ObjectiveOvarian needle aspiration and biopsy (ONAB) may be employed for pretreatment diagnosis of ovarian malignancies or intraoperatively to facilitate removal of ovarian masses. However, there is reluctance to utilize this procedure due to potential cyst rupture or seeding of malignant cells. The objective of this study was to examine the efficacy of ONAB over a 13-year period at our institution.MethodsBetween 2000 and 2013, all ONAB specimens were identified from the Queen's Medical Center Pathology Department database. All cytologic specimens were reviewed and correlated with histopathologic findings. A retrospective chart review was conducted to retrieve data on clinical course and treatment.ResultsThis study identified 144 cases of ovarian masses sampled by aspiration or needle biopsy between 2000 and 2013. Ninety-two (64%) cases had corresponding histopathology, 84 (91%) of which were obtained concomitantly. On histology, 12 (13%) cases were malignant and 80 (87%) benign. Three false negative cases were noted; 2 serous borderline tumors and 1 mucinous cystadenocarcinoma. These were sampling errors; no diagnostic tumor cells were present in the aspirates. Sensitivity and specificity of ONAB in the detection of malignancy were 75% and 100%, respectively. The positive and negative predictive values were 100% and 96%, respectively.ConclusionONAB represents a valuable tool in the diagnosis of malignancy and treatment of ovarian masses. In our study, it was highly specific, with excellent positive and negative predictive value.
Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic neoplasia (GTN). It most commonly occurs after a delivery but may arise after any type of pregnancy. PSTT arises after neoplastic transformation of intermediate trophoblastic cells. The most commonly reported symptoms are abnormal bleeding or amenorrhea. Due to the rarity of this disease, evidence on prognostic factors as well as optimal treatment is limited. While treatment for early-stage disease is usually limited to surgery, multimodal treatment with chemotherapy and surgery may be important for metastatic disease. Metastatic disease may be associated with minimal elevations of human chorionic gonadotropin (hCG). Here we present an unusual case of a patient with PSTT and an isolated breast metastasis who was successfully treated with surgical resection and single-agent chemotherapy.
e16501 Background: Ovarian needle biopsy (ONB) is well tolerated and underutilized. It may be employed for preoperative diagnosis and to treat symptomatic benign cysts. There is reluctance to utilize this procedure due to potential cyst rupture or seeding of malignant cells. We studied the efficacy of ONB over an 11-year period at our institution. Methods: Between January 2000 and August 2012, we retrieved 134 ONB specimens from our database. One hundred sixteen (87%) were performed by obstetrician-gynecologists, 8 (6%) by radiologists, 4 (3%) by surgeons, and 6 (4%) by other clinicians. Results: Eighty-four (63%) cases had corresponding surgical specimens, 78 (93%) of which were obtained concomitantly. Ten (12%) cases were malignant and 74 (88%) benign (Table). Sensitivity and specificity of ONB were 70% and 100%, respectively. Forty-one (53%) were benign ovarian neoplasms, and 30 (39%) were cysts. Regarding malignant lesions, 8 (80%) were primary ovarian epithelial cancers. There was 1 granulosa cell tumor and 1 metastatic lung adenocarcinoma. Three false negative cases were noted; 2 serous borderline tumors and 1 mucinous cystadenocarcinoma. These were sampling errors; no diagnostic tumor cells were present in the aspirates. Conclusions: ONB may be effective in diagnosing and treating ovarian lesions. In our study, it was highly specific and sensitive, with the exception of borderline tumors. [Table: see text]
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