Brenner tumor of the ovary — ultrasound features and clinical management of a rare ovarian tumor mimicking ovarian cancer

  Objectives: To describe the ultrasound features of benign Brenner tumor in the background of complex clinical and histopathological pictures. Material and methods: We retrospectively identified patients with histologically confirmed benign Brenner tumor of the ovary who were treated in our institution in 2003–2016, and for whom complete imaging, clinical, perioperative and histopathological data were available in the database. Ultrasound findings were drawn from images and reports using terms and definitions of the International Ovarian Tumor Analysis group and pattern recognition description was applied. Results: Twenty-three patients were identified, most postmenopausal and asymptomatic. On ultrasound, 19/23 tumors were found unilaterally, 4/23 bilaterally, and 82% of tumors were detected in the left ovary. Most Brenner tumors (16/23) contained solid components and revealed no or minimal blood flow by subjective color score upon Doppler examination (19/23, 83%). Calcifications with shadowing were observed in 57% of all Brenner tumors and in 81% of tumors containing solid components. The complex appearance of the tumor misled the sonographers to describe the mass as malignant in 9 cases (39%), and frozen section was performed perioperatively. Surgery was performed via laparoscopy in 11 (48%) and via laparotomy in 12 (52%) cases. Conclusions: The complexity of the ultrasound picture, consisting of features like calcifications with acoustic shadowing, a poorly vascularized solid mass, and a left-sided localization could be signs of a benign Brenner tumor and could preop­eratively help to differentiate between benign and malignant tumor

The amount of preoperative endometrial tissue surface in relation to final endometrial cancer classification

Objective: To evaluate whether the amount of preoperative endometrial tissue surface is related to the degree of concordance with final low- and high-grade endometrial cancer (EC). In addition, to determine whether discordance is influenced by sampling method and impacts outcome. Methods: A retrospective cohort study within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC). Surface of preoperative endometrial tissue samples was digitally calculated using ImageJ. Tumor samples were classified into low-grade (grade 1-2 endometrioid EC (EEC)) and high-grade (grade 3 EEC + non-endometroid EC). Results: The study cohort included 573 tumor samples. Overall concordance between pre- and postoperative diagnosis was 60.0%, and 88.8% when classified into low- and high-grade EC. Upgrading (preoperative low-grade, postoperative high-grade EC) was found in 7.8% and downgrading (preoperative high-grade, postoperative low-grade EC) in 26.7%. The median endometrial tissue surface was significantly lower in concordant diagnoses when compared to discordant diagnoses, respectively 18.7 mm2 and 23.5 mm2 (P = 0.022). Sampling method did not influence the concordance in tumor classification. Patients with preoperative high-grade and postoperative low-grade showed significant lower DSS compared to patients with concordant low-grade EC (P = 0.039). Conclusion: The amount of preoperative endometrial tissue surface was inversely related to the degree of concordance with final tumor low- and high-grade. Obtaining higher amount of preoperative endometrial tissue surface does not increase the concordance between pre- and postoperative low- and high-grade diagnosis in EC. Awareness of clinically relevant down- and upgrading is crucial to reduce subsequent over- or undertreatment with impact on outcome

Supplementary_Table_S4_RS_FINALafter_review - Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer

<p>Supplementary_Table_S4_RS_FINALafter_review for Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer by Luděk Záveský, Eva Jandáková, Vít Weinberger, Luboš Minář, Veronika Hanzíková, Daniela Dušková, Lenka Záveská Drábková, Iveta Svobodová, and Aleš Hořínek in Reproductive Sciences</p

Supplementary_Table_S3_RS_FINALafter_review - Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer

<p>Supplementary_Table_S3_RS_FINALafter_review for Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer by Luděk Záveský, Eva Jandáková, Vít Weinberger, Luboš Minář, Veronika Hanzíková, Daniela Dušková, Lenka Záveská Drábková, Iveta Svobodová, and Aleš Hořínek in Reproductive Sciences</p

Supplementary_Table_S2_RS_FINALafter_review - Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer

<p>Supplementary_Table_S2_RS_FINALafter_review for Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer by Luděk Záveský, Eva Jandáková, Vít Weinberger, Luboš Minář, Veronika Hanzíková, Daniela Dušková, Lenka Záveská Drábková, Iveta Svobodová, and Aleš Hořínek in Reproductive Sciences</p

Supplementary_Table_S1_RS_FINAL - Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer

<p>Supplementary_Table_S1_RS_FINAL for Ascites-Derived Extracellular microRNAs as Potential Biomarkers for Ovarian Cancer by Luděk Záveský, Eva Jandáková, Vít Weinberger, Luboš Minář, Veronika Hanzíková, Daniela Dušková, Lenka Záveská Drábková, Iveta Svobodová, and Aleš Hořínek in Reproductive Sciences</p