Surface epithelial-stromal tumor
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Synonyms and keywords: Synonym 1; Synonym 2; Synonym 3
Overview
Surface epithelial-stromal tumors are a class of ovarian neoplasms that may be benign or malignant. Neoplasms in this group are thought to be derived from the ovarian surface epithelium (modified peritoneum) or from ectopic endometrial or Fallopian tube (tubal) tissue. This group of tumors accounts for 90% to 95% of all cases of ovarian cancer.[1][2]
Historical Perspective
- Surface epithelial-stromal tumor was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
- In [year], [gene] mutations were first identified in the pathogenesis of surface epithelial-stromal tumor.
- In [year], the first [discovery] was developed by [scientist] to treat/diagnose surface epithelial-stromal tumor.
Classification
- Surface epithelial-stromal tumor may be classified according to [classification method] into [number] subtypes/groups:
- [group1]
- [group2]
- [group3]
- Other variants of surface epithelial-stromal tumor include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
Pathophysiology
- The pathogenesis of surface epithelial-stromal tumor is characterized by [feature1], [feature2], and [feature3].
- The [gene name] gene/Mutation in [gene name] has been associated with the development of surface epithelial-stromal tumor, involving the [molecular pathway] pathway.
- On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of surface epithelial-stromal tumor.
- On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of surface epithelial-stromal tumor.
Causes
- Surface epithelial-stromal tumor may be caused by either [cause1], [cause2], or [cause3].
- Surface epithelial-stromal tumor is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
- There are no established causes for surface epithelial-stromal tumor.
Differentiating Surface Epithelial-Stromal Tumor from Other Diseases
- Surface epithelial-stromal tumor must be differentiated from other diseases that cause abdominal distension, pelvic or abdominal pain, and nausea, such as:
- Ovarian dysgerminoma
- Ovarian yolk sac tumor
- Ovarian embryonal carcinoma
Epidemiology and Demographics
- The prevalence of surface epithelial-stromal tumor is approximately 3 per 100,000 individuals worldwide.
- In 2011, the delay-adjusted incidence of surface epithelial-stromal tumor was estimated to be 12.46 per 100,000 persons in the United States.[3]
- In the United States, the age-adjusted prevalence of surface epithelial-stromal tumor is 71.3 per 100,000 in 2011.[3]
Age
- Patients of all age groups may develop surface epithelial-stromal tumor.
- Surface epithelial-stromal tumor is more commonly observed among patients aged 55 to 75years old.
- Surface epithelial-stromal tumor is more commonly observed among postmenopausal women.
Gender
- Surface epithelial-stromal tumor only affects women.
Race
- There is no racial predilection for surface epithelial-stromal tumor.
Risk Factors
- Common risk factors in the development of surface epithelial-stromal tumor, include:
- Nulliparity
- Early menopause
- Gonadal dysgenesis
- Family history (e.g. BRCA1/BRCA2 mutations)
- Smoking
- Previous history of breast, endometrial or colon cancer (Lynch II)
- Common protective factors in the development of surface epithelial-stromal tumor, include:
- Oral contraceptives
Natural History, Complications and Prognosis
- The majority of patients with surface epithelial-stromal tumor remain asymptomatic for years.
- Early clinical features of surface epithelial-stromal tumor include pelvic fullness, abdominal distension, and abdominal pain.
- If left untreated, the minority of patients with surface epithelial-stromal tumor may progress to develop local invasion, lymphadenopathy, ascites, or metastases.
- Common complications of surface epithelial-stromal tumor include peritoneal metastases, or ovarian torsion.
- Prognosis is generally good, and the 5-year survival rate of patients with surface epithelial-stromal tumor is approximately 55 to 75%.
Diagnosis
Diagnostic Criteria
- The diagnosis of surface epithelial-stromal tumor is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- Surface epithelial-stromal tumor is usually asymptomatic.
- Symptoms of surface epithelial-stromal tumor may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
Physical Examination
- Patients with surface epithelial-stromal tumor usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- Laboratory findings consistent with the diagnosis of surface epithelial-stromal tumor, include:
- Elevated CA-125 level
- Often unspecific
- Useful for treatment response
Imaging Findings
- There are no [imaging study] findings associated with surface epithelial-stromal tumor.
- [Imaging study 1] is the imaging modality of choice for surface epithelial-stromal tumor.
- On [imaging study 1], surface epithelial-stromal tumor is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- Surface epithelial-stromal tumor may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for surface epithelial-stromal tumor; the mainstay of therapy is supportive care.
- The mainstay of therapy for surface epithelial-stromal tumor is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for surface epithelial-stromal tumor.
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of surface epithelial-stromal tumor.
- [Surgical procedure] can only be performed for patients with [disease stage] surface epithelial-stromal tumor.
Prevention
- There are no primary preventive measures available for surface epithelial-stromal tumor.
- Effective measures for the primary prevention of surface epithelial-stromal tumor include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with surface epithelial-stromal tumor are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References
- ↑ Bradshaw, Karen D.; Schorge, John O.; Schaffer, Joseph; Lisa M. Halvorson; Hoffman, Barbara G. (2008). Williams' Gynecology. McGraw-Hill Professional. ISBN 0-07-147257-6.
- ↑ Kosary, Carol L. (2007). "Chapter 16: Cancers of the Ovary" (PDF). In Baguio, RNL; Young, JL; Keel, GE; Eisner, MP; Lin, YD; Horner, M-J. SEER Survival Monograph: Cancer Survival Among Adults: US SEER Program, 1988-2001, Patient and Tumor Characteristics. SEER Program. NIH Pub. No. 07-6215. Bethesda, MD: National Cancer Institute. pp. 133–144.
- ↑ 3.0 3.1 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.