Nuclear Atypia Is a Necessary Factor for Diagnosis of Primary Ovarian Fibrosarcoma: A Case Report and Literature Review

Zhang, Zhidong; Yao, Ailin; Qi, Xin; Shi, Yubo; Zhang, Aihua

doi:10.1159/000510875

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…Because there have been no reports of solid ExG-OvTs larger than the present case [ 2 – 6 ], it was initially difficult to understand the patient's pathological condition and determine the proper surgical treatment. Therefore, we conducted a literature search, using the MEDLINE database, of ExG-OvTs to investigate the clinicopathological characteristics and postoperative complications associated with these tumors.…”

Section: Discussionmentioning

confidence: 96%

“…However, since extremely giant ovarian tumors (ExG-OvTs) are rare, most of relevant reports are just case reports and there are few reports that investigated a certain number of ExG-OvTs [ 1 ]. As for solid ExG-OvTs, there have been only a few case reports [ 2 – 6 ]. ExG-OvT patients experience many symptoms, including a marked decrease in activities of daily living, malnutrition, dehydration, and dyspnea [ 2 , 7 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

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A 36 kg Giant Ovarian Fibroma with Meigs Syndrome: A Case Report and Literature Review of Extremely Giant Ovarian Tumor

Tanaka

Yamanoi

Kitamura

et al. 2021

Case Reports in Obstetrics and Gynecology

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Ovarian tumors can get extremely giant to occupy the whole abdominal cavity. We report a case of 36 kg solid ovarian tumor, which was the largest ovarian solid tumor that have been ever reported. A 54-year-old woman presented to our hospital with a chief complaint of markedly distended abdominal wall. Preoperative imaging examinations revealed that most of the tumor was uniform and its density was like that of subcutaneous fat. Pleural effusion was detected in the right thoracic region. We organized a multidisciplinary team and successfully resected the right adnexa. The patient had an uneventful postoperative course, and she was discharged on the 7th postoperative day and diagnosed with a fibroma of the ovary with Meigs syndrome. A comprehensive literature search revealed 48 cases of extremely giant ovarian tumor in these 20 years. Six out of 48 cases are solid. Twelve out of 48 cases are malignant or borderline malignant, and patients’ age and tumor size/weight were not related to the frequency of malignancy/borderline malignancy. As many as 4 out of 48 patients died before their first hospital visit or early after surgery. Clinicians should consider a considerable high mortality and frequency of severe surgical complications when planning the treatment strategy for extremely giant ovarian tumors.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

A 36 kg Giant Ovarian Fibroma with Meigs Syndrome: A Case Report and Literature Review of Extremely Giant Ovarian Tumor

Tanaka

Yamanoi

Kitamura

et al. 2021

Case Reports in Obstetrics and Gynecology

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“…Since FS is a malignant tumor, does a giant tumor predict a poor prognosis? According to the researches of Zhang et al and Sulkowski et al, tumor size had no differential influence on the survival prognosis of FS patients with ovarian and infantile, respectively [ 18 , 19 ]. However, Ma et al found that a tumor size more than 5 cm and a Ki-67 index over 30% were associated with poor OS in patients with primary intracranial FS [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

A Novel Prognostic Nomogram and Risk Classification System for Predicting Cancer-Specific Survival of Postoperative Fibrosarcoma Patients: A Large Cohort Retrospective Study

Huang

Zhou

2022

Journal of Oncology

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Background. Fibrosarcoma (FS) is a typically invasive sarcoma formed by fibroblasts and collagen fibers. Currently, the standard treatment for FS is the surgical resection, but the high recurrence rate and poor prognosis limit the benefits of postoperative patients. Exploring what factors affect the benefit of postoperative patients is significant for guiding the implementation of surgical resection. Therefore, this study aims to construct a novel nomogram to predict the cancer-specific survival (CSS) of postoperative fibrosarcoma (POFS) patients. Methods. The included patients were randomly assigned to the training and validation sets at a ratio of 7 : 3. CSS was indexed as the research endpoint. Firstly, univariate and multivariate Cox regression analyses were used on the training set to determine independent prognostic predictors and build a nomogram for predicting the 1-, 3-, and 5-year CSS of POFS patients. Secondly, the nomogram's discriminative power and prediction accuracy were evaluated by receiver operating characteristic (ROC) and the calibration curve, and a risk classification system for POFS patients was constructed. Finally, the nomogram's clinical utility was evaluated using decision curve analysis (DCA). Results. Our study included 346 POFS patients, divided into the training (244) and validation sets (102). Multivariate Cox regression analysis demonstrated that tumor size, SEER stage, and tumor grade were independent prognostic predictors of CSS for POFS patients. They were used to create a nomogram. In the training and validation sets, the ROC curve showed that the 1-, 3-, and 5-year area under the curve (AUC) were higher than 0.700, indicating that the nomogram had good reliability and accuracy. DCA also showed that the nomogram has high application value in clinical practice. Conclusion. The larger tumor size, higher tumor grade, and distant metastasis were independently related to the poor prognosis of POFS patients. The nomogram constructed based on the above variables could accurately predict the 1-, 3-, and 5-year CSS of POFS patients. So, the nomogram and risk classification system we built might help make accurate judgments in clinical practice, optimize patient treatment decisions, maximize postoperative benefits, and ultimately improve the prognosis of POFS patients.

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“…Moderate to marked atypia along with high mitotic activity (>4 mitoses per 10 HPFs), are criteria to differentiate them from cellular and mitotically active fibromas [19,26]. Nuclear atypia has been found to be the only criteria associated with poor patient prognosis [55]. Thus, in the case of a high mitotic count but absence of atypia, the classification as cellular and mitotically active fibroma is recommended [8].…”

Section: Fibrosarcomamentioning

confidence: 99%

“…The immunoprofile of ovarian fibrosarcoma is not specific [10]. Fibrosarcomas may exhibit focal staining with sex cord-stromal immunomarkers, especially inhibin, and are typically negative for CD10 [8,55,56] and positive for vimentin and smooth-muscle actin [10,52]. The expression of progesterone and estrogen receptors is variable [10], complicating the differential diagnosis with fibrosarcoma from soft tissues.…”

Section: Fibrosarcomamentioning

confidence: 99%

Relevance of Molecular Pathology for the Diagnosis of Sex Cord–Stromal Tumors of the Ovary: A Narrative Review

Trecourt,

Donzel,

Alsadoun

et al. 2023

Cancers

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Ovarian sex cord–stromal tumors (SCSTs) account for 8% of all primary ovarian neo-plasms. Accurate diagnosis is crucial since each subtype has a specific prognostic and treatment. Apart from fibrosarcomas, stromal tumors are benign while sex cord tumors may recur, sometimes with a significant time to relapse. Although the diagnosis based on morphology is straightforward, in some cases the distinction between stromal tumors and sex cord tumors may be tricky. Indeed, the immunophenotype is usually nonspecific between stromal tumors and sex cord tumors. Therefore, molecular pathology plays an important role in the diagnosis of such entities, with pathognomonic or recurrent alterations, such as FOXL2 variants in adult granulosa cell tumors. In addition, these neoplasms may be associated with genetic syndromes, such as Peutz–Jeghers syndrome for sex cord tumors with annular tubules, and DICER1 syndrome for Sertoli–Leydig cell tumors (SLCTs), for which the pathologist may be in the front line of syndromic suspicion. Molecular pathology of SCST is also relevant for patient prognosis and management. For instance, the DICER1 variant is associated with moderately to poorly differentiated SLCTS and a poorer prognosis. The present review summarizes the histomolecular criteria useful for the diagnosis of SCST, using recent molecular data from the literature.

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Nuclear Atypia Is a Necessary Factor for Diagnosis of Primary Ovarian Fibrosarcoma: A Case Report and Literature Review

Cited by 3 publications

References 23 publications

A 36 kg Giant Ovarian Fibroma with Meigs Syndrome: A Case Report and Literature Review of Extremely Giant Ovarian Tumor

A 36 kg Giant Ovarian Fibroma with Meigs Syndrome: A Case Report and Literature Review of Extremely Giant Ovarian Tumor

A Novel Prognostic Nomogram and Risk Classification System for Predicting Cancer-Specific Survival of Postoperative Fibrosarcoma Patients: A Large Cohort Retrospective Study

Relevance of Molecular Pathology for the Diagnosis of Sex Cord–Stromal Tumors of the Ovary: A Narrative Review

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