Ovarian fibrosarcoma with long-term survival: A case report

Huang, Y.-C.; Hsu, K.-F.; Chou, C.-Y.; Dai, Yiwu; Tzeng, Ching‐Cherng

doi:10.1136/ijgc-00009577-200107000-00016

Cited by 12 publications

(11 citation statements)

References 6 publications

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“…In 1997, Tsuji et al established that the MIB‐1 (Ki‐67) labeling index and proliferative index by DNA flow cytometry, which were higher in fibrosarcomas, could also be used in the differential diagnosis especially in cases with 3–4 mitotic figures/hpf (8) . This finding has also been confirmed in some other recent reports (3,13,15) . Tsuji et al (8) also concluded that trisomy 8 cells in the tumor may be a reliable marker for diagnosis of fibrosarcomas; this has not yet been confirmed by other reports.…”

Section: Discussionsupporting

confidence: 51%

“…Primary ovarian sarcomas are very rare tumors and account for less than 3% of all ovarian neoplasias. Among the primary ovarian sarcomas, fibrosarcomas are relatively common (1,3) . However, there are only about 30 cases in the literature reported within past three decades, showing the extreme rarity of these tumors (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…They have high recurrence and mortality rates (1,2,13) . There are few reports of long‐term survival (3,14) . Surgical excision should be the initial step of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Primary ovarian fibrosarcoma: a case report and review of the literature

Gültekin

Dursun

Özyüncü

et al. 2005

Int J Gynecol Cancer

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Gultekin M, Dursun P, Ozyuncu O, Usubutun A, Yuce K, Ayhan A. Primary ovarian fibrosarcoma: a case report and review of the literature. Int J Gynecol Cancer 2005;15:1142-1147.Primary ovarian fibrosarcomas are very rare tumors with great heterogeneity among reported cases. There are only a few reports of the subject in the literature, and along with the nature of the disease, diagnosis and treatment still remain to be established. In this report, we reviewed the cases published in the English literature within the past 30 years and tried to highlight certain aspects of the disease. A 52-year-old parous woman was admitted to our hospital with the complaints of abdominopelvic pain. Initial diagnostic work-up revealed a solid mass on the right ovary. After explorative laparotomy, the pathologic examination reported a primary ovarian fibrosarcoma. The patient has been free of disease for 1 year without any adjuvant therapy. Although ovarian fibrosarcomas are unusual causes of solid masses in postmenopausal women, it should be kept in mind when evaluating adnexal masses in this age group.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Primary ovarian fibrosarcoma: a case report and review of the literature

Gültekin

Dursun

Özyüncü

et al. 2005

Int J Gynecol Cancer

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“…Ovarian fibrosarcoma is a rare and aggressive disease with poor prognosis despite radical surgery and adjuvant therapy 1–4 …”

Section: Discussionmentioning

confidence: 99%

Ovarian fibrosarcoma with metastasis after 12 years

Adams¹,

Gaskell

Barber

et al. 2011

Australian and New Zealand Journal of Obstetrics and Gynaecology

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19 Plante M, Renaud M, Hoskins I, Roy M. Vaginal radical trachelectomy: a valuable fertility-preserving option in the management of early-stage cervical cancer. A series of 50 pregnancies and review of the literature. Gynecol Oncol 2005; 98 (1): 3-10. 20 Farthing A. Future fertility after conservation surgery for cervical cancer. Br J Hosp Med 2006; 67 (5): 250-252. 21 Jolley JA, Battista L, Wing DA. Management of pregnancy after radical trachelectomy: case reports and systematic review of the literature. Am J Perinatol 2007; 24 (9): 531-539. 22 Shepherd JH. Challenging dogma: radical conservation surgery for early stage cervical cancer in order to retain fertility. Ann R Coll Surg Engl 2009; 91 (3): 181-187.A 62-year-old parous woman presented with a 2-month history of an increasing painless mass overlying her right scapular region. Examination revealed a 9 · 5 cm subcutaneous mass adherent to the latissimus dorsi muscle and a separate 4 · 3 cm right axillary mass. Staging CT scans showed no evidence of disease elsewhere. Twelve years earlier, the patient had undergone a right oophorectomy for a benign serous cystadenoma with a 15-mm mural nodule of fibrosarcoma. Eleven years later, she had a left ovarian serous cystadenoma with no cellular atypia removed, and peritoneal washings revealed no evidence of malignancy.The scapular mass was biopsied and subsequently widely excised, including the overlying skin and the underlying latissimus dorsi muscle. The resection defect was reconstructed with a contralateral latissimus dorsi myocutaneous free flap. The axillary mass, which arose from the musculocutaneous nerve, was excised, along with a level II axillary dissection. Adjuvant radiotherapy and chemotherapy was considered but not given.Macroscopic examination of the scapular mass revealed a completely excised 8.5 · 8.5 · 6.0 cm tumour with a pale pink slimy cut surface and areas of haemorrhage. Histology showed large nodular myxoid areas with abrupt transition to cellular fascicles of malignant spindle cells with moderate nuclear pleomorphism, vesicular nuclei, prominent nucleoli and 8 mitoses ⁄ 10 high-power fields (Fig. 1a). Immunohistochemical analysis revealed positive staining for vimentin and negative staining for CKAE 1 ⁄ 3, HMWCK, LMWCK, (a) (b) Figure 1 H&E staining (a) of the metastatic sarcoma in right scapular region showing fascicles of fibroblast-like spindle cells show moderate nuclear pleomorphism, with a mitotic rate of 8 mitotic figures ⁄ 10 high-power fields (·200 magnification); and (b) the original right ovarian specimen showing a benign serous cystadenoma containing a cellular nodule that comprises mildly atypical plump spindle cells with 8 mitotic figures ⁄ 10 high-power fields (·200 magnification).

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“…Currently, the treatments and prognostic factors of ovarian brosarcoma are still under discussion. Although there have been several reported cases with long survival [14,15], the prognosis of ovarian brosarcoma is still generally poor.…”

Section: Prognosismentioning

confidence: 99%

Ovarian Fibrosarcoma: 5 Case Reports and Review of Literature

Sun

Cheng

Cao

et al. 2020

Preprint

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Ovarian fibrosarcoma is an extremely rare and malignant sex-cord stromal tumor. Due to its low incidence and poor prognosis, till now very few cases have been reported and most of them are sporadic. The treatments and prognostic factors of ovarian fibrosarcoma are still under discussion. Here we report 5 cases of ovarian fibrosarcoma in Peking Union Medical College Hospital during the past 20 years. The 5 patients were 41, 51, 54, 76, 76 years old with initial symptoms of pelvic mass or pain. Manifestations on ultrasound are usually as unilateral pelvic masses, within which are uneven echo enhancement and some blood flow signals. There was no significant increase in preoperative tumor markers such as serum CA125 and sex hormones. Final diagnosis depends on postoperative histopathological results since these tumors were easily misdiagnosed by intraoperative frozen sections. Pathological examinations showed the tumor cells were spindle shaped with moderate to severe atypia and high mitotic counts. Immunohistochemistry is not specific but the positive rate of Ki-67 was consistent with the degree of malignancy and prognosis of the tumor. In addition, Vimentin, α-inhibin, SMA, estrogen receptor and progesterone receptor could also be positive. There were significant differences in surgical methods and there is also no unified chemotherapy. The overall survival was >15, >7, >6, <1, <1 year for each patient. After reviewing the literature, there is a lack of evidence-based large-scale case study. As for treatments, complete cytoreductive surgery plus regimens of malignant cord stromal tumors in NCCN guidelines are recommended. Due to its low incidence, multi-center clinical studies and molecular studies are required to give gynecologists a better understanding and guidance for future managements of ovarian fibrosarcoma.

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Ovarian fibrosarcoma with long-term survival: A case report

Cited by 12 publications

References 6 publications

Primary ovarian fibrosarcoma: a case report and review of the literature

Primary ovarian fibrosarcoma: a case report and review of the literature

Ovarian fibrosarcoma with metastasis after 12 years

Ovarian Fibrosarcoma: 5 Case Reports and Review of Literature

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