectomy with biopsy of the contralateral ovary performed. Histopathology report confirmed Burkitt lymphoma of ovary. There was no other evidence of lymphoma elsewhere. The primary Burkitt lymphoma of the ovaries was successfully managed with six courses of highly toxic chemotherapy (Berlin-Frankfurt- Munster 1986 protocol). The patient has remained disease free for the last 36 months.
Massive ovarian cysts are not commonly encountered. They frequently present a challenge to the gynaecologist who is faced with them. Two cases of successful removal of massive ovarian cysts are presented. Successful management would involve recognition of complications which occur at various steps in the treatment.
We report here a rare case of bilateral pure gonadoblastoma which accounts for only 0.2% of all ovarian tumours seen at Universiti Kebangsaan Malaysia from 1980 to 1987. This tumour occurred in an 18 year old Chinese "female" who presented with primary amenorrhoea. Examination showed a phenotypic female with poorly developed external gentalia. Exploratory laparotomy revealed a hypoplastic uterus, rudimentary fallopian tubes and streak gonads. Histological examination of the gonads showed a mixed tumour comprising large germ cells and smaller sex cord derivatives arranged in characteristic nests or islands containing hyaline material.
Torsion of ovarian tumors occurred predominantly in the reproductive age group. The majority of the cases presented in pregnant (22.7%) than in non-pregnant (6.1%) women. The major presenting symptom was pain but an abdominal mass was palpable in 79.4% of cases. Torsion was more common on the right ovary and 50% were gangrenous at laparotomy. Most of the tumors were benign cystic teratomas. Only 8.7% of the tumors were malignant.
The primary retroperitoneal serous adenocarcinoma (PRSAC) is a rare malignant tumor of the retroperitoneum. It shares the same pathological and biological behavior with ovarian serous carcinoma. Most of the cases develop as peritoneal adenocarcinoma and rarely occur in the retroperitoneum. It is reported as serous surface papillary carcinoma of the peritoneum and extraovarian peritoneal serous papillary carcinoma. We present a case of PRSAC in a 60-year-old woman. Only 11 cases of PRSAC have been reported from 1983 to 2019. Histopathological features with immunohistochemical expressions are important to diagnose PRSAC. The outcome and survival mainly depend on the possibility of surgical resection. Molecular genetics of PRSAC should also be studied in relation with its ovarian counterpart.
This is an analysis of ovarian neoplasms encountered in Sarawak during the period January 1976-December 1977. There were 149 benign and 36 primary malignant tumours with an incidence of 44.3 per cent and 23.6 per cent respectively, in neoplasms 01 the Reproductive System. Amongst the benign ovarian tumours Dermoid Cyst
(Cystic Teratoma) was quite frequent (29.5 per cent). In malignant neoplasms Cystadenocarcinomas constituted 66.7 per cent of the total. A case each of Granulosa cell earcinoma, Adenoacanthoma and Endodermal sinus tumours, 4 of Dysgerminoma and 6 of metastatic ovarian tumours were also recorded.
Pancreatic metastases are very uncommon and originate most commonly from lung, colon, breast and kidney cancer. Ovarian adenocarcinoma has been reported as a primary site of pancreatic metastasis, but its diagnosis has rarely being reported by endoscopic ultrasound guided fine needle aspiration (EUS-FNA). We report a case of multiple metastases to the pancreas from ovarian carcinoma occurring four years after original resection of the primary tumour. Our patient presented with severe epigastric pain which was initially treated as acute pancreatitis. Further imaging modalities showed multiple large pseudocystic lesions in the pancreatic head and body. Subsequent EUS-FNA confirmed that the lesions were metastatic disease from an advanced ovarian carcinoma. She underwent palliative chemotherapy and the pancreatic lesion showed receding size.
The decoction of the whole plant of Physalis minima L. is traditionally consumed to treat cancer. Its anticancer property has been previously verified (using in vitro cytotoxicity assays) against NCI-H23 lung, CORL23 lung and MCF7 breast cancer cell lines but the mechanism underlying the anticancer potency towards ovarian carcinoma cells remain unclear.
A dinuclear gold(I) pyrrolidinedithiocarbamato complex (1) with a bidentate carbene ligand has been constructed and shows potent in vitro cytotoxic activities towards cisplatin-resistant ovarian cancer cells A2780cis. Its rigid scaffold enables a zinc(II)-based metal-organic framework (Zn-MOF) to be used as a carrier in facilitating the uptake and release of 1 in solutions. Instead of using a conventional dialysis approach for the drug-release testing, in this study, a set of transwell assay-based experiments have been designed and employed to examine the cytotoxic and antimigratory activities of 1@Zn-MOF towards A2780cis.
An invasive mole causing uterine perforation is a rare occurrence. We describe below a case with an unusual presentation which was mistaken for an ovarian tumour. The difficulty in diagnosis and the need for a high index of suspicion is highlighted.
Twenty-three cases of ovarian fibroma, comprising 3% of all benign tumors seen over a 20-year period, were analyzed. It was unilateral in all cases affecting more commonly the left ovary (70%). Whilst a majority of cases (77%) were encountered in the reproductive age group, the tumor was rare before the second decade. Only in 13% of cases was ascitis clinically detectable. This was not influenced by the size and weight (average of 9.3 x 10.8 x 11.1 cm and 959 g, respectively) of the tumors; a smooth-surfaced tumor was, however, associated with a greater amount of peritoneal fluid. Varying degrees of calcification in some tumors are detectable on ultrasonography and occasionally on abdominal radiography. The classical Meig's Syndrome was seldom encountered. The histopathological features, diagnostic problems and management are discussed.
A study of 207 benign ovarian tumors seen at the University Hospital, Kuala Lumpur between 1968 and 1975 was made to evaluate the clinical features that might be useful in the preoperative differentiation of mucinous cystadenoma, serous cystadenoma, and cystic teratoma of the ovary. This study indicated that the pertinent information included the mean age of the patient, the marital and menstrual status, and the estimated tumor size. The racial background was an additional factor in serous cystadenoma. Features like parity, the location of the tumor, and ABO blood group pattern were of no value in the preoperative differentiation.
Vaginal Brenner tumor is extremely rare. Only five cases have been reported in the English literature to date. Here we report a vaginal Brenner tumor in a 76-year old postmenopausal woman, who presented with a 2.5cm-sized sessile vaginal polyp. Microscopically, it showed characteristic features of Brenner tumor consisting of three components; transitional islands, glands, and dense fibrous stroma. The epithelial tumor cells were positive for GATA-3, p63 and ER, but negative for PAX8. The origin of Brenner tumors in the vagina is unclear, but previous reports suggested of Müllerian origin. However, our case revealed that vaginal Walthard nests could be possible precursor lesions based on their immunohistochemical staining results.
Cancer is known to induce or alter the O-glycosylation of selective proteins that may eventually be excreted in the patients' urine. The present study was performed to identify O-glycosylated proteins that are aberrantly excreted in the urine of patients with early stage ovarian cancer (OCa). These urinary glycoproteins are potential biomarkers for early detection of OCa. In this study, urinary proteins of patients with early stage OCa and age-matched OCa negative women were subjected to two-dimensional gel electrophoresis and detection using a lectin that binds to the O-glycosylated proteins. Our analysis demonstrated significant enhanced expression of clusterin and leucine-rich alpha-2-glycoprotein, but lower levels of kininogen in the urine of the OCa patients compared to the controls. The different altered levels of these urinary glycoproteins were further confirmed using competitive ELISA. Our data are suggestive of the potential use of the aberrantly excreted urinary O-glycosylated proteins as biomarkers for the early detection of OCa, although this requires further validation in a large clinically representative population.
Ovarian cancer is the most common cause of death among gynecological malignancies. We discuss different types of clinical and nonclinical features that are used to study and analyze the differences between benign and malignant ovarian tumors. Computer-aided diagnostic (CAD) systems of high accuracy are being developed as an initial test for ovarian tumor classification instead of biopsy, which is the current gold standard diagnostic test. We also discuss different aspects of developing a reliable CAD system for the automated classification of ovarian cancer into benign and malignant types. A brief description of the commonly used classifiers in ultrasound-based CAD systems is also given.
This case represents a unique primary ovarian tumour consisting of malignant mucinous elements and granulosa-theca-cell elements, the histogenesis of which remains uncertain. It also underscores the need for thorough sampling of mucinous tumours in order to discover a possible coexisting, different neoplastic component.
Epithelial ovarian cancer is one of the most fatal gynecological malignancies in adult women. As studies on protein N-glycosylation have extensively reported aberrant patterns in the ovarian cancer tumor microenvironment, obtaining spatial information will uncover tumor-specific N-glycan alterations in ovarian cancer development and progression. matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) is employed to investigate N-glycan distribution on formalin-fixed paraffin-embedded ovarian cancer tissue sections from early- and late-stage patients. Tumor-specific N-glycans are identified and structurally characterized by porous graphitized carbon-liquid chromatography-electrospray ionization-tandem mass spectrometry (PGC-LC-ESI-MS/MS), and then assigned to high-resolution images obtained from MALDI-MSI. Spatial distribution of 14 N-glycans is obtained by MALDI-MSI and 42 N-glycans (including structural and compositional isomers) identified and structurally characterized by LC-MS. The spatial distribution of oligomannose, complex neutral, bisecting, and sialylated N-glycan families are localized to the tumor regions of late-stage ovarian cancer patients relative to early-stage patients. Potential N-glycan diagnostic markers that emerge include the oligomannose structure, (Hex)6 + (Man)3 (GlcNAc)2 , and the complex neutral structure, (Hex)2 (HexNAc)2 (Deoxyhexose)1 + (Man)3 (GlcNAc)2 . The distribution of these markers is evaluated using a tissue microarray of early- and late-stage patients.
Nigella sativa is also known for its properties as a traditional herbal healing for many ailments. In this study, the anticancer properties of thyomquinone (TQ), the active ingredient of N. sativa, were studied using ovarian cancer cell line (Caov-3 cells). The anti-proliferative activity of TQ was determined using MTT and the apoptosis was investigated using Flowcytometry and Annexin-V Assays. Multiparameteric cytotoxicity bioassays were used to quantify the changes in cell permeability and mitochondrial membrane potential. Reactive oxygen species (ROS) and apoptosis-involved cell markers were examined to verify cell death mechanism. The MTT-assay showed that TQ induces anti-proliferative activity on Caov-3 with an IC50 of 6.0±0.03 μg/mL, without any cytotoxic activity towards WRL-68 normal hepatocytes. A significant induction of early phase of apoptosis was shown by annexin-V analysis. Treatment of Caov-3 cells with TQ induces decreases in plasma membrane permeability and mitochondrial membrane potential. Visible decrease in the nuclear area was also observed. A significant decrease is observed in Bcl-2 while Bax is down-regulated. TQ-triggered ROS-mediated has found to be associated with Hsp70 dysregulation, an indicator of oxidative injury. We found that TQ induced anti-cancer effect involves intrinsic pathway of apoptosis and cellular oxidative stress. Our results considered collectively indicated that thyomquinone may be a potential agent for ovarian cancer drug development.
Leydig cell tumours (LCTs) of the ovary are rare ovarian tumours that usually present with hyperandrogenism. Conventional radiological imagings are helpful in localising these tumours. However, some tumours may be too small to be localised before curative surgical removal. It is important to identify these androgen-secreting neoplasms which originate mostly from adrenals or ovaries because they are potentially malignant and require specific treatment. When conventional imagings are unrevealing, selective ovarian and adrenal venous sampling (SOAVS) is the next option. We report a case of LCT that was localised by SOAVS after results from other imaging modalities remained inconclusive.