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Purpose: To evaluate the incidence, character, and prognosis of ovarian tumors diagnosed as benign before laparoscopic surgery but identified as malignant or of borderline malignancy by postoperative histopathology.Subjects: Of 1,066 laparoscopic ovarian tumor resections at Tohoku Kosai Hospital from April 2001 to May 2010, a total of 22 patients were postoperatively confirmed as having overt or borderline malignancies. Methods: For this patient subset, the following factors were analyzed: postsurgical histopathology, patient age, tumor size, solid tumor component, CA125 and CA19-9 markers, laparoscopic technique, tumor capsule status, adjunctive therapy, and prognosis.Results: The rate of preoperative diagnostic error was 2.2% (22/1,066). Of the 22 misinterpreted tumors, five were clearly malignant, and 17 were of borderline malignant potential. Although no specific tendencies were evident, based on analysis of preoperative features, malignant lesions were more likely in older patients or in those with large sized cysts. For two of the five patients with malignancies, definitive cancer surgery was performed, followed by chemotherapy, while the other three received chemotherapy alone. Three of the 17 patients with borderline malignancy also opted for surgery. Endometrial carcinoma was found in one patient with malignancy, and recurrent mucinous cysts occurred in two patients with borderline tumors, but the long-term prognosis for these patients in close follow-up was fairly good.Conclusion: Preoperative misdiagnosis of ovarian malignancies may be unavoidable, despite thorough assessment. However, even with laparoscopic resection, the prognosis of such tumors is not poor, given adequate adjunctive therapy and/or careful clinical follow-up.

The human spermatozoal centrosome acts as a microtubule organizing center and is essential for male and female pronuclear migration and apposition. In this study, we assess centrosomal function of spermatozoa from infertile patients using heterologus intracytoplasmic sperm injection (ICSI) into bovine eggs. Spermatozoa from 15 infertile patients undergoing assisted reproductive technology (ART) treatment and 3 fertile donors were tested. Microtubules and DNA were imaged by immuocytochemistry and epifluorescence microscopy. Decondensed female chromosomes and sperm nuclei, pronuclear formation and sperm aster formation were examined. The average rate of sperm aster formation using spermatozoa from infertile individuals was lower (47.0%) than that with spermatozoa from fertile individuals (66.1%). We compared the sperm aster formation rates after ART with various clinical parameters, including semen characteristics, pronuclear formation rates, embryonic cleavage rates and pregnancy outcome. Clinical semen characteristics and the rate of pronuclear formation appeared independent of sperm centrosomal function. In contrast, the centrosomal function had a substantial effect on embryonic cleavage rate and pregnancy after ART. These results suggested that centrosomal function is essential for pregnancy and embryonic development. The method described using bovine eggs is suitable to assay human centrosome function and predict pregnancy after ART.