F Moro1, G Magoga2, T Pasciuto1, F Mascilini1, M C Moruzzi1, D Fischerova3, L Savelli4, S Giunchi4, R Mancari5, D Franchi5, A Czekierdowski6, W Froyman7, D Verri8, E Epstein9, V Chiappa10, S Guerriero11, G F Zannoni12, D Timmerman7, G Scambia1, L Valentin13, A C Testa2. 1. Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. 2. Instituo di Ginecologia e Obstetricia, Università Cattolica del Sacro Cuore, Rome, Italy. 3. Gynecological Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University, Prague, Czech Republic. 4. Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 5. Preventive Gynecology Unit, Division of Gynecology, European Institute of Oncology, Milan, Italy. 6. First Department of Gynecological Oncology and Gynecology, Medical University of Lublin, Lublin, Poland. 7. Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium. 8. Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy. 9. Department of Clinical Science and Education, Södersjukhuset and Department of Women's and Children's Health Karolinska Institutet, Stockholm, Sweden. 10. Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. 11. Department of Obstetrics and Gynecology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy. 12. Institute of Histopathology, Catholic University of the Sacred Heart, Rome, Italy. 13. Skåne University Hospital Malmö, Lund University, Malmö, Sweden.
Abstract
OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure endometrioid carcinomas. METHODS: This was a retrospective multicenter study of patients with a histological diagnosis of pure endometrioid carcinoma. We identified 161 patients from the International Ovarian Tumor Analysis (IOTA) database who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016, and another 78 patients from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. In addition, one author reviewed all available ultrasound images and described them using pattern recognition. RESULTS: Median age of the 239 patients was 55 years (range, 19-88 years). On ultrasound examination, two (0.8%) endometrioid carcinomas were described as unilocular cysts, three (1.3%) as multilocular cysts, 37 (15.5%) as unilocular-solid cysts, 115 (48.1%) as multilocular-solid cysts and 82 (34.3%) as solid masses. Median largest tumor diameter was 102.5 mm (range, 20-300 mm) and median largest diameter of the largest solid component was 63 mm (range, 9-300 mm). Papillary projections were present in 70 (29.3%) masses. Most cancers (188 (78.7%)) were unilateral. In 49 (20.5%) cases, the cancer was judged by the pathologist to develop from endometriosis. These cancers, compared with those without evidence of tumor developing from endometriosis, more often manifested papillary projections on ultrasound (46.9% (23/49) vs 24.7% (47/190)), were less often bilateral (8.2% (4/49) vs 24.7% (47/190)) and less often associated with ascites (6.1% (3/49) vs 28.4% (54/190)) and fluid in the pouch of Douglas (24.5% (12/49) vs 48.9% (93/190)). Retrospective analysis of available ultrasound images using pattern recognition revealed that many tumors without evidence of tumor developing from endometriosis (36.3% (41/113)) had a large central solid component entrapped within locules, giving the tumor a cockade-like appearance. CONCLUSIONS: Endometrioid cancers are usually large, unilateral, multilocular-solid or solid tumors. The ultrasound characteristics of endometrioid carcinomas developing from endometriosis differ from those without evidence of tumor developing from endometriosis, the former being more often unilateral cysts with papillary projections and no ascites.
OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure endometrioid carcinomas. METHODS: This was a retrospective multicenter study of patients with a histological diagnosis of pure endometrioid carcinoma. We identified 161 patients from the International Ovarian Tumor Analysis (IOTA) database who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016, and another 78 patients from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. In addition, one author reviewed all available ultrasound images and described them using pattern recognition. RESULTS: Median age of the 239 patients was 55 years (range, 19-88 years). On ultrasound examination, two (0.8%) endometrioid carcinomas were described as unilocular cysts, three (1.3%) as multilocular cysts, 37 (15.5%) as unilocular-solid cysts, 115 (48.1%) as multilocular-solid cysts and 82 (34.3%) as solid masses. Median largest tumor diameter was 102.5 mm (range, 20-300 mm) and median largest diameter of the largest solid component was 63 mm (range, 9-300 mm). Papillary projections were present in 70 (29.3%) masses. Most cancers (188 (78.7%)) were unilateral. In 49 (20.5%) cases, the cancer was judged by the pathologist to develop from endometriosis. These cancers, compared with those without evidence of tumor developing from endometriosis, more often manifested papillary projections on ultrasound (46.9% (23/49) vs 24.7% (47/190)), were less often bilateral (8.2% (4/49) vs 24.7% (47/190)) and less often associated with ascites (6.1% (3/49) vs 28.4% (54/190)) and fluid in the pouch of Douglas (24.5% (12/49) vs 48.9% (93/190)). Retrospective analysis of available ultrasound images using pattern recognition revealed that many tumors without evidence of tumor developing from endometriosis (36.3% (41/113)) had a large central solid component entrapped within locules, giving the tumor a cockade-like appearance. CONCLUSIONS: Endometrioid cancers are usually large, unilateral, multilocular-solid or solid tumors. The ultrasound characteristics of endometrioid carcinomas developing from endometriosis differ from those without evidence of tumor developing from endometriosis, the former being more often unilateral cysts with papillary projections and no ascites.
Authors: Eleftherios P Samartzis; S Intidhar Labidi-Galy; Michele Moschetta; Mario Uccello; Dimitrios R Kalaitzopoulos; J Alejandro Perez-Fidalgo; Stergios Boussios Journal: Ann Transl Med Date: 2020-12
Authors: Dirk Timmerman; François Planchamp; Tom Bourne; Chiara Landolfo; Andreas du Bois; Luis Chiva; David Cibula; Nicole Concin; Daniela Fischerova; Wouter Froyman; Guillermo Gallardo Madueño; Birthe Lemley; Annika Loft; Liliana Mereu; Philippe Morice; Denis Querleu; Antonia Carla Testa; Ignace Vergote; Vincent Vandecaveye; Giovanni Scambia; Christina Fotopoulou Journal: Int J Gynecol Cancer Date: 2021-06-10 Impact factor: 3.437