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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Total hysterectomy or bilateral salpingo-oophorectomy is the preferred treatment. Surgery may be done by the laparoscopic, open, robotic, or vaginal routes. If the tumor is located in the uterus, minimally invasive surgery is preferred. For young women with stage I endometrioid adenocarcinoma, the ovaries must be preserved. For stage II or III tumors, treatments include pelvic radiation therapy, with or without chemotherapy. Patients with combined surgery and radiation therapy have a better prognosis. Total hysterectomy and bilateral salpingo-oophorectomy are avoided if the patient has bulky parametrial disease. Stage IV cancer usually involves surgery combined with radiation and chemotherapy. Hormone therapy is sometimes used.
Neoplasia in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Germ cell tumors, both benign and malignant, occur primarily in young women (121). The two most common malignant types are dysgerminomas and endodermal sinus (yolk sac) tumors. As dysgerminomas are the most common malignant germ cell tumors and most often occur in young women, it is not surprising that they are the most common malignant adnexal mass found in pregnancy. Approximately 10% to 15% of dysgerminomas occur bilaterally. A review of 27 reported cases of dysgerminomas reported all patients presented with large-size tumors ranging from 12 to 28cm and most were stage IA (122). Because of their large size, obstetric complications have been reported in association with dysgerminomas including obstructed labor and cesarean section (122). Surgical treatment is required as an initial management for all patients regardless of pregnancy status. Oftentimes, if appropriate, surgery will be postponed until 16 to 18 weeks when the risk for spontaneous abortion is minimized (83,123). Unilateral salpingo-oophorectomy with preservation of the contralateral ovary and of the uterus is adequate for early-stage disease of both germ cell and epithelial cancers.
Clinical Cancer Genetics
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Rosalind A. Eeles, Lisa J. Walker
Prevention strategies can take many forms including prophylactic surgery and chemoprevention. The evidence in support of the efficacy of these measures is variable, mainly due to the rarity of the genetic mutation making clinical trials difficult to perform. Established measures include total colectomy in the familial adenomatous polyposis syndrome25 and total thyroidectomy in the MEN2 syndrome.26 More contentious roles for prophylactic surgery include mastectomy in women with pathogenic BRCA1/2 mutations. Limited retrospective data suggest that the risk of breast cancer is reduced by 90 per cent following prophylactic mastectomy although there is still a residual risk due to the inability to remove all breast epithelial cells at mastectomy.27 Prophylactic salpingo-oophorectomy has been shown to reduce ovarian cancer risk.28 A risk of peritoneal carcinomatosis remains due to the shared embryonic origin of both peritoneum and ovarian epithelium.29
Tyrosine kinase inhibitor treatment and long-term follow-up for metastatic malignant struma ovarii
Published in Pediatric Hematology and Oncology, 2022
Tarek Taha, Hosam Abu-sini, Salem Billan
SO treatment has not yet been standardized and, although still controversial, generally includes surgery for benign and malignant localized disease.16 The surgery may be a unilateral salpingo-oophorectomy that can be done in a fertility-preserving manner, or a hysterectomy with bilateral salpingo-oophorectomy in bulky disease or for postmenopausal patients. Adjuvant treatment has not been standardized either. As reported in the literature, these include radioactive iodine, radiation therapy, and a variety of chemotherapeutic protocols (e.g., cisplatin, cyclophosphamide, etoposide and tegafur-uracil, carboplatin, and paclitaxel).17,18 Due to the small number of cases reported for this disease, no clear treatment guidelines exist. t is accepted though (still with no consensus) that adjuvant therapy should be given in cases of advanced stage or highly aggressive disease (e.g., >2 cm, extra ovarian extension, aggressive histological features).19–21
Menopausal hormonal therapy in surgically menopausal women with underlying endometriosis
Published in Climacteric, 2022
P. Tanmahasamut, M. Rattanachaiyanont, K. Techatraisak, S. Indhavivadhana, T. Wongwananuruk, P. Chantrapanichkul
Surgically induced menopause is the menopausal state following surgical removal of both ovaries (i.e. bilateral salpingo-oophorectomy [BSO]). BSO is associated with a sudden decrease in estrogen level, and a hypoestrogenic state can significantly impair quality of life due to menopause-related symptoms that include vasomotor symptoms, sleep deprivation, mood change and dyspareunia. These symptoms are more prevalent and severe in women with surgical menopause than those who naturally transition into menopause [1]. Furthermore, hypoestrogenism is a risk factor for cardiovascular disease and osteoporosis [2,3]. The Global Consensus Statement on menopausal hormone therapy (MHT) recommends that MHT for surgically menopausal women be initiated soon after surgery and continued until at least the average age at natural menopause to prevent long-term health consequences from early menopause [4,5].
Two cases of ovarian serous surface papillary borderline tumours with discordant 18F-FDG PET features
Published in Journal of Obstetrics and Gynaecology, 2020
Ara Ko, Sung Bin Park, Ju Won Seok, Mi Kyung Kim, Seung-Su Han, Eun Sun Lee, Hyun Jeong Park
Ovarian serous tumours are the most common ovarian tumours, and they are classified as benign (60%), borderline (15%), or malignant (25%) (Tanaka et al. 2011; Kwon et al. 2013; Park et al. 2018). Borderline ovarian tumours represent an intermediate neoplasm between benign and malignant ovarian tumours, characterised by increased atypical epithelial cell proliferation without any destructive stromal invasion (Naqvi et al. 2015). With a low malignant potential, they have a better prognosis than their malignant counterparts (Park et al. 2018). Owing to the younger age of onset, and better prognosis, patients can undergo conservative surgery with unilateral salpingo-oophorectomy to preserve fertility (Naqvi et al. 2015; Park et al. 2018). The 18 F-fluorodeoxyglucose positron-emission tomography (FDG-PET) is generally used to determine malignancy (Risum et al. 2007). Some investigators suggest that FDG-PET/CT can differentiate borderline ovarian tumours from malignant tumours with a high diagnostic performance and the cut-off value is 2.9 (Kitajima et al. 2011; Tanizaki et al. 2014). However, to the best of our knowledge, the FDG-PET features of ovarian serous surface papillary borderline tumours (SSPBTs) have not been previously reported. Here, we present two cases of SSPBTs with discordant FDG-PET features.