Is Omentectomy Necessary for Non-Endometrioid Endometrial Cancer?

Background: In subtypes of non-endometrioid endometrium cancers (non-ECC), it is not clear whether the omentectomy is a part of debulking if visual assessment is normal. Recently, the ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group in their report titled "Endometrial Cancer: diagnosis, treatment and follow-up" recommended that omentectomy be performed in the serous subtype, but not in carcinosarcoma, undifferentiated endometrial carcinoma or clear cell. In this study, the question is whether omentectomy should be a part of a staging procedure in patients with non-ECC. Besides, the sensitivity and specificity of the visual assessment of omentum were analyzed. Methods:Patients diagnosed with non-ECC in 2 gynecological oncology clinics between 2005 and 2015 were retrospectively reviewed. Occult (absence of visible lesions) and gross (presence of visible lesions) omental metastasis rates of histological subtypes were analyzed. Results: We identified 218 patients with non-ECC. Thirty-four of them (15.1%) had omental metastases and 44.1% of these metastases (n = 15) were occult metastases. The sensitivity of the surgeon's visual assessment of an omentum (positive or negative) was 0.55. The highest rate of omental metastasis was found in carcinosarcoma followed by serous, mixed subtypes, and clear-cell (20.4, 17.3, 16.6, 10.0%, respectively). Adnexal metastasis was the only factor associated with occult omental metastasis (p = 0.003). Conclusion: Omental metastases occur too often to omit omentectomy during surgical procedures for non-ECC regardless of histological subtypes, and visual assessment is insufficient in recognizing the often occult metastases. Omentectomy should be a part of the staging surgery in patients with non-ECC. (C) 2017 S. Karger AG, Base

Brenner tumor in pregnancy: Clinical approach and pathological findings

The Brenner tumor is art uncommon ovarian tumor in pregnancy with only three previous cases in the English published reports. A 35-year-old woman delivered abdominally because of distress symptoms and a Brenner tumor was resected incidentally. Histological examination revealed a tumor composed of epithelial nests and areas of stromal luteinization. The patient was treated conservatively. Brenner tumor should be considered in the differential diagnosis of adnexal masses during pregnancy. These tumors are mainly benign and show typical luteinization associated with the hormonal milieu in pregnancy

Angiokeratoma of the clitoris with evident vulvar varicosity

Angiokeratomas of the vulva are uncommon, benign vascular lesions that are generally located on the labia. However, the clitoris is an extremely rare location, with only three published cases. We report a case of clitoral angiokeratoma in a 22-year-old nulligravida with a history of surgery to remove a clitoral mass at 6 years of age. The case described herein is distinguished from the other case reports by an accompanying varicose structure involving the vulva

Uterine adenosarcoma with ovarian sex cord-like differentiation: A case report and review of the literature

Objectives: To determine the prognosis of uterine adenosarcoma with ovarian sex cord like-differentiation after treatment and to review the literature

Uterine adenosarcoma with ovarian sex cord-like differentiation: A case report and review of the literature

Objectives: To determine the prognosis of uterine adenosarcoma with ovarian sex cord like-differentiation after treatment and to review the literature

Mucinous adenocarcinoma arising in ovarian mature cystic teratoma in pregnancy

We report a case of mucinous adenocarcinoma arising from mature cystic teratoma (MCT) of the ovary ascertained incidentally during pregnancy. An ovarian adnexal mass was seen in a 38-year-old pregnant woman during cesarean section. Oophorectomy revealed a mucinous adenocarcinoma arising from MCT with additional capsule invasion. Following this, staging procedures were applied. The patient was staged as IC and adjuvant chemotherapy was applied. She has remained disease-free for over 24 months. To our knowledge, this is a case of mucinous adenocarcinoma arising from MCT and the third case of malignant transformation from MCT in pregnancy in English literature

Malignant transformation arising from mature cystic teratoma of the ovary: A report of six cases

Aim: Malignant transformation of mature cystic teratoma (MCT) is an uncommon complication. Preoperative diagnosis is difficult because of the lack of specific symptoms and signs indicating malignancy. Thus, we retrospectively analyzed the clinical characteristics of patients and the role of surgery in their management

Complete surgical resection of retroperitoneal leiomyosarcoma in pregnancy: a case report

Retroperitoneal soft tissue sarcoma (RPS) is extremely rare in pregnancy, so there has been little experience in dialing with this condition. We report our experience of a pregnant patient with a retroperitoneal soft tissue sarcoma, which was treated by complete surgical resection at 17 weeks gestation. After regular follow-up, the patient admitted to our hospital in labor, in the 38th gestational week and vaginally delivered a male fetus weighing 3,200 g with Apgar score of 8 and 10 at 1 and 5 min respectively. Adjuvant radiotherapy and chemotherapy is controversial in RPS and due to postoperative continuation of pregnancy in our case, the adjuvant therapy was not practiced. The patient had an uneventful recovery, and no recurrence was detected for 20 months in the follow-up period