Unexpected ovarian malignancy after conservative laparoscopic surgery: five case series in a half decade of experience

Wahab, Noraziana Abd.; Chalermchockchareonkit, Amphan; Chaisilwattana, Pongsakdi; Mustafa, Kamarul Bahyah

doi:10.1007/s00404-011-2177-2

Cited by 4 publications

(5 citation statements)

References 15 publications

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Section: Discussionmentioning

confidence: 92%

“…Whereas a study from Japan, the overall incidence rate of unexpected ovarian malignancy was 1.5%, of which 0.45% was contributed by the postmenopausal group [ 13 ]. In a previous study, the author reported the rate of unexpected ovarian malignancy in 0.43% of laparoscopic surgery cases in premenopausal women with benign ovarian mass [ 14 ]. The incidence of unexpected malignancy may vary from 11-19% with surgeon's strategies when laparoscopic surgeries were done for adnexal mass that appeared complex on ultrasonography [ 8 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Evaluating the Frequency and Characteristics of Unexpected Ovarian Malignancy in Postmenopausal Women Who Have Undergone Laparoscopic Surgery for Adnexal Masses - A Review of Five Years

Pegu¹,

Saranya²,

subburaj³

et al. 2023

Cureus

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Aim The aim of this study was to estimate the frequent existence of unexpected ovarian malignant lesions after laparoscopic surgery for an apparent benign adnexal mass and assess its clinical and ultrasound characteristics in postmenopausal women. Methods We re-examined the hospital records of 96 cases of postmenopausal women who underwent laparoscopic surgery for benign adnexal mass over five years. The age of the patient, parity, ultrasound findings, tumor markers level, intraoperative findings, and histopathological report were collected. Pearson's Chi-squared test and Fisher's exact test were used for statistical analysis, and a p-value of <0.05 was accepted as statistically significant. Results Of a total of 96, benign adnexal mass was in 93 (96.83%), an unexpected ovarian malignancy was observed in two (2.08%) cases, and one (1.04%) had a borderline ovarian tumor. Tumor marker CA-125 was done for all those cases of adnexal mass in postmenopausal women, and not a single case was found to have above 35 IU/ml, defined as the cut-off value for CA-125. Statistically significant differences were observed between the benign and malignant groups in relation to symptoms (p<0.05), ultrasound score (p=0.001), and bilaterality (p=0.013) of the tumor mass. Conclusion In postmenopausal women, the critical concern for laparoscopic surgery of benign adnexal mass is unexpected malignancy. So it is essential to select patients carefully for laparoscopic surgery. If a benign-looking adnexal mass turned out to be malignant on the histopathological report, we should try to post the patient for subsequent staging laparotomy as soon as possible.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Evaluating the Frequency and Characteristics of Unexpected Ovarian Malignancy in Postmenopausal Women Who Have Undergone Laparoscopic Surgery for Adnexal Masses - A Review of Five Years

Pegu¹,

Saranya²,

subburaj³

et al. 2023

Cureus

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“…Every year, a large number of women undergo laparoscopic surgery for the removal of ovarian cysts which are initially thought to be benign. However, a small percentage (<2%) of unexpected malignancy has been encountered during postsurgery tumor analysis 18–20. The choice of management becomes straightforward for the surgeon in the case of postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

<p>SERS-based detection of haptoglobin in ovarian cyst fluid as a point-of-care diagnostic assay for epithelial ovarian cancer</p>

Perumal

Mahyuddin

Balasundaram

et al. 2019

CMAR

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PurposeTo evaluate haptoglobin (Hp) in ovarian cyst fluid as a diagnostic biomarker for epithelial ovarian cancers (EOCs) using surface-enhanced Raman spectroscopy (SERS)-based in vitro diagnostic assay for use in an intraoperative setting.MethodsSERS-based method was used to detect and quantify Hp in archived ovarian cyst fluids collected from suspicious ovarian cysts and differentiate benign tumors from EOCs. The diagnostic performance of SERS-based assay was verified against the histopathology conclusions and compared with the results of CA125 test and frozen sections.ResultsHp concentration present in the clinical cyst fluid measured by SERS was normalized to 3.3 mg/mL of standard Hp. Normalized mean values for patients with benign cysts were 0.65 (n=57) and malignant cysts were 1.85 (n=54), demonstrating a significantly (P<0.01) higher Hp in malignant samples. Verified against histology, Hp measurements using SERS had a sensitivity of 94% and specificity of 91%. Receiver operating characteristic curve analysis of SERS-based Hp measurements resulted in area under the curve of 0.966±0.03, establishing the robustness of the method. CA125 test on the same set of patients had a sensitivity of 85% and specificity of 90%, while frozen section analysis on 65 samples had 100% sensitivity and specificity.ConclusionWith a total execution time of <10 minutes and consistent performance across different stages of cancer, the SERS-based Hp detection assay can serve as a promising intra-operative EOC diagnostic test.

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“…Approximately 13% of ovarian cancer patients are younger than 45 years of age. [2][3][4][5] The detection of normal ovarian parenchyma can be challenging. A surgeon can evaluate an ovary visually, by palpation, or by intraoperative ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Ultrasound Leads to Conservative Management of Benign Ovarian Tumors: A Retrospective, Single-Center Study

Badiglian-Filho

Menezes

Faloppa

et al. 2019

Rev Bras Ginecol Obstet

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Objective To evaluate whether the use of intraoperative ultrasound leads to more conservative surgeries for benign ovarian tumors. Methods Women who underwent surgery between 2007 and 2017 for benign ovarian tumors were retrospectively analyzed. The women were classified into two groups: those who underwent intraoperative ultrasound (group A) and those who did not (group B). In group A, minimally-invasive surgery was performed for most patients (a specific laparoscopic ultrasound probe was used), and four patients were submitted to laparotomy (a linear ultrasound probe was used). The primary endpoint was ovarian sparing surgery (oophoroplasty). Results Among the 82 cases identified, only 36 met the inclusion criteria for the present study. Out of these cases, 25 underwent intraoperative ultrasound, and 11 did not. There were no significant differences in arterial hypertension, diabetes, smoking history, and body mass index for the two groups (p = 0.450). Tumor diameter was also similar for both groups, ranging from 1 cm to 11 cm in group A and from 1.3 cm to 10 cm in group B (p = 0.594). Tumor histology confirmed mature teratomas for all of the cases in group B and for 68.0% of the cases in group A. When the intraoperative ultrasound was performed, a more conservative surgery was performed (p < 0.001). Conclusion The use of intraoperative ultrasound resulted in more conservative surgeries for the resection of benign ovarian tumors at our center.

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Unexpected ovarian malignancy after conservative laparoscopic surgery: five case series in a half decade of experience

Cited by 4 publications

References 15 publications

Evaluating the Frequency and Characteristics of Unexpected Ovarian Malignancy in Postmenopausal Women Who Have Undergone Laparoscopic Surgery for Adnexal Masses - A Review of Five Years

Evaluating the Frequency and Characteristics of Unexpected Ovarian Malignancy in Postmenopausal Women Who Have Undergone Laparoscopic Surgery for Adnexal Masses - A Review of Five Years

<p>SERS-based detection of haptoglobin in ovarian cyst fluid as a point-of-care diagnostic assay for epithelial ovarian cancer</p>

Intraoperative Ultrasound Leads to Conservative Management of Benign Ovarian Tumors: A Retrospective, Single-Center Study

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