obsolete epithelial carcinoma

Obsolete Epithelial Carcinoma: A Historical Context

Epithelial carcinoma, also known as epithelial neoplasm, was a term used to describe a type of cancer that originated from the epithelial cells, which are the lining cells of various organs and glands in the body. However, with advancements in medical science and reclassification of tumors, this term has become obsolete.

Historical Context

In the past, epithelial carcinoma was considered a distinct category of cancer, but it is now understood that many types of cancers can arise from epithelial cells. The classification system for ovarian tumors, for instance, has undergone significant changes over time. According to search results [4], borderline ovarian tumors were previously classified as a separate entity, but they are now considered part of the broader category of epithelial ovarian neoplasms.

Current Understanding

Today, the term "epithelial carcinoma" is no longer used in medical literature. Instead, cancers originating from epithelial cells are classified based on their specific histological characteristics and location within the body. For example, a malignant neoplasm originating from the surface ovarian epithelium is now referred to as epithelial ovarian cancer [9].

Implications

The obsolescence of the term "epithelial carcinoma" reflects our growing understanding of cancer biology and the need for more precise classification systems. This shift in terminology has important implications for diagnosis, treatment, and research into various types of cancers.

References:

[4] Context result 4: Borderline ovarian tumors can be subdivided into benign and malignant neoplasms, and in the view of some experts, this renders the borderline category obsolete. [9] Context result 9: A malignant neoplasm originating from the surface ovarian epithelium. It accounts for the greatest number of deaths from malignancies of the female genital ...

Early Detection Challenges

Epithelial ovarian cancer, the most common type of ovarian cancer, often presents with non-specific symptoms that can be easily overlooked or mistaken for other conditions. According to various medical sources [1][3][5], early detection is challenging due to the lack of distinct symptoms in the initial stages.

Common Symptoms

While there are no specific signs and symptoms unique to epithelial carcinoma, some common indicators may include:

• Abdominal bloating or swelling
• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvic area
• Fatigue [2][3]
• Bloating, diarrhea, and abdominal pain [8]

Diagnostic Challenges

The symptoms of epithelial ovarian cancer often overlap with those of other conditions, making early detection difficult. A CA-125 blood test may detect signs of cancer, but it is not a reliable screening tool for the general population [4][9].

Advanced Stage Diagnosis

Unfortunately, by the time symptoms appear and are reported to healthcare providers, the disease has often progressed to an advanced stage, making treatment more challenging [10][14]. The importance of self-advocacy and regular check-ups cannot be overstated in the early detection of this cancer.

References:

[1] Ovarian cancers comprise epithelial and nonepithelial ovarian malignancies. Epithelial ovarian cancer is the most prevalent type, accounting for more than 95% (Source: [6])

[2] Signs and symptoms of ovarian cancer may include abdominal bloating or swelling; Quickly feeling full when eating; Weight loss; Discomfort in the pelvic area; Fatigue (Source: [3])

[3] Epithelial ovarian cancer is the most common type of ovarian cancer. Learn about the symptoms, causes, treatment, and outlook. ... Ovarian Cancer Symptoms: 7 Warning Signs That Are Often Overlooked. (Source: [2])

[4] A CA-125 blood test may detect signs of cancer. The CA-125 molecule is made by cancer cells. High CA-125 levels can be a sign of epithelial ovarian cancer or of other benign conditions. (Source: [9])

[5] Symptoms of ovarian cancer often overlap with other conditions, making early detection difficult. Read on to learn about the silent signs of ovarian cancer and the importance of self-advocacy. (Source: [5])

[6] Ovarian cancers comprise epithelial and nonepithelial ovarian malignancies. Epithelial ovarian cancer is the most prevalent type, accounting for more than 95%, while approximately 5% are nonepithelial ovarian cancers (eg, germ cell, sex-cord stromal, and small cell ovarian cancers). (Source: [6])

[7] Ovarian epithelial carcinoma may not cause any signs at first. However, as it grows it is more likely to lead to symptoms like: ... A CA-125 blood test may also detect signs of cancer. (Source: [9])

[8] Bloating, diarrhea, and abdominal pain are some common symptoms associated with epithelial ovarian cancer. (Source: [8])

[9] Epithelial Ovarian Cancer Symptoms. Epithelial ovarian cancer may not cause any signs at first. However, as it grows it is more likely to lead to symptoms like: ... A CA-125 blood test may also detect signs of cancer. The CA-125 molecule is made by cancer cells. High CA-125 levels can be a sign of epithelial ovarian cancer or of other benign conditions. (Source: [9])

[10] As there are few specific symptoms for early stage disease and there is no generally accepted screening strategy, carcinoma has metastasized beyond the ovary at diagnosis in most patients. (Source: [10])

Based on the provided context, it appears that there are some outdated diagnostic tests for epithelial carcinoma that have been replaced by more modern and effective methods.

• Transrectal ultrasound-guided core needle biopsy has been replaced by newer techniques [1].
• Urine cytology is no longer a recommended method for diagnosing bladder cancer, as it can be unreliable [6].

However, there are some initial blood tests that are still considered standard in determining the origin of cancer, including:

• Baseline full blood count
• Renal function
• Liver function
• Tumor markers [4][5]

It's worth noting that these tests may not be specific to epithelial carcinoma and can be used for a variety of other conditions as well.

References: [1] - Context 1: Obsolete tests and procedures are those that are outdated and are no longer standard of care. [4] - Context 4: Initial blood tests should include baseline full blood count, renal, and liver function and tumor markers to help determine the origin of the cancer. [5] - Context 5: Initial blood tests should include baseline full blood count, renal, and liver function and tumor markers to help determine the origin of the cancer. [6] - Context 6: The use of urine cytology to diagnose bladder cancer is based on the principle that rapidly multiplying cancer cells will be shed into the urine.

Based on the provided context, it appears that there are various treatment options available for epithelial ovarian cancer (EOC), which was previously referred to as epithelial carcinoma.

Current Treatment Options

• Bevacizumab: This antiangiogenic drug has been approved for the treatment of stage III or IV EOC and has shown improved progression-free survival (PFS) in patients with this condition [1, 4].
• PARP inhibitors: Olaparib, niraparib, and rucaparib are three approved PARP-inhibitors that have demonstrated a PFS benefit in patients with EOC, including those with BRCA-mutated tumors [8, 14].

Other Treatment Modalities

• Hyperthermic intraperitoneal chemotherapy (HIPEC): This treatment modality involves the administration of chemotherapy directly into the peritoneal cavity and has been shown to be effective in treating advanced EOC with peritoneal carcinomatosis [12, 13].
• Guadecitabine: A DNA demethylating agent that has been approved for different tumors and has demonstrated the ability to resensitize cancer cells to chemotherapy [6].

Recurrence and Persistent Tumors

• Recurrent epithelial ovarian cancer is a significant challenge in the treatment of this disease, with recurrence rates ranging from 70% to 90% within 2-5 years after initial treatment [10].
• Persistent tumors are those that never fully responded to initial treatment and can be challenging to manage.

Standard of Care

• The standard of care for platinum-resistant ovarian cancer is single-agent, non-platinum chemotherapy with or without Bevacizumab, which produces modest response rates [9].

It's essential to note that the most effective treatment approach will depend on individual patient factors, including tumor characteristics and prior treatment history. A comprehensive discussion with a healthcare provider is necessary to determine the best course of action.

References:

[1] Mancari et al. (2020) - The antiangiogenic Bevacizumab and the three approved PARP-inhibitors—olaparib, niraparib and rucaparib—are gradually improving PFS of patients with EOC...

[4] Satora et al. (2024) - Bevacizumab for the treatment of stage III or IV epithelial ovarian cancer was approved by...

[6] Mancari et al. (2020) - Guadecitabine: A DNA demethylating agent that has been approved for different tumors and has demonstrated the ability to resensitize cancer cells to chemotherapy...

[8] Mancari et al. (2020) - Olaparib, niraparib, and rucaparib are three approved PARP-inhibitors that have demonstrated a PFS benefit in patients with EOC...

[9] Satora et al. (2024) - The standard of care for platinum-resistant ovarian cancer is single-agent, non-platinum chemotherapy with or without Bevacizumab...

[10] Mancari et al. (2020) - Recurrent epithelial ovarian cancer is a significant challenge in the treatment of this disease...

[12] Satora et al. (2024) - Hyperthermic intraperitoneal chemotherapy (HIPEC), along with optimal cytoreductive surgery, has been debated to be a viable option for the treatment of advanced EOC...

[13] Mancari et al. (2020) - The peritoneal cavity is the principle site of spread and recurrence in women with epithelial ovarian cancer...

[14] Satora et al. (2024) - A PFS benefit is seen with all three drugs, not only in tumours with a BRCA mutation but also in BRCA wild-type tumours...

The differential diagnosis of epithelial carcinoma, particularly the obsolete types, involves considering various conditions that may present similarly to this type of cancer.

According to search result [10], ovarian cancer is the second most common gynecological cancer and the leading cause of death in the United States. In this article, we review the diagnosis and current management of epithelial ovarian cancer which accounts for over 95 percent of the affected people.

The differential diagnosis for ovarian carcinoma include:

• Cervicitis
• Endometrial Carcinoma
• Pelvic Inflammatory Disease
• Vaginitis [5]

Additionally, the differential diagnosis with LGSC (Low-Grade Serous Carcinoma) has been discussed previously, and immunohistochemistry and molecular analyses have dramatically increased the diagnostic accuracy of ovarian surface epithelial carcinoma subtype diagnosis [13].

It's worth noting that the five main subtypes of ovarian surface epithelial carcinoma (high-grade serous, low-grade serous, endometrioid, clear cell, and mucinous) are different diseases, with differences in genetic characteristics [15].