Approaches to the Diagnosis and Management of Ovarian Cancer in Pregnancy

Michalczyk, Kaja; Cymbaluk‐Płoska, Aneta

doi:10.2147/cmar.s290592

Cited by 11 publications

(27 citation statements)

References 56 publications

(73 reference statements)

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“…La incidencia de cáncer en el embarazo se estima en un 0,05-1% y ha aumentado en los últimos 30 años, siendo más frecuente cuanto mayor es la edad materna 3,10 .…”

Section: Discussionunclassified

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Manejo con cirugía conservadora de tumor mucinoso infiltrante ovárico coexistente con tumor mucinoso borderline contralateral en gestante de 8 semanas

Smith-Ballester¹,

Martínez-Aspas²,

Hernández-Martínez³

et al. 2024

RECHOG

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Introducción: Aproximadamente un 4% de mujeres embarazadas presentan tumoraciones anexiales en el primer trimestre de gestación, siendo la mayoría quistes anexiales simples. Solo el 1,5% persisten tras el primer trimestre y en torno al 0,9% son malignos. Caso clínico: Paciente de 31 años que consultó en urgencias por sangrado y amenorrea de 5 semanas. La ecografía transvaginal evidenció un saco gestacional intraútero y una tumoración anexial izquierda compleja de 68 mm, multilocular, sólida, de ecogenicidad mixta, con septos gruesos y un área sólida vascularizada de 40 mm, sospechosa de neoplasia de ovario. Se realizó manejo quirúrgico conservador mediante anexectomía bilateral laparoscópica en la octava semana de gestación. El diagnóstico fue de adenocarcinoma mucinoso infiltrante bien diferenciado en ovario derecho, coexistente con tumor mucinoso borderline en ovario izquierdo (etapa IC FIGO). El embarazo cursó con normalidad, a excepción de feto pequeño para la edad gestacional en la semana 39. Se finalizó la gestación en la semana 40 mediante parto vaginal. Debido al deseo de la paciente, la cirugía se realizó en el primer trimestre de embarazo en lugar de en el segundo como se recomienda. La cirugía se completó meses después del parto, con histerectomía y apendicectomía laparoscópica. Discusión: El cáncer de ovario es el segundo tumor ginecológico más diagnosticado durante el embarazo. Suele diagnosticarse en el primer trimestre debido al cribado ecográfico gestacional. Ocurre en mujeres con baja paridad y en sus últimos años de edad reproductiva. Esto podría verse reflejado en un aumento de su incidencia debido al retraso de la edad materna al primer embarazo. Normalmente se diagnostica en etapa I, siendo entonces la supervivencia superior al 90% a los 5 años. En etapas iniciales en mujeres embarazadas, la laparoscopia es tan válida como la laparotomía.

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“…La incidencia de cáncer en el embarazo se estima en un 0,05-1% y ha aumentado en los últimos 30 años, siendo más frecuente cuanto mayor es la edad materna 3,10 .…”

Section: Discussionunclassified

“…Mientras que el de tipo epitelial es el cáncer de ovario más frecuente en no gestantes, durante el embarazo lo es el de células germinales 10 . Alrededor del 35% de las neoplasias de ovario en gestantes son carcinomas epiteliales 6 , siendo el adenocarcinoma mucinoso un subtipo poco frecuente de ellos 10,12 .…”

Section: Discussionunclassified

Manejo con cirugía conservadora de tumor mucinoso infiltrante ovárico coexistente con tumor mucinoso borderline contralateral en gestante de 8 semanas

Smith-Ballester¹,

Martínez-Aspas²,

Hernández-Martínez³

et al. 2024

RECHOG

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“…Prophylactic perioperative tocolytic therapy might help delay preterm delivery [ 36 ]. Staging surgery can be performed, along with a CS, after the fetus is delivered at term [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Two-Port Laparoscopic Surgery on Pregnancy Outcomes of Patients with Concurrent Adnexal Masses

Hsu

et al. 2022

JCM

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Adnexal masses are common in pregnancy, with 2–10% of pregnancies presenting with an ovarian mass and approximately 1–6% of these masses being malignant. For suspected malignancy or masses with symptoms, surgery must be performed as early as possible. We retrospectively investigated the effect of two-port laparoscopic surgery on the outcomes of patients with concurrent adnexal masses between 2012 and 2019 (including large mucinous tumor, large teratoma, serous borderline tumor, and heterotopic pregnancy). Laparoscopic right partial oophorectomy was performed for a 27 cm ovarian mucinous tumor at a gestational age (GA) of 21 weeks, laparoscopic right oophorocystectomy for an 18 cm teratoma at a GA of 10 weeks, and laparoscopic left salpingo-oophorectomy for a 7 cm serous borderline tumor at a GA of 7 weeks after ultrasonographic confirmation of an intrauterine gestational sac with a fetal heartbeat. Laparoscopic excision of a tubal pregnancy was performed in a heterotopic pregnancy at a GA of 12 weeks with massive internal bleeding. Laparoscopic surgery is easier and safe to perform during early pregnancy because a smaller uterus allows for superior visualization. All of these patients had optimal postoperative recovery and normal spontaneous delivery at term. We discussed several aspects of treatment and delivery, namely treatment option (expectant management or surgery), surgery timing (early or advanced pregnancy), surgery type (laparoscopy or laparotomy), and delivery route (normal spontaneous delivery or cesarean section), in patients with concurrent adnexal tumors and their effects on pregnancy outcomes.

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“…Understanding the molecular mechanisms implicated in ovarian cancer recurrence and progression has improved as technology has advanced, and biomarkers can significantly enhance the prognosis of ovarian cancer patients [17]. Tumor markers and imaging studies play important roles in diagnosis, helping to differentiate benign masses from malignancies to optimize treatment planning [18]. Less than half of ovarian cancer patients live longer than five years after being diagnosed.…”

Section: Plos Onementioning

confidence: 99%

Sensitivity and specificity of microRNA-204, CA125, and CA19.9 as biomarkers for diagnosis of ovarian cancer

et al. 2022

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Background Ovarian cancer is usually detected at later stages and no effective screening approach, has been identified. Therefore, sensitive and specific biomarkers for detecting ovarian cancer are urgently needed. Objective This study aimed to investigate the efficacy of six biomarkers for the early clinical diagnosis of ovarian cancer. Subjects & methods The study included 120 patients (benign ovarian tumors and early and late ovarian carcinoma) and 30 control healthy volunteers. MiRNA-204, CA125, CA19.9, hepcidin, microfibril-associated glycoprotein 2, and ferroportin levels were determined in all patients and control volunteers. Results The combined area under the receiver operating characteristic curves for miRNA-204, CA125, and CA19.9 were 0.938, 1.000, and 0.998 for benign tumors and early and late ovarian carcinomas, respectively. The sensitivities of miRNA-204, CA125, and CA19.9 were 98.04%, 100.00%, and 96.19% and the specificities were 58.33%, 62.50%, and 57.78%, respectively. Conclusion The positive predictivity of miRNA-204, CA125, and CA19.9 for ovarian cancer is high (59.57%, 58.24%, and 61.67%, respectively). Thus, the combination of these three biomarkers is a good diagnostic tool for ovarian cancer.

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Approaches to the Diagnosis and Management of Ovarian Cancer in Pregnancy

Cited by 11 publications

References 56 publications

Manejo con cirugía conservadora de tumor mucinoso infiltrante ovárico coexistente con tumor mucinoso borderline contralateral en gestante de 8 semanas

Manejo con cirugía conservadora de tumor mucinoso infiltrante ovárico coexistente con tumor mucinoso borderline contralateral en gestante de 8 semanas

Effect of Two-Port Laparoscopic Surgery on Pregnancy Outcomes of Patients with Concurrent Adnexal Masses

Sensitivity and specificity of microRNA-204, CA125, and CA19.9 as biomarkers for diagnosis of ovarian cancer

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