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Ovarian cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Stephanie Nougaret, Helen Addley, Evis Sala, Anju Sahdev
These tumours are histologically similar to clear cell tumours of the endometrium, cervix, and vagina but are not associated with exposure to diethylstilboestrol in utero. These tumours have a better prognosis as they are usually confined to the ovaries at diagnosis. Approximately 75% are stage I and over 85% are stage I or II at the time of diagnosis (32). Clear cell carcinoma may develop in patients with endometriosis (31,33). A chronic endometrioma developing or presenting with enhancing solid components or thickened enhancing walls with restricted diffusion should raise the suspicion of malignancy. Common imaging findings in clear cell carcinoma include a unilocular large cyst, with signal intensity on T1-weighted (T1W) MRI varying from low to very high and solid mural nodules protruding into the lumen (Figure 19.6).
The Renin-Angiotensin System
Published in Austin E. Doyle, Frederick A. O. Mendelsohn, Trefor O. Morgan, Pharmacological and Therapeutic Aspects of Hypertension, 2020
This exceedingly rare cause of hypertension provides the most clear-cut type of renin-dependent hypertension. First described by Robertson et al.554 and shortly after by Kihara et al.,555 only about a dozen cases have been subsequently described so far (for reviews, see References 556 and 557). These patients usually have moderate to severe hypertension, hypokalemia, increased peripheral plasma renin activity and angiotensin-II levels, and secondary hyperaldosteronism. The renal tumors are usually of the juxtaglomerular cell type or Wilms tumours (for review, see Reference 557), although clear cell carcinoma has been associated with this syndrome.557
Histopathological aspects of peritoneal malignancy
Published in Tom Cecil, John Bunni, Akash Mehta, A Practical Guide to Peritoneal Malignancy, 2019
Babatunde Rowaiye, Norman Carr
Macroscopically, they can be solid or partially cystic. Histologically, clear cell carcinoma is typically characterised by pleomorphic cells with clear cytoplasm forming solid, tubular, cystic or papillary patterns. They often have a hobnail appearance with bulbous nuclei. Clear cells alone are insufficient for the diagnosis; multiple complex papillae and densely hyaline basement membrane material should be present, and hyaline bodies are another common diagnostic feature. Endometrioid tumours resemble their counterparts arising in the uterine corpus and commonly show focal squamous differentiation. As in other ovarian neoplasms, the presence of destructive stromal invasion defines carcinoma [49].
Clear cell carcinoma of the ovary and venous thromboembolism: a systematic review and meta-analysis
Published in Current Medical Research and Opinion, 2023
Hamidreza Didar, Farah Farzaneh, Hanieh Najafiarab, Kosar Namakin, Kimiya Gohari, Ali Sheidaei, Sepehr Ramezani
In our finding, the pooled prevalence of VTE among patients with early and advanced stages of OCCC was 16.54% and 37.79%, respectively. This discrepancy could be due to the more extended hospitalization period, comorbidities, extra blood transfusion, extensive use of erythropoiesis-stimulating agents, and central venous catheters in advanced stages58. Furthermore, chemotherapy medications, such as bevacizumab, are a predisposing factor for VTE events61. Despite the higher prevalence of VTE in the advanced stages compared to the early stages, the expression of TF did not differ between the two stages36,47. Although cancer-associated thrombosis is a multifactorial phenomenon, the mechanism is still poorly understood. However, further studies are recommended to determine the association between the stages of clear cell carcinoma and VTE events.
Effectiveness of oral etoposide in recurrent or refractory epithelial ovarian cancer, primary peritoneal cancer and fallopian tube cancer
Published in Journal of Obstetrics and Gynaecology, 2022
Chompunoot Kongsawatvorakul, Chuenkamon Charakorn, Suwicha Chittithaworn, Arb-Aroon Lertkhachonsuk
Compared with other study conducted in Thailand, Thavaramara et al. reported 4.8 months (range 3.3–6.4 months) of PFS for a daily dose of 75 mg of oral etoposide (Thavaramara et al. 2009). Besides the difference in dosage, other factors can also contribute to such difference. For example, 52% of their patients were prescribed oral etoposide as the second-line treatment, whereas around half of our patients were treated as the third-line chemotherapy. Our study included 13 patients who received one cycle of oral etoposide while Thavaramara et al. excluded them. Moreover, the majority of histopathological subtypes were different; serous carcinoma and clear cell carcinoma accounted for two-thirds of our included patients, but serous carcinoma and endometrioid carcinoma accounted for half of theirs. Also study of Bozkaya et al. with majority of serous papillary carcinoma subtypes has slightly longer OS and PFS (Bozkaya et al. 2017). We hypothesised that clear cell carcinoma which has a worse prognosis played an important role in this response. The comparison of previous retrospective studies to this study is shown in Table 3.
Incidentally detected steroid cell tumour presenting with abnormal uterine bleeding: a rare case report with review of literature
Published in Journal of Obstetrics and Gynaecology, 2022
Priyanka Yadav, Navpreet Kaur, Shramana Mandal, Nita Khurana, Ashok Kumar
Steroid cell tumours are generally unilateral and varies in size from 1.2 to 45 cm. Grossly they are solid, cut surface from yellow-orange to red brown, areas of haemorrhage and necrosis can also been seen. Tumour in our case was solid and pale yellow. Microscopically, cells are arranged in nest or trabeculae, polygonal with eosinophilic granular or vacuolated cytoplasm. The differential diagnosis includes stromal luteoma, pregnancy luteoma, Leydig cell tumour. Clear cell carcinoma and Metastatic renal cell carcinoma. These can be differentiated from Steroid cell tumours NOS as Stromal luteoma occurs within the ovarian stroma and associated with stomal hyperthecosis, pregnancy leutomas occurs bilaterally and regresses after pregnancy, Leydig’s cell tumour contains Reinke crystals and associated with Leydig’s cell hyperplasia (Bhagat et al. 2016). This was absent in the present case. Both clear cell carcinomas and metastatic renal cell carcinoma show PAS positivity which is negative in Steroid cell tumours (Mehdi et al. 2011). On Immunohistochemistry these cells are immunoreactive for Inhibin and Calretinin.