Sexcord/ stromal ovarian tumors diagnostic study of choice
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Sexcord/ stromal ovarian tumors Microchapters |
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Differentiating Sexcord/ Stromal Ovarian Tumors from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Maneesha Nandimandalam, M.B.B.S.[2]
Overview
Biopsy is the gold standard test for the diagnosis of sexcord/ stromal ovarian tumors. There is no single diagnostic study of choice for the diagnosis of sexcord/ stromal ovarian tumors, but these can be diagnosed based on CT and MRI findings
Diagnostic Study of Choice
Study of choice
Biopsy is the gold standard test for the diagnosis of sexcord/ stromal ovarian tumors. There is no single diagnostic study of choice for the diagnosis of sexcord/ stromal ovarian tumors, but these can be diagnosed based on CT and MRI findings
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
- CT
- MRI
- Biopsy
Name of Diagnostic Criteria
There are no established criteria for the diagnosis of sexcord/ stromal ovarian tumors
Staging
The TNM staging for sex cord/stromal ovarian tumors is mentioned in the following table:[1][2][3][4][5][6][7]
| T category | FIGO stage | T criteria |
| TX | Primary tumor cannot be assessed | |
| T0 | No evidence of primary tumor | |
| T1 | I | Tumor limited to ovaries (one or both) or fallopian tube(s) |
| T1a | IA | Tumor limited to one ovary (capsule intact) or fallopian tube,
no tumor on ovarian or fallopian tube surface; no malignant cells in ascites or peritoneal washings |
| T1b | IB | Tumor limited to both ovaries (capsules intact) or fallopian tubes;
no tumor on ovarian or fallopian tube surface; no malignant cells in ascites or peritoneal washings |
| T1c | IC | Tumor limited to one or both ovaries or fallopian tubes, with any of the following: |
| T1c1 | IC1 |
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| T1c2 | IC2 |
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| T1c3 | IC3 |
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| T2 | II | Tumor involves one or both ovaries or fallopian tubes with pelvic extension below pelvic brim or primary peritoneal cancer |
| T2a | IIA | Extension and/or implants on the uterus and/or fallopian tube(s) and/or ovaries |
| T2b | IIB | Extension to and/or implants on other pelvic tissues |
| T3 | III | Tumor involves one or both ovaries or fallopian tubes, or primary peritoneal cancer,
with microscopically confirmed peritoneal metastasis outside the pelvis and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes |
| T3a | IIIA2 | Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or
without positive retroperitoneal lymph nodes |
| T3b | IIIB | Macroscopic peritoneal metastasis beyond pelvis 2 cm or
less in greatest dimension with or without metastasis to the retroperitoneal lymph nodes |
| T3c | IIIC | Macroscopic peritoneal metastasis beyond the pelvis more than 2 cm in greatest dimension with or
without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ) |
| N category | FIGO stage | N criteria |
| NX | Regional lymph nodes cannot be assessed | |
| N0 | No regional lymph node metastasis | |
| N0(i+) | Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm | |
| N1 | IIIA1 | Positive retroperitoneal lymph nodes only (histologically confirmed) |
| N1a | IIIA1i | Metastasis up to and including 10 mm in greatest dimension |
| N1b | IIIA1ii | Metastasis more than 10 mm in greatest dimension |
| M category | FIGO stage | M criteria |
| M0 | No distant metastasis | |
| M1 | IV | Distant metastasis, including pleural effusion with positive cytology;
liver or splenic parenchymal metastasis; metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine |
| M1a | IVA | Pleural effusion with positive cytology |
| M1b | IVB | Liver or splenic parenchymal metastases;
metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); transmural involvement of intestine |
References
- ↑ Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P, Hauptmann S, Sehouli J (October 2015). "Statement by the Kommission Ovar of the AGO: The New FIGO and WHO Classifications of Ovarian, Fallopian Tube and Primary Peritoneal Cancer". Geburtshilfe Frauenheilkd. 75 (10): 1021–1027. doi:10.1055/s-0035-1558079. PMC 4629993. PMID 26556905.
- ↑ Duska LR, Kohn EC (November 2017). "The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications". Ann. Oncol. 28 (suppl_8): viii8–viii12. doi:10.1093/annonc/mdx445. PMID 29232468.
- ↑ Prat J (April 2015). "FIGO's staging classification for cancer of the ovary, fallopian tube, and peritoneum: abridged republication". J Gynecol Oncol. 26 (2): 87–9. doi:10.3802/jgo.2015.26.2.87. PMC 4397237. PMID 25872889.
- ↑ Saida T, Tanaka YO, Matsumoto K, Satoh T, Yoshikawa H, Minami M (February 2016). "Revised FIGO staging system for cancer of the ovary, fallopian tube, and peritoneum: important implications for radiologists". Jpn J Radiol. 34 (2): 117–24. doi:10.1007/s11604-015-0513-3. PMID 26696400.
- ↑ Prat J (July 2015). "Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum: Abridged Republication of Guidelines From the International Federation of Gynecology and Obstetrics (FIGO)". Obstet Gynecol. 126 (1): 171–4. doi:10.1097/AOG.0000000000000917. PMID 26241270.
- ↑ Chen, Vivien W.; Ruiz, Bernardo; Killeen, Jeffrey L.; Cot�, Timothy R.; Wu, Xiao Cheng; Correa, Catherine N.; Howe, Holly L. (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (S10): 2631–2642. doi:10.1002/cncr.11345. ISSN 0008-543X. replacement character in
|last4=at position 4 (help) - ↑ Wang J, Li J, Chen R, Lu X (July 2018). "Contribution of lymph node staging method and prognostic factors in malignant ovarian sex cord-stromal tumors: A world wide database analysis". Eur J Surg Oncol. 44 (7): 1054–1061. doi:10.1016/j.ejso.2018.03.027. PMID 29705285.