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[1]
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[2]
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:[3][4][5][6][7][8][9]
| 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
- ↑ Hashmi AA, Naz S, Edhi MM, Faridi N, Hussain SD, Mumtaz S, Khan M (March 2016). "Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience". World J Surg Oncol. 14: 91. doi:10.1186/s12957-016-0849-x. PMC 4815136. PMID 27029917.
- ↑ Ratnavelu ND, Brown AP, Mallett S, Scholten RJ, Patel A, Founta C, Galaal K, Cross P, Naik R (March 2016). "Intraoperative frozen section analysis for the diagnosis of early stage ovarian cancer in suspicious pelvic masses". Cochrane Database Syst Rev. 3: CD010360. doi:10.1002/14651858.CD010360.pub2. PMC 6457848. PMID 26930463.
- ↑ 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.