Sexcord/ stromal ovarian tumors diagnostic study of choice: Difference between revisions
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{{Sexcord/ stromal ovarian tumors}} | {{Sexcord/ stromal ovarian tumors}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}};{{M.N}} | ||
== Overview == | == Overview == | ||
[[Biopsy]] is the gold standard test for the [[diagnosis]] of sexcord/ stromal ovarian tumors. There is no single [[diagnostic]] study of choice for the [[diagnosi]]s of sexcord/ stromal ovarian tumors, but these can be diagnosed based on [[CT]] and [[MRI]] findings<ref name="pmid27029917">{{cite journal |vauthors=Hashmi AA, Naz S, Edhi MM, Faridi N, Hussain SD, Mumtaz S, Khan M |title=Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience |journal=World J Surg Oncol |volume=14 |issue= |pages=91 |date=March 2016 |pmid=27029917 |pmc=4815136 |doi=10.1186/s12957-016-0849-x |url=}}</ref> | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice === | === Study of choice === | ||
[ | [[Biopsy]] is the gold standard test for the [[diagnosis]] of sexcord/ stromal ovarian tumors. There is no single [[diagnostic]] study of choice for the [[diagnosi]]s of sexcord/ stromal ovarian tumors, but these can be diagnosed based on [[CT]] and [[MRI]] findings<ref name="pmid26930463">{{cite journal |vauthors=Ratnavelu ND, Brown AP, Mallett S, Scholten RJ, Patel A, Founta C, Galaal K, Cross P, Naik R |title=Intraoperative frozen section analysis for the diagnosis of early stage ovarian cancer in suspicious pelvic masses |journal=Cochrane Database Syst Rev |volume=3 |issue= |pages=CD010360 |date=March 2016 |pmid=26930463 |pmc=6457848 |doi=10.1002/14651858.CD010360.pub2 |url=}}</ref><ref name="pmid27029917">{{cite journal |vauthors=Hashmi AA, Naz S, Edhi MM, Faridi N, Hussain SD, Mumtaz S, Khan M |title=Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience |journal=World J Surg Oncol |volume=14 |issue= |pages=91 |date=March 2016 |pmid=27029917 |pmc=4815136 |doi=10.1186/s12957-016-0849-x |url=}}</ref><ref name="pmid27172748">{{cite journal |vauthors=Abudukadeer A, Azam S, Zunong B, Mutailipu AZ, Huijun B, Qun L |title=Accuracy of intra-operative frozen section and its role in the diagnostic evaluation of ovarian tumors |journal=Eur. J. Gynaecol. Oncol. |volume=37 |issue=2 |pages=216–20 |date=2016 |pmid=27172748 |doi= |url=}}</ref><ref name="pmid15853005">{{cite journal |vauthors=Ivanov S, Ivanov S, Khadzhiolov N |title=[Ovarian tumours--accuracy of frozen section diagnosis] |language=Bulgarian |journal=Akush Ginekol (Sofiia) |volume=44 |issue=1 |pages=11–3 |date=2005 |pmid=15853005 |doi= |url=}}</ref><ref name="pmid30123350">{{cite journal |vauthors=Huang Z, Li L, Li C, Ngaujah S, Yao S, Chu R, Xie L, Yang X, Zhang X, Liu P, Jiang J, Zhang Y, Cui B, Song K, Kong B |title=Diagnostic accuracy of frozen section analysis of borderline ovarian tumors: a meta-analysis with emphasis on misdiagnosis factors |journal=J Cancer |volume=9 |issue=16 |pages=2817–2824 |date=2018 |pmid=30123350 |doi=10.7150/jca.25883 |url=}}</ref> | ||
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=== Sequence of Diagnostic Studies === | |||
The various investigations must be performed in the following order: | The various investigations must be performed in the following order: | ||
* | *CT | ||
* | *MRI | ||
*Biopsy | |||
=== Name of Diagnostic Criteria === | === Name of Diagnostic Criteria === | ||
There are no established criteria for the diagnosis of sexcord/ stromal ovarian tumors | |||
There are no established criteria for the diagnosis of | |||
===Staging=== | ===Staging=== | ||
The TNM staging for sex cord/stromal ovarian tumors is mentioned in the following table:<ref name="pmid26556905">{{cite journal |vauthors=Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P, Hauptmann S, Sehouli J |title=Statement by the Kommission Ovar of the AGO: The New FIGO and WHO Classifications of Ovarian, Fallopian Tube and Primary Peritoneal Cancer |journal=Geburtshilfe Frauenheilkd |volume=75 |issue=10 |pages=1021–1027 |date=October 2015 |pmid=26556905 |pmc=4629993 |doi=10.1055/s-0035-1558079 |url=}}</ref><ref name="pmid29232468">{{cite journal |vauthors=Duska LR, Kohn EC |title=The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications |journal=Ann. Oncol. |volume=28 |issue=suppl_8 |pages=viii8–viii12 |date=November 2017 |pmid=29232468 |doi=10.1093/annonc/mdx445 |url=}}</ref><ref name="pmid25872889">{{cite journal |vauthors=Prat J |title=FIGO's staging classification for cancer of the ovary, fallopian tube, and peritoneum: abridged republication |journal=J Gynecol Oncol |volume=26 |issue=2 |pages=87–9 |date=April 2015 |pmid=25872889 |pmc=4397237 |doi=10.3802/jgo.2015.26.2.87 |url=}}</ref><ref name="pmid26696400">{{cite journal |vauthors=Saida T, Tanaka YO, Matsumoto K, Satoh T, Yoshikawa H, Minami M |title=Revised FIGO staging system for cancer of the ovary, fallopian tube, and peritoneum: important implications for radiologists |journal=Jpn J Radiol |volume=34 |issue=2 |pages=117–24 |date=February 2016 |pmid=26696400 |doi=10.1007/s11604-015-0513-3 |url=}}</ref><ref name="pmid26241270">{{cite journal |vauthors=Prat J |title=Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum: Abridged Republication of Guidelines From the International Federation of Gynecology and Obstetrics (FIGO) |journal=Obstet Gynecol |volume=126 |issue=1 |pages=171–4 |date=July 2015 |pmid=26241270 |doi=10.1097/AOG.0000000000000917 |url=}}</ref><ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref><ref name="pmid29705285">{{cite journal |vauthors=Wang J, Li J, Chen R, Lu X |title=Contribution of lymph node staging method and prognostic factors in malignant ovarian sex cord-stromal tumors: A world wide database analysis |journal=Eur J Surg Oncol |volume=44 |issue=7 |pages=1054–1061 |date=July 2018 |pmid=29705285 |doi=10.1016/j.ejso.2018.03.027 |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+'''Primary tumor (T)''' | |+'''Primary tumor (T)''' | ||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''T category'''}} | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''FIGO stage'''}} | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''T criteria'''}} | |||
|- | |- | ||
|TX | |TX | ||
Line 194: | Line 89: | ||
and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes | and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes | ||
|- | |- | ||
|T3a | |||
|IIIA2 | |||
|Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or | |||
without positive retroperitoneal lymph nodes | |||
|- | |||
|T3b | |||
|IIIB | |||
|Macroscopic peritoneal metastasis beyond pelvis 2 cm or | |||
less in greatest dimension with or without metastasis to the retroperitoneal lymph nodes | |||
|- | |||
|T3c | |||
|IIIC | |||
|Macroscopic peritoneal metastasis beyond the pelvis more than 2 cm in greatest dimension with or | |||
without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ) | |||
|} | |||
{| class="wikitable" | |||
|+'''Regional lymph nodes (N)''' | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''N category'''}} | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''FIGO stage'''}} | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''N criteria'''}} | |||
|- | |||
|NX | |||
| | | | ||
|Regional lymph nodes cannot be assessed | |||
|- | |||
|N0 | |||
| | | | ||
|No regional lymph node metastasis | |||
|- | |||
|N0(i+) | |||
| | | | ||
|Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm | |||
|- | |||
|N1 | |||
|IIIA1 | |||
|Positive retroperitoneal lymph nodes only (histologically confirmed) | |||
|- | |- | ||
|N1a | |||
|IIIA1i | |||
|Metastasis up to and including 10 mm in greatest dimension | |||
|- | |||
|N1b | |||
|IIIA1ii | |||
|Metastasis more than 10 mm in greatest dimension | |||
|} | |||
{| class="wikitable" | |||
|+'''Distant metastasis (M)''' | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''M category'''}} | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''FIGO stage'''}} | |||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''M criteria'''}} | |||
|- | |||
|M0 | |||
| | | | ||
| | |No distant metastasis | ||
| | |- | ||
|M1 | |||
|IV | |||
|Distant metastasis, including pleural effusion with positive cytology; | |||
liver or splenic parenchymal metastasis; | |||
metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); | |||
and transmural involvement of intestine | |||
|- | |- | ||
| | |M1a | ||
| | |IVA | ||
| | |Pleural effusion with positive cytology | ||
|- | |- | ||
| | |M1b | ||
| | |IVB | ||
| | |Liver or splenic parenchymal metastases; | ||
metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); | |||
transmural involvement of intestine | |||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Types of cancer]] | |||
[[Category:Gynecology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Gynecology]] | |||
[[Category:Surgery]] |
Latest revision as of 19:20, 7 May 2019
Sexcord/ stromal ovarian tumors Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Maneesha Nandimandalam, M.B.B.S.[2]
Overview
Biopsy is the gold standard test for the diagnosis of sexcord/ stromal ovarian tumors. There is no single diagnostic study of choice for the diagnosis of sexcord/ stromal ovarian tumors, but these can be diagnosed based on CT and MRI findings[1]
Diagnostic Study of Choice
Study of choice
Biopsy is the gold standard test for the diagnosis of sexcord/ stromal ovarian tumors. There is no single diagnostic study of choice for the diagnosis of sexcord/ stromal ovarian tumors, but these can be diagnosed based on CT and MRI findings[2][1][3][4][5]
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
- CT
- MRI
- Biopsy
Name of Diagnostic Criteria
There are no established criteria for the diagnosis of sexcord/ stromal ovarian tumors
Staging
The TNM staging for sex cord/stromal ovarian tumors is mentioned in the following table:[6][7][8][9][10][11][12]
T category | FIGO stage | T criteria |
TX | Primary tumor cannot be assessed | |
T0 | No evidence of primary tumor | |
T1 | I | Tumor limited to ovaries (one or both) or fallopian tube(s) |
T1a | IA | Tumor limited to one ovary (capsule intact) or fallopian tube,
no tumor on ovarian or fallopian tube surface; no malignant cells in ascites or peritoneal washings |
T1b | IB | Tumor limited to both ovaries (capsules intact) or fallopian tubes;
no tumor on ovarian or fallopian tube surface; no malignant cells in ascites or peritoneal washings |
T1c | IC | Tumor limited to one or both ovaries or fallopian tubes, with any of the following: |
T1c1 | IC1 |
|
T1c2 | IC2 |
|
T1c3 | IC3 |
|
T2 | II | Tumor involves one or both ovaries or fallopian tubes with pelvic extension below pelvic brim or primary peritoneal cancer |
T2a | IIA | Extension and/or implants on the uterus and/or fallopian tube(s) and/or ovaries |
T2b | IIB | Extension to and/or implants on other pelvic tissues |
T3 | III | Tumor involves one or both ovaries or fallopian tubes, or primary peritoneal cancer,
with microscopically confirmed peritoneal metastasis outside the pelvis and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes |
T3a | IIIA2 | Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or
without positive retroperitoneal lymph nodes |
T3b | IIIB | Macroscopic peritoneal metastasis beyond pelvis 2 cm or
less in greatest dimension with or without metastasis to the retroperitoneal lymph nodes |
T3c | IIIC | Macroscopic peritoneal metastasis beyond the pelvis more than 2 cm in greatest dimension with or
without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ) |
N category | FIGO stage | N criteria |
NX | Regional lymph nodes cannot be assessed | |
N0 | No regional lymph node metastasis | |
N0(i+) | Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm | |
N1 | IIIA1 | Positive retroperitoneal lymph nodes only (histologically confirmed) |
N1a | IIIA1i | Metastasis up to and including 10 mm in greatest dimension |
N1b | IIIA1ii | Metastasis more than 10 mm in greatest dimension |
M category | FIGO stage | M criteria |
M0 | No distant metastasis | |
M1 | IV | Distant metastasis, including pleural effusion with positive cytology;
liver or splenic parenchymal metastasis; metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine |
M1a | IVA | Pleural effusion with positive cytology |
M1b | IVB | Liver or splenic parenchymal metastases;
metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); transmural involvement of intestine |
References
- ↑ 1.0 1.1 Hashmi AA, Naz S, Edhi MM, Faridi N, Hussain SD, Mumtaz S, Khan M (March 2016). "Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience". World J Surg Oncol. 14: 91. doi:10.1186/s12957-016-0849-x. PMC 4815136. PMID 27029917.
- ↑ Ratnavelu ND, Brown AP, Mallett S, Scholten RJ, Patel A, Founta C, Galaal K, Cross P, Naik R (March 2016). "Intraoperative frozen section analysis for the diagnosis of early stage ovarian cancer in suspicious pelvic masses". Cochrane Database Syst Rev. 3: CD010360. doi:10.1002/14651858.CD010360.pub2. PMC 6457848. PMID 26930463.
- ↑ Abudukadeer A, Azam S, Zunong B, Mutailipu AZ, Huijun B, Qun L (2016). "Accuracy of intra-operative frozen section and its role in the diagnostic evaluation of ovarian tumors". Eur. J. Gynaecol. Oncol. 37 (2): 216–20. PMID 27172748.
- ↑ Ivanov S, Ivanov S, Khadzhiolov N (2005). "[Ovarian tumours--accuracy of frozen section diagnosis]". Akush Ginekol (Sofiia) (in Bulgarian). 44 (1): 11–3. PMID 15853005.
- ↑ Huang Z, Li L, Li C, Ngaujah S, Yao S, Chu R, Xie L, Yang X, Zhang X, Liu P, Jiang J, Zhang Y, Cui B, Song K, Kong B (2018). "Diagnostic accuracy of frozen section analysis of borderline ovarian tumors: a meta-analysis with emphasis on misdiagnosis factors". J Cancer. 9 (16): 2817–2824. doi:10.7150/jca.25883. PMID 30123350.
- ↑ Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P, Hauptmann S, Sehouli J (October 2015). "Statement by the Kommission Ovar of the AGO: The New FIGO and WHO Classifications of Ovarian, Fallopian Tube and Primary Peritoneal Cancer". Geburtshilfe Frauenheilkd. 75 (10): 1021–1027. doi:10.1055/s-0035-1558079. PMC 4629993. PMID 26556905.
- ↑ Duska LR, Kohn EC (November 2017). "The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications". Ann. Oncol. 28 (suppl_8): viii8–viii12. doi:10.1093/annonc/mdx445. PMID 29232468.
- ↑ Prat J (April 2015). "FIGO's staging classification for cancer of the ovary, fallopian tube, and peritoneum: abridged republication". J Gynecol Oncol. 26 (2): 87–9. doi:10.3802/jgo.2015.26.2.87. PMC 4397237. PMID 25872889.
- ↑ Saida T, Tanaka YO, Matsumoto K, Satoh T, Yoshikawa H, Minami M (February 2016). "Revised FIGO staging system for cancer of the ovary, fallopian tube, and peritoneum: important implications for radiologists". Jpn J Radiol. 34 (2): 117–24. doi:10.1007/s11604-015-0513-3. PMID 26696400.
- ↑ Prat J (July 2015). "Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum: Abridged Republication of Guidelines From the International Federation of Gynecology and Obstetrics (FIGO)". Obstet Gynecol. 126 (1): 171–4. doi:10.1097/AOG.0000000000000917. PMID 26241270.
- ↑ Chen, Vivien W.; Ruiz, Bernardo; Killeen, Jeffrey L.; Cot�, Timothy R.; Wu, Xiao Cheng; Correa, Catherine N.; Howe, Holly L. (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (S10): 2631–2642. doi:10.1002/cncr.11345. ISSN 0008-543X. replacement character in
|last4=
at position 4 (help) - ↑ Wang J, Li J, Chen R, Lu X (July 2018). "Contribution of lymph node staging method and prognostic factors in malignant ovarian sex cord-stromal tumors: A world wide database analysis". Eur J Surg Oncol. 44 (7): 1054–1061. doi:10.1016/j.ejso.2018.03.027. PMID 29705285.