Laparoscopic evaluation of metastatic ovarian cancer: A case report

Objective aid case: Both noninvasive and invasive methods have limited value in the diagnosis of metastatic ovarian cancer. We present a case with the initial complaint of abdominal distention in whom primary and metastatic tumor sites were safely diagnosed by using laparoscopy: a gastric tumor with ovarian metastasis

Malignant germ cell tumors of the ovary: a review of 41 cases and risk factors for recurrence.

Objective: To review the outcome of treatment in patients with malignant ovarian germ cell tumors and to define the risk factors for recurrence. Material and Methods: Forty-one patients with malignant ovarian germ cell tumors were reviewed retrospectively. Survival time and survival rate were obtained. Risk factors such as stage, histological type, and type of operation were evaluated for recurrence. Results: Twenty-three (56%) had dysgerminomas, eight (19.5%) had mixed germ cell tumors, three (7.3%) had yolk sac tumors, three (7.3%) had immature teratomas, two (4.8%) had squamous cell carcinoma arising from a mature teratoma, one (2.4%) had embryonal carcinoma and one choriocarcinoma. Most of the cases (73%) were in Stage I. Twenty-nine patients (70.7%) underwent conservative surgery and 12 patients (29.3%) had at least bilateral salpingo-oophorectomy. Thirty patients were operated on optimally with surgical staging, and 11 suboptimally. Seven patients (17%) had recurrence after remission. The overall survival time was 187 +/- 8.43 months for all cases. 195 +/- 8.49 for dysgerminoma and 161 +/- 10.96 for non-dysgerminoma cases with a median follow-up time of 98.52 (8-204) months. Non-dysgerminoma histologic type, being operated on suboptimally and radically, and advanced tumor stage have been found to be risk factors for recurrence. Conclusion: Regardless of histologic types and stages the prognosis of germ cell tumors are satisfactory with current therapeutic strategies

Heart Failure and Epicardial Adipose Tissue

Epicardial adipose tissue (EAT) has been investigated in patients with both systolic and diastolic heart failure and suggested to play a pathogenic role, although results are not univocal. Experimental studies suggest a potential protective role of the brown fat features of EAT against the systolic heart failure. A function of EAT p53 and adiponectin has been also suggested in patients with heart failure. A neuromodulatory role of EAT in heart failure has been also considered. Clinically, diastolic heart failure is commonly associated with higher EAT. The role of EAT in the systolic heart failure is more controversial, as it could be influenced by concomitant confounders, such as coronary artery disease, diabetes and obesity. Some studies found that EAT volume was higher in patients with systolic heart failure, whereas other studies showed that either CT, MRI or ultrasound measured epicardial fat was actually lower in subjects with systolic heart failure. Epicardial fat may incur in fibrotic changes during chronic and advanced cardiac failure. Whether EAT plays a role in the long-term prognosis of heart failure requires future investigation