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Ovarian Clear Cell Neoplasm

Clear Cell Tumor of Ovary


Presentation

  • Hobnail cells are present; however they do not exhibit stromal invasion. hemorrhage is repeatedly associated with this malignant transformation.[file.scirp.org]
  • Women typically present between the ages of 40 and 70 with the peak incidence at age 52. Between 1/3 and 2/3 are nulliparous. Presenting symptoms are usually related to an enlarging abdominal mass.[path.upmc.edu]
  • No cancer cells are present in the abdomen IIB: Cancer is present in one or both of the ovaries and has spread to other pelvic organs, such as the bladder, colon, or rectum IIC: Cancer is present in one or both ovaries, and it has spread to the pelvic[dovemed.com]
  • However, our case presented as a clear cell RCC with simultaneous ovarian metastasis. Case Presentation A 45 year old lady presented to surgery outpatient department with complaints of hematuria for 7 months.[npplweb.com]
  • Median age (48 years) in the present study supports the fact that CCO is a disease of young women.[indianjcancer.com]
Infertility
  • Furthermore, this disease is typically associated with painful symptoms, dysmenorrhea, dyspareunia, pelvic pain, infertility, and malignant transformation [2].[file.scirp.org]
  • They also cause infertility. These rare subtypes may be unique among the other ovarian cancers. But most women with one of these subtypes will get the same treatment as women with a more common type of ovarian cancer.[healthline.com]
  • She was noted for primary infertility, conceived 6 yr later and delivered a live baby by caesarean section. She had presented again 2 yr later for dysmenorrhoea and left ovarian cyst was noted on ultrasound examination.[ijp.iranpath.org]
  • Hormonal factors: History of infertility and use of fertility drugs - eg, clomifene. Nulliparous women are more likely to develop an ovarian malignancy than women who have been pregnant three or more times. Early menarche and late menopause.[patient.info]
  • Introduction Endometriosis is a benign gynecological condition that affects approximately 5%–10% of reproductive aged women causing symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility. 1, 2 Though endometriosis is a benign disease[dovepress.com]
Turkish
  • Synchronous primary cancers of the female reproductive tract in Turkish women. Asian Pac J Cancer Prev 2011;12:857-9. 3. Nayal B, Mathew M, Rao L, Nagel B, Kumar P.[jmidlifehealth.org]
Aspiration
  • Add fresh medium, aspirate and dispense into new flasks.[atcc.org]
  • Ultrasound guided fine-needle aspiration cytology smears from left ovarian cyst showed papillary fragments of crowded atypical glandular cells with large overlapping pleomorphic nuclei with prominent nucleoli and were diagnosed as serous papillary adenocarcinoma[ijpmonline.org]
  • Absence of tingible body macrophages in germinal centers Pitfall 2 小円形細胞腫瘍 Small round cell tumor Clue 30 唾液腺腫瘍における形質細胞様細胞 Plasmacytoid hyaline cells in the salivary gland tumor Clue 31 粘液球・硝子球(穿刺吸引細胞診) Mucous balls and/or hyaline balls(in fine needle aspiration[kinpodo-pub.co.jp]
Pelvic Pain
  • Furthermore, this disease is typically associated with painful symptoms, dysmenorrhea, dyspareunia, pelvic pain, infertility, and malignant transformation [2].[file.scirp.org]
  • Abdominal pain (the pain is usually a pelvic pain) Abdominal swelling due to the mass or due to fluid accumulation in the belly (called ascites) Increased abdominal girth due to fluid accumulation (ascites) Persistent feeling of abdominal bloating with[dovemed.com]
  • Introduction Endometriosis is a benign gynecological condition that affects approximately 5%–10% of reproductive aged women causing symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility. 1, 2 Though endometriosis is a benign disease[dovepress.com]
Dyspareunia
  • Furthermore, this disease is typically associated with painful symptoms, dysmenorrhea, dyspareunia, pelvic pain, infertility, and malignant transformation [2].[file.scirp.org]
  • […] as constipation Feeling full soon after eating less (having a feeling of satiety after eating less) Loss of appetite with weight loss Fatigue, feeling tired easily Frequent urination (polyuria) and difficulty while urinating Frequent pain during sex (dyspareunia[dovemed.com]
  • Introduction Endometriosis is a benign gynecological condition that affects approximately 5%–10% of reproductive aged women causing symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility. 1, 2 Though endometriosis is a benign disease[dovepress.com]
Pelvic Pain
  • Furthermore, this disease is typically associated with painful symptoms, dysmenorrhea, dyspareunia, pelvic pain, infertility, and malignant transformation [2].[file.scirp.org]
  • Abdominal pain (the pain is usually a pelvic pain) Abdominal swelling due to the mass or due to fluid accumulation in the belly (called ascites) Increased abdominal girth due to fluid accumulation (ascites) Persistent feeling of abdominal bloating with[dovemed.com]
  • Introduction Endometriosis is a benign gynecological condition that affects approximately 5%–10% of reproductive aged women causing symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility. 1, 2 Though endometriosis is a benign disease[dovepress.com]
Adnexal Mass
  • Página 406 - Goldstein SR, Subramanyam B, Snyder JR et al: The postmenopausal cystic adnexal mass, the potential role of ultrasound in conservative management. Obstet Gynaecol 73:8, 1989. ‎ Página 46 - Kelly, SJ (1977).[books.google.es]
  • Right adnexal mass was sent for frozen section. Diagnosis of adult granulosa cell tumor (AGCT) was given. Patient underwent trans-abdominal hysterectomy with bilateral salpingo-oopherectomy.[jmidlifehealth.org]
Dysmenorrhea
  • Furthermore, this disease is typically associated with painful symptoms, dysmenorrhea, dyspareunia, pelvic pain, infertility, and malignant transformation [2].[file.scirp.org]
  • Introduction Endometriosis is a benign gynecological condition that affects approximately 5%–10% of reproductive aged women causing symptoms of chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility. 1, 2 Though endometriosis is a benign disease[dovepress.com]

Workup

Ground Glass Appearance
  • glass appearance in a cyst suggests an endometrioma, which in postmenopausal women should be evaluated carefully to rule out a component of clear cell carcinoma ( Ultrasonography 2015;34:173 ) Prognostic factors When confined to the pelvis, clear cell[pathologyoutlines.com]
Thrombocytosis
  • Thus, thrombocytosis is also common in patients with EOC [ 13 ]. Since tumor cells secret thrombopoietic cytokines such as interleukin-6, thrombocytosis is related to poor response in solid tumors, combined with lymphocytopenia [ 22 ].[e-crt.org]
Lymphocytopenia
  • Discussion SIR involves secondary changes in the levels of circulating leukocytes, which show neutrophilia, monocytosis, lymphocytopenia and thrombocytosis [ 10 ].[e-crt.org]
Ovarian Mass
  • Right ovarian mass was cystic with intact capsule. Left ovarian mass was partly cystic, partly solid and was ruptured at the cystic part with chocolate materials. Uterus was bulky and POD was filled with dense adhesion and serous fluid.[ijp.iranpath.org]
  • MRI Often seen as a cystic ovarian mass with the margin being generally smooth. Solid protrusions are often both round and few in number.[radiopaedia.org]
  • We encountered an incidental left ovarian, International Federation of Gynecology and Obstetrics grade 2, endometrioid carcinoma in a patient presenting with a right ovarian mass immunohistopathologically proven to be clear cell carcinoma.[jmidlifehealth.org]
  • In most cases, the ovarian mass was detected after the diagnosis of the renal tumor [ 3 ]. However, our case presented as a clear cell RCC with simultaneous ovarian metastasis.[npplweb.com]
  • mass is usually not painful and is poorly defined These tumors can cause para-endocrine hypercalcemia (a disorder occurring due to ovarian mass) The nodule is typically less than 15 cm in size (along the larger dimension); however, some may grow to greater[dovemed.com]

Treatment

  • For stage II to IV, adjuvant treatment may have similar options like those given to treat epithelial ovarian cancer. (See Guide 8 on page 54 for possible treatment options).[nccn.org]
  • […] evaluating innovative treatment strategies.[texasoncology.com]
  • When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial.[my.clevelandclinic.org]
  • Lead researcher: Professor Iain McNeish Location: University of Glasgow Research strand: Treatment This project is looking at developing new treatments for ovarian clear cell carcinoma, a rare subtype of ovarian cancer.[targetovariancancer.org.uk]

Prognosis

  • They said clear cell borderline ovarian tumors carry a good prognosis. However, the power of this conclusion is limited.[file.scirp.org]
  • In some studies, the prognosis appears similar to that for other ovarian carcinomas, but in others, the prognosis is said to be worse.[ovariancancer.jhmi.edu]
  • […] than high grade serous carcinoma However, advanced stage clear cell carcinoma has a worse prognosis ( Am J Surg Pathol 2011;35:36 ) Presence of GPC3 is associated with poor prognosis ( J Clin Pathol 2010;63:962 ), Treatment Comprehensive surgical staging[pathologyoutlines.com]
  • General Prognosis: Worse prognosis versus other surface epithelial tumours. [1] Poor response to platinum-based chemotherapy. [2] 2.5x risk for thromboembolism compared to other ovarian carcinomas. [3] Epidemiology: Asians appear to be at an increased[librepathology.org]
  • Women with stage IA OCCC have excellent prognosis, and future studies should explore whether they benefit from adjuvant chemotherapy.[ncbi.nlm.nih.gov]

Etiology

  • Right ovary showed heterogeneously enhancing adnexal lesion likely to be of malignant etiology. Serum CA-125 level was normal.[npplweb.com]
  • Wu Youke developed the concept that some diseases were caused by transmissible agents and his book Wenyi Lun can be regarded as the main etiological work that brought forward the concept, ultimately attributed to Westerners, of germs as a cause of epidemic[wikivisually.com]
  • Evidence exists to support a unique etiology of these tumors compared to other types of ovarian cancers.[dovepress.com]
  • […] into the following: Serous cystadenoma Borderline serous tumour Serous cystadenocarcinoma Adenofibroma Cystadenofibroma Mucinous tumours are further classified as: Mucinous cystadenoma Borderline mucinous tumour Mucinous cystadenocarcinoma Adenofibroma Etiology[atlasgeneticsoncology.org]

Epidemiology

  • General Prognosis: Worse prognosis versus other surface epithelial tumours. [1] Poor response to platinum-based chemotherapy. [2] 2.5x risk for thromboembolism compared to other ovarian carcinomas. [3] Epidemiology: Asians appear to be at an increased[librepathology.org]
  • Epidemiologie – Epidemiology is the study and analysis of the patterns, causes, and effects of health and disease conditions in defined populations.[wikivisually.com]
  • This assumes epidemiological relevance because mucinous cystadenocarcinomas have not been found in intimate association with endometriosis, which is frequently found with other ovarian neoplasms such as endometrioid and clear cell carcinomas. 3, 8, 9[jcp.bmj.com]
  • PMID 8275457 Epidemiology and primary prevention of cancers of the breast, endometrium, and ovary. A brief overview. Kelsey JL, Whittemore AS Annals of epidemiology. 1994 ; 4 (2) : 89-95.[atlasgeneticsoncology.org]
  • Borderline endometrioid Epidemiology [ 3 ] Ovarian cancer has a lifetime risk of around 2% for women in England and Wales. It is the leading cause of death from gynaecological cancer [ 4 ].[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Endometriosis and ovarian cancer: thoughts on shared pathophysiology. Am J Obstet Gynecol. 2003;189:280–294. 63. Hou Z, Sun L, Gao L, Liao L, Mao Y, Liu J.[dovepress.com]

Prevention

  • You Should Know Anatomy Prevention Risk Factors Genetics Screening CA 125 Symptoms Early Detection Diagnosis Radiology Pathologists Staging Treatment Recurrent Disease Recurrent Q & A Nutrition Prognosis Clinical Trials Glossary Discussion Board Questions[ovariancancer.jhmi.edu]
  • Opportunistic salpingectomy: uptake, risks, and complications of a regional initiative for ovarian cancer prevention. Am J Obstet Gynecol. 2014;210(471):e1–e11. 84. Salpingectomy for ovarian cancer prevention. Committee Opinion No 620.[dovepress.com]
  • There is no evidence as yet for any maintenance chemotherapy to prevent or delay relapse. NICE guidelines recommend paclitaxel or PLD for recurrent disease but not alternatives gemcitabine, trabectedin or topotecan [ 23 ].[patient.info]
  • These aggressive treatments prevent the cancer from moving to nearby organs. They also cause infertility. These rare subtypes may be unique among the other ovarian cancers.[healthline.com]
  • BRCA genes are involved with repairing damaged DNA and normally work to prevent tumor development.[texasoncology.com]

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