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INTRODUCTION: Serous ovarian carcinomas constitute the largest group of epithelial ovarian cancer (60%-75%) and are further classified into high- and low-grade serous carcinoma. Low-grade serous carcinoma (LGSC) is a relatively rare subtype (approximately 5% of serous carcinomas) and epidemiologic studies of large cohorts are scarce. With the present study we aimed to report trends in stage, primary treatment and relative survival of LGSC of the ovary in a large cohort of patients in an effort to identify opportunities to improve clinical practice and outcome of this relatively rare disease.MATERIAL AND METHODS: Patients diagnosed with LGSC between 2000 and 2019 were identified from the Netherlands Cancer Registry (n = 855). Trends in FIGO stages and primary treatment were analyzed with the Cochran-Armitage trend test, and differences in and trends of 5-year relative survival were analyzed using multivariable Poisson regression.RESULTS: Over time, LGSC was increasingly diagnosed as stage III (39.9%-59.0%) and IV disease (5.7%-14.4%) and less often as stage I (34.6%-13.5%; p 1 cm residual disease in only 15/252 patients (6%), compared with 17/95 patients (17.9%) after interval surgery. Full cohort 5-year survival was 61% and survival after primary debulking surgery was superior to the outcome following interval debulking surgery (60% vs 34%). Survival following primary debulking surgery without macroscopic residual disease (73%) was better compared with ≤1 cm (47%) and >1 cm residual disease (22%). Survival following interval debulking surgery without macroscopic residual disease (51%) was significantly higher than after >1 cm residual disease (24%). Except FIGO stage II (85%-92%), survival did not change significantly over time.CONCLUSIONS: Over the years, LGSC has been diagnosed as FIGO stage III and stage IV disease more often and interval debulking surgery has been increasingly preferred over primary debulking in these patients. Relative survival did not change over time (except for stage II) and worse survival outcomes after interval debulking surgery were observed. The results support the common recommendation to perform primary debulking surgery in patients eligible for primary surgery.

Laparoscopic surgery has been suggested as a safe and effective alternative to laparotomy for the treatment of early stage endometrial cancer. In this study, we presented a 39-year-old patient who underwent pelvic lymphadenectomy through laparoscopy at our center following incomplete surgery at another center for early stage endometrium cancer. Laparoscopic lymphadenectomy seems to be a safe and reliable method for gynecologic malignancies that require lymph node dissection. Turkish Başlık: Erken Evre Endometrium Kanserinde Eksik Cerrahi Sonrası Laparoskopik Pelvik Lenf Nodu Diseksiyonu: Olgu Sunumu Anahtar Kelimeler: Adenokarsinom/patoloji/cerrahi; endometrial neoplaziler/patoloji/cerrahi; lenf nodu eksizyonu; over neoplazileri/ cerrahi; cerrahi, laparoskopik Erken evre endometrium kanserinde geleneksel laparotomik cerrahi evrelemenin yerine laparoskopik yaklaşım, güvenli ve etkin bir seçenek olarak sunulmaya başlanmıştır. Bu yazıda, erken evre endometrium kanseri nedeniyle başka bir merkezde eksik cerrahi uygulanan, daha sonra merkezimizde laparoskopik pelvik lenfadenektomi yapılan 39 yaşındaki bir hasta sunuldu. Laparoskopik lenfadenektomi, lenf nodu diseksiyonu gerektiren jinekolojik maligniteler için teknik olarak geçerli ve güvenli bir yöntem olarak görünmektedir., Erken evre endometrium kanserinde geleneksel laparotomik cerrahi evrelemenin yerine laparoskopik yaklaşım, güvenli ve etkin bir seçenek olarak sunulmaya başlanmıştır. Bu yazıda, erken evre endometrium kanseri nedeniyle başka bir merkezde eksik cerrahi uygulanan, daha sonra merkezimizde laparoskopik pelvik lenfadenektomi yapılan 39 yaşındaki bir hasta sunuldu. Laparoskopik lenfadenektomi, lenf nodu diseksiyonu gerektiren jinekolojik maligniteler için teknik olarak geçerli ve güvenli bir yöntem olarak görünmektedir.

Androgen-secreting ovarian tumours are extremely rare accounting for

Objective To assess how many epithelial ovarian cancer (EOC) patients are eligible for fertility-sparing surgery (FSS) in a population-based study. Study design Using data from the Geneva Cancer Registry, we conducted a retrospective review of all women diagnosed with epithelial ovarian cancer (EOC) between January 1979 and December 2008. Patients were classified into two age groups (“young group” ≤ 45 years and “old group” > 45 years) and as “eligible for FSS” (FIGO IA, G1-G2 or unilateral ICG1) and “non-eligible for FSS” (FIGO IA, G3; IC G2-G3; IB or II–IV). Patients and tumor characteristics were tested with the chi-square test. Estimates of survival were calculated using the Kaplan-Meyer method and differences between groups were analyzed by the log-rank test. Results A total of 888 EOC patients were analyzed. The young group included 87 patients (9.8%): eleven (1.2%) were identified as eligible for FSS and 6 (0.6%) were nulliparous. The annual incidence of EOC women eligible for FSS in Geneva was 0.48/100,000 (0.5 women/year) and the expected annual incidence rate for Switzerland (8 million inhabitants) is 6.5 women/year. Conclusion Only a very small proportion of EOC patients are eligible for FSS. These results highlight the need to centralize FSS data in dedicated European units, in order to maintain expertise and quality of care for these patients.

The ovarian cystic teratoma is a rare cause of autoimmune haemolytic anaemia by warm antibodies, resistant to corticotherapy, with few case reports published in the medical literature. We present a case of a 45-year-old woman admitted to hospital due to general weakness. Laboratory studies revealed macrocytic anaemia, biochemical parameters of haemolysis and peripheral spherocytosis. The direct Coombs test was positive. Viral serologies, anti-nuclear antibodies, anti-double-stranded DNA antibodies and β2-microglobulin were negative. CT scan of the thorax, abdomen and pelvis showed a heterogeneous right anexial lesion. The patient was treated with corticotherapy without improvement of anaemia. Regression of extra-vascular haemolysis and normalisation of haemoglobin was obtained only after laparoscopic splenectomy and right ooforectomy, and the histopathology of the right anexial mass revealed a cystic teratoma. Previously published cases controlled the haemolysis by surgically removing the lesion associated with splenectomy.

Primary leiomyoma of the ovary is rare. It is usually reported in women of childbearing age. Clinically most patients are asymptomatic and are incidentally diagnosed. Uterine leiomyomas may accompany ovarian leiomyomas. A 55-year-old postmenopausal woman presented with left-sided pelvic pain. She underwent total abdominal hysterectomy and bilateral salpingo–oophorectomy with an initial diagnosis of a left cystic mass. Macroscopically, it was a solid, gray-white, tumorous nodule, 1 cm in size, with prominent borders. Histopathologic diagnosis was leiomyoma. In the absence of hormonal therapy, the occurrence of a solitary ovarian leiomyoma without uterine involvement is quite rare in postmenopausal women. Turkish Başlık: Overin Primer Leiomiyomu Anahtar Kelimeler: Histerektomi; leiomiyoma/patoloji/cerrahi; over neoplazileri/cerrahi Overin primer leiomiyomu nadirdir. Genellikle çocuk doğurma yaşındaki kadınlarda bildirilmiştir. Hastaların çoğu asemptomatiktir ve rastlantısal olarak tanı konur. Over leiomyomlarının birçoğuna uterin leiomyomlar eşlik eder. Sol pelvik ağrı nedeniyle başvuran 55 yaşında postmenopozal kadın hastaya, sol overde kistik kitle nedeniyle total abdominal histerektomi ve bilateral salpingooferektomi yapıldı. Sağ overde saptanan, makroskopik olarak kesit yüzü gri-beyaz, sınırları belirgin, 1 cm çapındaki solid kitlenin mikroskopik inceleme sonucu leiomiyom olarak rapor edildi. Hormonal tedavi almayan, postmenopozal bir kadın hastada, uterusta olmaksızın sadece overde leiomiyom görülmesi nadir bir durum olduğu için sunmayı uygun bulduk., Overin primer leiomiyomu nadirdir. Genellikle çocuk doğurma yaşındaki kadınlarda bildirilmiştir. Hastaların çoğu asemptomatiktir ve rastlantısal olarak tanı konur. Over leiomyomlarının birçoğuna uterin leiomyomlar eşlik eder. Sol pelvik ağrı nedeniyle başvuran 55 yaşında postmenopozal kadın hastaya, sol overde kistik kitle nedeniyle total abdominal histerektomi ve bilateral salpingooferektomi yapıldı. Sağ overde saptanan, makroskopik olarak kesit yüzü gri-beyaz, sınırları belirgin, 1 cm çapındaki solid kitlenin mikroskopik inceleme sonucu leiomiyom olarak rapor edildi. Hormonal tedavi almayan, postmenopozal bir kadın hastada, uterusta olmaksızın sadece overde leiomiyom görülmesi nadir bir durum olduğu için sunmayı uygun bulduk.