Rationale: Malignant transformation of mature cystic teratoma is very rare, of which squamous cell carcinoma (SCC) is the most common type. Prognosis of SCC arising in mature cystic teratoma of the ovary is very poor. Our experience may provide new ideas for the treatment of this disease. Patient concerns: The patient was a 56-year-old woman and was admitted for a lower abdominal pain. She underwent a laparoscopic surgery with 4 cycles of chemotherapy and had achieved a complete response; 10 months after the completion of initial treatment, her cancer relapsed. She underwent a cytoreductive surgery with concurrent chemoradiotherapy and has achieved a complete response again. Diagnoses: This patient was initially diagnosed with ovarian cancer (stage IIIB) arising from malignant transformation of mature teratoma; 10 months after the completion of initial treatment, she was diagnosed with recurrent ovarian cancer. Interventions: This patient was initially treated with laparoscopic bilateral salpingo-oophorectomy. After histopathological confirmation that she had ovarian cancer, she underwent laparoscopic total hysterectomy and omentectomy with 4 cycles of chemotherapy. After her ovarian cancer recurred, she underwent open cytoreductive surgery and concurrent chemoradiotherapy. Outcomes: The patient achieved complete response after both initial and relapsed treatment. Lessons: Optimal cytoreduction and concurrent chemoradiotherapy may be an option to improve the prognosis of patients with recurrent SCC arising in ovary mature cystic teratoma.
Aim Coffee drinking is considered as a risk factor of endometrial cancer (EC). Here, we conducted a meta‐analysis of observational study to evaluate the relationship between coffee drinking and the risk of EC. Methods The MEDLINE and EMBASE databases were searched until July 2018. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random‐effects model. Results A total of 24 studies (12 case–control and 12 cohort studies) on coffee intake with 9833 incident cases of EC and 699 234 subjects were included in the meta‐analysis. The pooled RR of endometrial cancer for the highest versus the lowest categories of coffee intake was 0.71 (95% CI: 0.65–0.77; I2 = 14%, p for heterogeneity = 0.26). By study design, the pooled RRs were 0.68 (95% CI: 0.56–0.83) for case–control studies and 0.70 (95% CI: 0.63–0.77) for cohort studies. For different regions, the pooled RRs were 0.74 (95% CI: 0.62–0.88) in Europe, 0.71 (95% CI: 0.64–0.79) in United States/Canada, and 0.40 (95% CI: 0.28–0.57) in Japan. By additional subgroup analysis, a stronger inverse association was shown in caffeinated coffee drinkers (RR 0.66, 95% CI: 0.52–0.83), individuals with the higher body mass index (BMI) (RR 0.65, 95% CI: 0.54–0.79), never smokers (RR 0.68, 95% CI: 0.56–0.84), ever smokers (RR 0.56, 95% CI: 0.45–0.70), and those who never used hormone replacement therapy (HRT) (RR 0.88, 95% CI: 0.79–0.98). The consumption of filtered or boiled coffee showed no significant association. Conclusions Increased coffee intake is associated with a reduced risk of EC.
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