D-dimer elevation is a prognostic factor for ovarian clear cell carcinoma, irrespective to thromboembolic status.• mRNA expression of Tissue factor and IL6 was significantly higher in CCC than other cancers.• D-dimer high CCC was divided into two subtypes: immunologically hot-and cold-tumors.

Background We report a case of pulmonary edema induced by tocolytic agents that was successfully managed with noninvasive positive-pressure ventilation (NPPV) and resulted in extended gestation. Case presentation A 36-year-old Japanese pregnant woman received tocolytic therapy with ritodrine hydrochloride, magnesium sulfate, nifedipine, and betamethasone from 28 weeks of gestation. She developed respiratory failure. and her chest X-ray showed enlarged pulmonary vascular shadows. At 29 weeks and 1 day of gestation, she was diagnosed with pulmonary edema induced by tocolytic agents. Because respiratory failure worsened 2 days after ritodrine hydrochloride and magnesium sulfate were stopped, NPPV was initiated. Her respiratory status improved and she was weaned off of NPPV after 3 days. She underwent cesarean section because of breech presentation at 30 weeks and 0 days of gestation due to initiation of labor pains. Conclusions NPPV can be safely administered in cases of tocolytic agent-induced pulmonary edema during pregnancy.

Pipelle endometrial biopsy has been widely performed as an effective and minimally invasive test for endometrial diseases. However, the effectiveness of pretreatment pipelle endometrial biopsy in the ovarian, fallopian tube, and peritoneal cancers remains unexplored. We performed pretreatment pipelle endometrial biopsy for 90 patients with ovarian, fallopian tube, and primary peritoneal cancers from January 2014 to November 2021. We retrospectively analyzed the association between the results of pipelle endometrial biopsy and clinicopathological data. 25/61 (41.0%) cases with clinical stage II or higher were diagnosed with pipelle endometrial biopsy-positive (Pipelle-positive) and Pipelle-positive was not observed in 29 cases with clinical stage I. Pipelle-positive had significantly more high-grade serous carcinomas, positive peritoneal cytology, positive endometrial cytology, and positive cervical cytology than pipelle endometrial biopsy-negative cases. In 23 Pippele-positive, we confirmed surgical pathology, and 17/23 (74.0%) had a completely same diagnosis with pipelle endometrial biopsy. Conversely, 6/23 (26.0%) showed a minor diagnostic discrepancy between pipelle endometrial biopsy and surgical pathology. Companion diagnostic tests were performed using pipelle endometrial biopsy samples in four primarily inoperable patients and all tests were evaluable. Pipelle endometrial biopsy may allow for prompt histological diagnosis and initiation of chemotherapy while collecting tumor tissue for genetic testing in some advanced cases.

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Background There have been several reports of ovarian cancer cells being detected on endometrial cytology. Recently, pipelle endometrial biopsy has been widely performed as an effective, minimally invasive, and low-cost test for endometrial diseases. However, the effectiveness of pretreatment pipelle endometrial biopsy in the ovarian, fallopian tube, and peritoneal cancers remains unexplored. Methods We performed pretreatment pipelle endometrial biopsy for 90 patients with ovarian, fallopian tube, and primary peritoneal cancers from January 2014 to November 2021. We retrospectively analyzed the association between the results of pipelle endometrial biopsy and clinicopathological data. Results 25/61 (41.0%) cases with clinical stage II or higher were diagnosed with pipelle endometrial biopsy-positive (Pipelle-positive) and Pipelle-positive was not observed in 29 cases with clinical stage I. Pipelle-positive had significantly more high-grade serous carcinomas (p = 0.005), positive peritoneal cytology (p < 0.001), positive endometrial cytology (p < 0.001), and positive cervical cytology (p < 0.001) than pipelle endometrial biopsy-negative cases. In 23 Pippele-positive patients, we confirmed surgical pathology, and 17/23 (74.0%) had a completely same diagnosis with pipelle endometrial biopsy. Conversely, 6/23 (26.0%) showed a minor diagnostic discrepancy between pipelle endometrial biopsy and surgical pathology. Companion diagnostic tests (myChoice CDx and microsatellite instability test) were performed using pipelle endometrial biopsy samples in four primarily inoperable high-grade serous carcinoma patients and all tests were evaluable. Conclusion Pipelle endometrial biopsy is useful as a minimally invasive tumor sampling method for some advanced ovarian, fallopian tube, and peritoneal cancers. It may allow for prompt histological diagnosis and initiation of chemotherapy while collecting tumor tissue for genetic testing in primarily inoperable patients.