Ovarian Sarcoma: Difference between revisions
Line 457: | Line 457: | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
*An elevated concentration of CA-125 in serum is seen in some patients of ovarian sarcoma.<ref name="pmid23304240">{{cite journal| author=Shakuntala P, Umadevi K, Usha A, Abhilasha N, Bafna U| title=Primary ovarian adenosarcoma with elevated Ca-125 levels and normal ascitic fluid cytology: a case report and review of literature. | journal=Ecancermedicalscience | year= 2012 | volume= 6 | issue= | pages= 284 | pmid=23304240 | doi=10.3332/ecancer.2012.284 | pmc=3530409 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23304240 }} </ref><ref name="pmid2310684">{{cite journal| author=Mogensen O, Mogensen B, Jakobsen A| title=Tumour-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA 125) in mucinous ovarian tumours. | journal=Br J Cancer | year= 1990 | volume= 61 | issue= 2 | pages= 327-9 | pmid=2310684 | doi=10.1038/bjc.1990.64 | pmc=1971406 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2310684 }} </ref> | *An elevated concentration of CA-125 in serum is seen in some patients of ovarian sarcoma.<ref name="pmid23304240">{{cite journal| author=Shakuntala P, Umadevi K, Usha A, Abhilasha N, Bafna U| title=Primary ovarian adenosarcoma with elevated Ca-125 levels and normal ascitic fluid cytology: a case report and review of literature. | journal=Ecancermedicalscience | year= 2012 | volume= 6 | issue= | pages= 284 | pmid=23304240 | doi=10.3332/ecancer.2012.284 | pmc=3530409 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23304240 }} </ref><ref name="pmid2310684">{{cite journal| author=Mogensen O, Mogensen B, Jakobsen A| title=Tumour-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA 125) in mucinous ovarian tumours. | journal=Br J Cancer | year= 1990 | volume= 61 | issue= 2 | pages= 327-9 | pmid=2310684 | doi=10.1038/bjc.1990.64 | pmc=1971406 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2310684 }} </ref><ref name="pmid21304524">{{cite journal| author=Van Gorp T, Cadron I, Despierre E, Daemen A, Leunen K, Amant F et al.| title=HE4 and CA125 as a diagnostic test in ovarian cancer: prospective validation of the Risk of Ovarian Malignancy Algorithm. | journal=Br J Cancer | year= 2011 | volume= 104 | issue= 5 | pages= 863-70 | pmid=21304524 | doi=10.1038/sj.bjc.6606092 | pmc=3048204 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21304524 }} </ref> | ||
*There are no diagnostic laboratory findings associated with ovarian sarcoma. | *There are no diagnostic laboratory findings associated with ovarian sarcoma. | ||
Revision as of 20:11, 30 July 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]
Overview
Ovarian carcinosarcoma, which is also known as a malignant mixed mullerian tumor (MMMT) of the ovary, is a rare, aggressive cancer of the ovary with two distinct characteristic cancer types i.e carcinoma and sarcoma.
Historical Perspective
[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].
The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].
There have been several outbreaks of [disease name], including -----.
In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].
Classification
- There is no established system for the classification of ovarian Sarcoma.[1]
- Primary ovarian sarcomas occur as pure sarcomas or mixed müllerian tumors (MMTs).
- Pure sarcomas are comprised of a single malignant mesenchymal element and are further categorized as:
- Stromal cell sarcomas
- Fibrosarcomas
- Leiomyosarcomas
- Neurofibrosarcomas
- Rhabdomyosarcomas
- Chondrosarcomas
- Angiosarcomas
- Liposarcomas
- On the other hand mixed mullerian tumors(MMTs) are defined by the presence of both carcinomatous and sarcomatous elements and are more common than pure sarcomas.
- Ovarian MMTs can be further classified as homologous or heterologous on the basis of the tissue components present.
- Homologous tumors contain elements that are native to the ovary whereas heterologous tumors contain elements that normally are not present in the ovary.
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].
Pathophysiology
- The exact pathogenesis of ovarian sarcoma is not fully understood
- Clonal loss of the wild-type BRCA2 allele as well as the same somatic mutation of the TP53 gene was evident in histologic components
Causes
Disease name] may be caused by [cause1], [cause2], or [cause3].
OR
Common causes of [disease] include [cause1], [cause2], and [cause3].
OR
The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
OR
The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
Differentiating ovarian sarcoma from Other Diseases
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age of onset | Symptoms | Physical examination | |||||||||||
Lab Findings | Imaging | Immunohistopathology | |||||||||||
pelvic/abdominal pain or pressure | vaginal bleeding/discharge | GI dysturbance | Fever | Tenderness | CT scan/US | MRI | |||||||
Serous cystadenoma/carcinoma [2][3][4][5] |
|
+/– | – | – | – | +/– |
|
|
| ||||
Mucinous cystadenoma/carcinoma [6][7][8] |
|
+/– | – | – | – | +/– |
|
|
|
|
| ||
Endometrioma [9][10][11] |
|
+ | + | +/– | – | + |
|
|
|
| |||
Teratoma [12][13][14][15]
|
|
+/– | – | – | – | +/– |
|
|
| ||||
Granulosa cell tumor [16][17][18][19] |
|
+ | +/– | – | – |
|
| ||||||
Sertoli-leydig cell tumor [20][21] |
|
+/– | – | – | – | – |
|
|
|
| |||
Tubal | tubo-ovarian abscess [22][23][24][25] |
|
+ | + | – | + | + |
|
|
|
| ||
Fallopian tube carcinoma [26] |
|
+ | + | + | – | +/– |
|
|
|
| |||
Uterine | Leiomyoma [27][28] |
|
+ | + | – | – | +/– |
|
| ||||
Choriocarcinoma [29][30][31][32] |
|
+ | + | +/– | – | + |
|
|
|
| |||
Leiomyosarcoma [33][34][35][36][37] |
|
+ | + | – | – | +/– |
|
|
|
|
OR
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Epidemiology and Demographics
- Ovarian sarcoma is one of the least common gynecologic malignancy, constituting approximately 1% of all ovarian malignancies.[1][38][39][40][41][42]
- In 2012, approximately 239,000 women were diagnosed with ovarian cancer worldwide, and 152,000 died of the disease.
- Patients of all age groups may develop sarcoma of the ovary both postmenopausal and premenopausal women.
- The incidence of ovarian Sarcoma increases with age; the median age at diagnosis is 50-60 years.
- There is no racial predilection to ovarian Sarcoma
Risk Factors
There are no established risk factors for [disease name].
OR
The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
Screening
There is insufficient evidence to recommend routine screening for ovarian sarcoma.
Natural History, Complications, and Prognosis
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognostic factors for this tumor type remain unclear because of its rarity.
- Prognosis is generally poor, and the 5-year survival rate of patients with ovarian sarcoma is approximately 28.2%.
- Some possible factors such as age and menopausal status have been proposed.
Diagnostic Study of Choice
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
There are no established criteria for the diagnosis of [disease name].
History and Symptoms
Most of the women are asymptomatic, when present, symptoms may include:[43][44][45]
- Pain in the abdomen or pelvic area
- Bloating or swelling of the abdomen
- Quickly feeling full when eating
- Other digestive problems
Physical Examination
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Laboratory Findings
- An elevated concentration of CA-125 in serum is seen in some patients of ovarian sarcoma.[46][47][48]
- There are no diagnostic laboratory findings associated with ovarian sarcoma.
Electrocardiogram
There are no ECG findings associated with [disease name].
OR
An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
X-ray
There are no x-ray findings associated with ovarian Sarcoma.
Echocardiography or Ultrasound
There are no echocardiography/ultrasound findings associated with ovarian Sarcoma.
CT scan
There are no CT scan findings associated with [disease name].
OR
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
MRI
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Other Imaging Findings
There are no other imaging findings associated with [disease name].
OR
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
There is no medical treatment for ovarian sarcoma, the mainstay of therapy is surgery and chemotherapy.
Surgery
- Surgery is the mainstay of treatment for ovarian sarcoma.
- The management is similar to that of epithelial carcinoma of ovary, consisting of cytoreductive surgery followed by adjuvant chemotherapy.
Chemotherapy
- Chemotherapy with various regimens has been used in different centers without defined conclusions on efficacy[44][45][49][50][51]
- Multiple chemotherapeutic regimens have been evaluated with modest response rates ranging from 12% to 100%.
- Among all chemotherapeutic regimens that are being used, they are divided into two groups like platinum containing regimens and non-platinum regimens.
- Platinum containing chemotherapy regimens
- Carboplatin and ifosfamide (Carbo-I)
- Carboplatin (Carbo)
- Cyclophosphamide, adriamycin and cisplatin (CAP)
- Carboplatin and cyclophosphamide (Carbo-C)
- Epirubicin, carboplatin and 5FU (E-Carbo-F)
- Epirubicin, cisplatin and 5FU (ECF)
- Taxol and Carboplatin (T-Carbo)
- Other chemotherapy regimens
- Doxorubicin (A)
- Doxorubicin and cyclophosphamide (AC)
- Cyclophosphamide (IV)
- Cyclophosphamide (oral)
- Melphalan
Primary Prevention
There are no established measures for the primary prevention of ovarian sarcoma.
Secondary Prevention
There are no established measures for the secondary prevention of ovarian sarcoma.
References
- ↑ 1.0 1.1 Harris, M A; Delap, L M; Sengupta, P S; Wilkinson, P M; Welch, R S; Swindell, R; Shanks, J H; Wilson, G; Slade, R J; Reynolds, K; Jayson, G C (2003). "Carcinosarcoma of the ovary". British Journal of Cancer. 88 (5): 654–657. doi:10.1038/sj.bjc.6600770. ISSN 0007-0920.
- ↑ Jung, Seung Eun; Lee, Jae Mun; Rha, Sung Eun; Byun, Jae Young; Jung, Jung Im; Hahn, Seong Tai (2002). "CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis". RadioGraphics. 22 (6): 1305–1325. doi:10.1148/rg.226025033. ISSN 0271-5333.
- ↑ Imai, Shunsuke; Kiyozuka, Yasuhiko; Maeda, Hiroko; Noda, Tuneo; Hosick, Howard L. (1990). "Establishment and Characterization of a Human Ovarian Serous Cystadenocarcinoma Cell Line That Produces the Tumor Markers CA-125 and Tissue Polypeptide Antigen". Oncology. 47 (2): 177–184. doi:10.1159/000226813. ISSN 0030-2414.
- ↑ Malpica A, Deavers MT, Lu K, Bodurka DC, Atkinson EN, Gershenson DM, Silva EG (April 2004). "Grading ovarian serous carcinoma using a two-tier system". Am. J. Surg. Pathol. 28 (4): 496–504. PMID 15087669.
- ↑ Li J, Fadare O, Xiang L, Kong B, Zheng W (March 2012). "Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis". J Hematol Oncol. 5: 8. doi:10.1186/1756-8722-5-8. PMID 22405464.
- ↑ Hoerl HD, Hart WR (December 1998). "Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up". Am. J. Surg. Pathol. 22 (12): 1449–62. PMID 9850171.
- ↑ Lee KR, Scully RE (November 2000). "Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with 'pseudomyxoma peritonei'". Am. J. Surg. Pathol. 24 (11): 1447–64. PMID 11075847.
- ↑ Jung, Seung Eun; Lee, Jae Mun; Rha, Sung Eun; Byun, Jae Young; Jung, Jung Im; Hahn, Seong Tai (2002). "CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis". RadioGraphics. 22 (6): 1305–1325. doi:10.1148/rg.226025033. ISSN 0271-5333.
- ↑ Mol BW, Bayram N, Lijmer JG, Wiegerinck MA, Bongers MY, van der Veen F, Bossuyt PM (December 1998). "The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis". Fertil. Steril. 70 (6): 1101–8. PMID 9848302.
- ↑ Kinkel, Karen; Frei, Kathrin A.; Balleyguier, Corinne; Chapron, Charles (2005). "Diagnosis of endometriosis with imaging: a review". European Radiology. 16 (2): 285–298. doi:10.1007/s00330-005-2882-y. ISSN 0938-7994.
- ↑ de Ziegler, Dominique; Borghese, Bruno; Chapron, Charles (2010). "Endometriosis and infertility: pathophysiology and management". The Lancet. 376 (9742): 730–738. doi:10.1016/S0140-6736(10)60490-4. ISSN 0140-6736.
- ↑ Kawai, Michiyasu; Kano, Takeo; Kikkawa, Fumitaka; Morikawa, Yoshimitsu; Oguchi, Hidenori; Nakashima, Nobuo; Ishizuka, Takao; Kuzuya, Kazuo; Ohta, Masahiro; Arii, Yoshitaro; Tomoda, Yutaka (1992). "Seven tumor markers in benign and malignant germ cell tumors of the ovary". Gynecologic Oncology. 45 (3): 248–253. doi:10.1016/0090-8258(92)90299-X. ISSN 0090-8258.
- ↑ Dunzendorfer, Thomas; deLAS MORENAS, ANTONIO; Kalir, Tamara; Levin, Robert M. (1999). "Struma Ovarii and Hyperthyroidism". Thyroid. 9 (5): 499–502. doi:10.1089/thy.1999.9.499. ISSN 1050-7256.
- ↑ Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
- ↑ Saba, Luca; Guerriero, Stefano; Sulcis, Rosa; Virgilio, Bruna; Melis, GianBenedetto; Mallarini, Giorgio (2009). "Mature and immature ovarian teratomas: CT, US and MR imaging characteristics". European Journal of Radiology. 72 (3): 454–463. doi:10.1016/j.ejrad.2008.07.044. ISSN 0720-048X.
- ↑ Pectasides D, Pectasides E, Psyrri A (February 2008). "Granulosa cell tumor of the ovary". Cancer Treat. Rev. 34 (1): 1–12. doi:10.1016/j.ctrv.2007.08.007. PMID 17945423.
- ↑ Stenwig, Jan Trygve; Hazekamp, Johan The.; Beecham, Jackson B. (1979). "Granulosa cell tumors of the ovary. A clinicopathological study of 118 cases with long-term follow-up". Gynecologic Oncology. 7 (2): 136–152. doi:10.1016/0090-8258(79)90090-8. ISSN 0090-8258.
- ↑ Morikawa K, Hatabu H, Togashi K, Kataoka ML, Mori T, Konishi J (1997). "Granulosa cell tumor of the ovary: MR findings". J Comput Assist Tomogr. 21 (6): 1001–4. PMID 9386298.
- ↑ Ko SF, Wan YL, Ng SH, Lee TY, Lin JW, Chen WJ, Kung FT, Tsai CC (May 1999). "Adult ovarian granulosa cell tumors: spectrum of sonographic and CT findings with pathologic correlation". AJR Am J Roentgenol. 172 (5): 1227–33. doi:10.2214/ajr.172.5.10227493. PMID 10227493.
- ↑ Lantzsch, T.; Stoerer, S.; Lawrenz, K.; Buchmann, J.; Strauss, H.-G.; Koelbl, H. (2001). "Sertoli-Leydig cell tumor". Archives of Gynecology and Obstetrics. 264 (4): 206–208. doi:10.1007/s004040000114. ISSN 0932-0067.
- ↑ Jung, Seung Eun; Rha, Sung Eun; Lee, Jae Mun; Park, Soo Youn; Oh, Soon Nam; Cho, Kyoung Sik; Lee, Eun Ju; Byun, Jae Young; Hahn, Seong Tai (2005). "CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary". American Journal of Roentgenology. 185 (1): 207–215. doi:10.2214/ajr.185.1.01850207. ISSN 0361-803X.
- ↑ Landers, D. V.; Sweet, R. L. (1983). "Tubo-ovarian Abscess: Contemporary Approach to Management". Clinical Infectious Diseases. 5 (5): 876–884. doi:10.1093/clinids/5.5.876. ISSN 1058-4838.
- ↑ Stewart Taylor, E.; McMillan, James H.; Greer, Benjamin E.; Droegemueller, William; Thompson, Horace E. (1975). "The intrauterine device and tubo-ovarian abscess". American Journal of Obstetrics and Gynecology. 123 (4): 338–348. doi:10.1016/S0002-9378(16)33434-2. ISSN 0002-9378.
- ↑ Ha, H. K.; Lim, G. Y.; Cha, E. S.; Lee, H. G.; Ro, H. J.; Kim, H. S.; Kim, H. H.; Joo, S. W.; Jee, M. K. (1995). "MR Imaging of Tubo-Ovarian Abscess". Acta Radiologica. 36 (5): 510–514. doi:10.1080/02841859509173418. ISSN 0284-1851.
- ↑ Varras M, Polyzos D, Perouli E, Noti P, Pantazis I, Akrivis C (2003). "Tubo-ovarian abscesses: spectrum of sonographic findings with surgical and pathological correlations". Clin Exp Obstet Gynecol. 30 (2–3): 117–21. PMID 12854857. Vancouver style error: initials (help)
- ↑ Niloff, Jonathan M.; Klug, Thomas L.; Schaetzl, Elena; Zurawski, Vincent R.; Knapp, Robert C.; Bast, Robert C. (1984). "Elevation of serum CA125 in carcinomas of the fallopian tube, endometrium, and endocervix". American Journal of Obstetrics and Gynecology. 148 (8): 1057–1058. doi:10.1016/S0002-9378(84)90444-7. ISSN 0002-9378.
- ↑ Bulletti, Carlo; De Ziegler, Dominique; Polli, Valeria; Flamigni, Carlo (1999). "The role of leiomyomas in infertility". The Journal of the American Association of Gynecologic Laparoscopists. 6 (4): 441–445. doi:10.1016/S1074-3804(99)80008-5. ISSN 1074-3804.
- ↑ Murase, Eiko; Siegelman, Evan S.; Outwater, Eric K.; Perez-Jaffe, Liza A.; Tureck, Richard W. (1999). "Uterine Leiomyomas: Histopathologic Features, MR Imaging Findings, Differential Diagnosis, and Treatment". RadioGraphics. 19 (5): 1179–1197. doi:10.1148/radiographics.19.5.g99se131179. ISSN 0271-5333.
- ↑ Seckl, Michael J; Fisher, Rosemary A; Salerno, Giovanni; Rees, Helene; Paradinas, Fernando J; Foskett, Marianne; Newlands, Edward S (2000). "Choriocarcinoma and partial hydatidiform moles". The Lancet. 356 (9223): 36–39. doi:10.1016/S0140-6736(00)02432-6. ISSN 0140-6736.
- ↑ Nishikawa, Yoshiki; Kaseki, Shigeaki; Tomoda, Yutaka; Ishizuka, Takao; Asai, Yasumasa; Suzuki, Toshio; Ushijima, Hiroshi (1985). "Histopathologic classification of uterine choriocarcinoma". Cancer. 55 (5): 1044–1051. doi:10.1002/1097-0142(19850301)55:5<1044::AID-CNCR2820550520>3.0.CO;2-7. ISSN 0008-543X.
- ↑ Libshitz HI, Baber CE, Hammond CB (April 1977). "The pulmonary metastases of choriocarcinoma". Obstet Gynecol. 49 (4): 412–6. PMID 558566.
- ↑ Diouf A, Cissé ML, Laïco A, Ndiaye D, Moreau JC, Diadhiou F (May 2005). "[Sonographic features of gestational choriocarcinoma]". J Radiol (in French). 86 (5 Pt 1): 469–73. PMID 16114202.
- ↑ Seki, K.; Hoshihara, T.; Nagata, I. (1992). "Leiomyosarcoma of the Uterus: Ultrasonography and Serum Lactate Dehydrogenase Level". Gynecologic and Obstetric Investigation. 33 (2): 114–118. doi:10.1159/000294861. ISSN 1423-002X.
- ↑ Juang CM, Yen MS, Horng HC, Twu NF, Yu HC, Hsu WL (2006). "Potential role of preoperative serum CA125 for the differential diagnosis between uterine leiomyoma and uterine leiomyosarcoma". Eur. J. Gynaecol. Oncol. 27 (4): 370–4. PMID 17009628.
- ↑ Pattani, Sita J.; Kier, Ruben; Deal, Robert; Luchansky, Edward (1995). "MRI of uterine leiomyosarcoma". Magnetic Resonance Imaging. 13 (2): 331–333. doi:10.1016/0730-725X(95)93813-5. ISSN 0730-725X.
- ↑ McLeod, A J; Zornoza, J; Shirkhoda, A (1984). "Leiomyosarcoma: computed tomographic findings". Radiology. 152 (1): 133–136. doi:10.1148/radiology.152.1.6729102. ISSN 0033-8419.
- ↑ Robboy, Stanley J.; Bentley, Rex C.; Butnor, Kelly; Anderson, Malcolm C. (2000). "Pathology and Pathophysiology of Uterine Smooth-Muscle Tumors". Environmental Health Perspectives. 108: 779. doi:10.2307/3454306. ISSN 0091-6765.
- ↑ Ferlay, Jacques; Soerjomataram, Isabelle; Dikshit, Rajesh; Eser, Sultan; Mathers, Colin; Rebelo, Marise; Parkin, Donald Maxwell; Forman, David; Bray, Freddie (2015). "Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012". International Journal of Cancer. 136 (5): E359–E386. doi:10.1002/ijc.29210. ISSN 0020-7136.
- ↑ Ferlay, Jacques; Shin, Hai-Rim; Bray, Freddie; Forman, David; Mathers, Colin; Parkin, Donald Maxwell (2010). "Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008". International Journal of Cancer. 127 (12): 2893–2917. doi:10.1002/ijc.25516. ISSN 0020-7136.
- ↑ Parkin DM, Bray F, Ferlay J, Pisani P (2005). "Global cancer statistics, 2002". CA Cancer J Clin. 55 (2): 74–108. PMID 15761078.
- ↑ Cresanta JL (1992). "Epidemiology of cancer in the United States". Prim Care. 19 (3): 419–41. PMID 1410056.
- ↑ Bray, Freddie; Ferlay, Jacques; Soerjomataram, Isabelle; Siegel, Rebecca L.; Torre, Lindsey A.; Jemal, Ahmedin (2018). "Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries". CA: A Cancer Journal for Clinicians. 68 (6): 394–424. doi:10.3322/caac.21492. ISSN 0007-9235.
- ↑ Dai Y, Shen K, Lang JH, Huang HF, Pan LY, Wu M; et al. (2011). "Primary sarcoma of the ovary: clinicopathological characteristics, prognostic factors and evaluation of therapy". Chin Med J (Engl). 124 (9): 1316–21. PMID 21740740.
- ↑ 44.0 44.1 del Carmen MG, Birrer M, Schorge JO (2012). "Carcinosarcoma of the ovary: a review of the literature". Gynecol Oncol. 125 (1): 271–7. doi:10.1016/j.ygyno.2011.12.418. PMID 22155675.
- ↑ 45.0 45.1 Kim HJ, Lee HM, Kim MK, Lee YK, Lee IH, Lee KH; et al. (2017). "Prognostic assessment of sarcomatous histologic subtypes of ovarian carcinosarcoma". Obstet Gynecol Sci. 60 (4): 350–356. doi:10.5468/ogs.2017.60.4.350. PMC 5547082. PMID 28791266.
- ↑ Shakuntala P, Umadevi K, Usha A, Abhilasha N, Bafna U (2012). "Primary ovarian adenosarcoma with elevated Ca-125 levels and normal ascitic fluid cytology: a case report and review of literature". Ecancermedicalscience. 6: 284. doi:10.3332/ecancer.2012.284. PMC 3530409. PMID 23304240.
- ↑ Mogensen O, Mogensen B, Jakobsen A (1990). "Tumour-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA 125) in mucinous ovarian tumours". Br J Cancer. 61 (2): 327–9. doi:10.1038/bjc.1990.64. PMC 1971406. PMID 2310684.
- ↑ Van Gorp T, Cadron I, Despierre E, Daemen A, Leunen K, Amant F; et al. (2011). "HE4 and CA125 as a diagnostic test in ovarian cancer: prospective validation of the Risk of Ovarian Malignancy Algorithm". Br J Cancer. 104 (5): 863–70. doi:10.1038/sj.bjc.6606092. PMC 3048204. PMID 21304524.
- ↑ Brown E, Stewart M, Rye T, Al-Nafussi A, Williams AR, Bradburn M; et al. (2004). "Carcinosarcoma of the ovary: 19 years of prospective data from a single center". Cancer. 100 (10): 2148–53. doi:10.1002/cncr.20256. PMID 15139057.
- ↑ Harris MA, Delap LM, Sengupta PS, Wilkinson PM, Welch RS, Swindell R; et al. (2003). "Carcinosarcoma of the ovary". Br J Cancer. 88 (5): 654–7. doi:10.1038/sj.bjc.6600770. PMC 2376340. PMID 12618869.
- ↑ Cicin I, Saip P, Eralp Y, Selam M, Topuz S, Ozluk Y; et al. (2008). "Ovarian carcinosarcomas: clinicopathological prognostic factors and evaluation of chemotherapy regimens containing platinum". Gynecol Oncol. 108 (1): 136–40. doi:10.1016/j.ygyno.2007.09.003. PMID 17936342.