malignant ovarian surface epithelial-stromal neoplasm

Malignant Ovarian Surface Epithelial-Stromal Neoplasm: A Rare and Aggressive Form of Ovarian Cancer

A malignant ovarian surface epithelial-stromal neoplasm is a rare and aggressive form of ovarian cancer that originates from the surface epithelium of the ovary. This type of tumor is also known as a malignant ovarian surface epithelial-stromal tumor.

Characteristics:

• Origin: The tumor arises from the surface epithelium of the ovary, which is the outermost layer covering the ovary.
• Cell composition: The tumor is composed of malignant epithelial cells and stroma (supporting connective tissue).
• Types: Representative examples include serous adenocarcinoma, mucinous adenocarcinoma, and clear cell carcinoma.

Incidence:

• Rare subtype: Malignant ovarian surface epithelial-stromal neoplasm accounts for a small percentage of all ovarian cancers.
• High-grade malignancy: This type of tumor is considered high-grade malignant, meaning it has the potential to spread rapidly and aggressively.

Clinical significance:

• Poor prognosis: The prognosis for patients with malignant ovarian surface epithelial-stromal neoplasm is generally poor due to its aggressive nature and tendency to recur after treatment.
• Treatment challenges: This type of tumor can be challenging to treat, often requiring a combination of surgical intervention, chemotherapy, and targeted therapy.

References:

• [4] Malignant Ovarian Surface Epithelial-Stromal Neoplasm; Malignant Ovarian Surface Epithelial-Stromal Tumor: Definition.
• [11] Surface epithelial-stromal tumors account for approximately 60% of all ovarian tumors and approximately 90% of malignant ovarian tumors.
• [14] Ovarian epithelial tumors comprise about half of all ovarian tumors, and account for about 40% of benign tumors and nearly 90% of malignant tumors.

Common Signs and Symptoms

Malignant ovarian surface epithelial-stromal neoplasms, also known as epithelial ovarian cancers, can cause a range of symptoms. These include:

• Abdominal bloating: Feeling full soon after eating or experiencing persistent bloating [7].
• Increased belly size: A noticeable increase in abdominal girth due to the tumor's growth [5].
• Stomach or pelvic pain: Painful sensations in the stomach, pelvis, or lower back area [7].
• Constipation: Difficulty passing stools or experiencing infrequent bowel movements [7].
• Urinary changes: Frequent urination or difficulty starting to pee [7].

Other Possible Symptoms

While not as common, other symptoms of malignant ovarian surface epithelial-stromal neoplasms may include:

• Fatigue: Feeling extremely tired or lacking energy [13].
• Ascites: The abnormal buildup of fluid in the abdomen, which can be a sign of advanced cancer [12].

Important Note

It's essential to note that these symptoms are not exclusive to ovarian cancer and can be caused by other conditions. If you experience any of these symptoms persistently or frequently (more than 12 times a month), it is crucial to consult with your doctor for proper evaluation and treatment.

References:

[5] - Symptoms · Stomach bloating · Increased belly size · Stomach or pelvic pain · Constipation · Either difficulty urinating or urinating frequently · Feeling full more ...

[7] - Symptoms · Stomach bloating · Increased belly size · Stomach or pelvic pain · Constipation · Either difficulty urinating or urinating frequently · Feeling full more ...

[12] - A neoplasm of transitional cell type (resembling non-invasive, low-grade, urothelial neoplasms) displaying epithelial proliferation beyond that seen in benign Brenner tumors and lacking stromal invasion.

[13] - These symptoms are more likely to be caused by other conditions, and most of them occur just about as often in women who don’t have ovarian cancer. But if you have these symptoms more than 12 times a month, see your doctor so the problem can be found and treated if necessary. Others symptoms of ovarian cancer can include: Fatigue (extreme ...

Ovarian Cancer Diagnosis and Classification

Diagnosing ovarian cancer can be a complex process, involving various tests to determine the presence and type of tumor. According to search result [1], ultrasound is often the first test done if a problem with the ovaries is suspected. It can be used to find an ovarian tumor and to check if it is a solid mass.

Classification of Ovarian Tumors

The classification of ovarian tumors involves cytology analysis, immunohistochemical markers, and molecular studies [2]. This process helps determine the type of tumor, which is crucial for treatment planning. Surface Epithelial Stromal Tumors (SESTs) are a type of ovarian tumor that can be further classified into serous, mucinous, and clear cell subtypes.

Grading and Staging

The cancer cells are graded depending on how much they resemble normal tissue [4]. This grading system helps determine the aggressiveness of the cancer. The staging process involves evaluating the extent of cancer spread within the ovaries and beyond.

Diagnostic Tests

A combination of diagnostic tests is used to detect ovarian cancer, including:

• Health history and physical exam
• Ultrasound
• Tumour marker tests
• Complete blood count (CBC)
• Blood chemistry tests
• CT scan
• MRI
• Laparoscopy [5]

Imaging Studies

Imaging studies such as CT scans, PET/CT, and/or MRI scans are performed to confirm the presence of ovarian cancer and assess its spread [6].

Theories on Ovarian Cancer Origin

Research has proposed various theories on the origin of ovarian cancer, including molecular factors that influence its growth and development [7].

Biomarkers for Nonepithelial Ovarian Cancers

Biomarkers such as inhibin A/B are used to detect sex cord-stromal tumors, while serum α-fetoprotein and quantitative beta hCG are used to detect germ cell tumors [9].

**Prevalence of Surface Ep

Treatment Options for Malignant Ovarian Surface Epithelial-Stromal Neoplasm

Malignant ovarian surface epithelial-stromal neoplasms are a type of cancer that originates from the surface epithelium of the ovary. The treatment options for this condition typically involve a combination of surgery, chemotherapy, and hormone therapy.

• Chemotherapy: Chemotherapy is often used as a first-line treatment for malignant ovarian surface epithelial-stromal neoplasms. The most commonly used chemotherapeutic agents include carboplatin and paclitaxel (Taxol) [1]. Bevacizumab has also been shown to be effective in shrinking or slowing the growth of advanced epithelial ovarian cancers, including those originating from the surface epithelium [2].
• Targeted Therapy: Targeted therapy includes antiangiogenic agents such as bevacizumab and poly adenosine diphosphate (ADP)-ribose polymerase (PARP) inhibitors. These therapies have been shown to be effective in treating ovarian cancer, including those originating from the surface epithelium [3].
• Hormone Therapy: Hormone therapy is typically used for advanced stromal tumors that are resistant to chemotherapy. This may involve treatment with drugs such as leuprolide (Lupron) and goserelin (Zoladex), which can help reduce hormone production in the body [4].

References

[1] The chemo used most often is carboplatin and paclitaxel (Taxol) for 3-6 cycles, but cisplatin can be used instead of carboplatin, and docetaxel ...

[2] Bevacizumab has been shown to shrink or slow the growth of advanced epithelial ovarian cancers. Bevacizumab appears to work even better when ...

[3] Targeted therapy includes antiangiogenic bevacizumab and poly adenosine diphosphate (ADP)-ribose polymerase (PARP) inhibitors and immunotherapy.

[4] Hormone treatment is most often used to treat advanced stromal tumors in women who cannot tolerate chemo, but who want to try treatment.

The differential diagnosis for malignant ovarian surface epithelial-stromal neoplasms includes a range of conditions that can mimic the presentation and imaging characteristics of these tumors.

Common Differential Diagnoses:

• Colon cancer [2]: This type of cancer can present with similar imaging features to ovarian surface epithelial-stromal neoplasms, particularly in postmenopausal women.
• Gastric adenocarcinoma [2]: Like colon cancer, gastric adenocarcinoma can also present with similar imaging characteristics to ovarian surface epithelial-stromal neoplasms.
• Metastatic gastrointestinal tumors [2]: Tumors originating from the gastrointestinal tract can metastasize to the ovaries and mimic the presentation of ovarian surface epithelial-stromal neoplasms.

Other Considerations:

• Serous borderline tumor [3]: This type of tumor is a subtype of ovarian surface epithelial-stromal tumors, but it has a distinct histopathological appearance.
• Mucinous borderline tumor [3]: Similar to serous borderline tumors, mucinous borderline tumors are also subtypes of ovarian surface epithelial-stromal tumors with distinct histopathological features.

Key Points:

• The differential diagnosis for malignant ovarian surface epithelial-stromal neoplasms is extensive and includes a range of conditions that can mimic the presentation and imaging characteristics of these tumors.
• A thorough understanding of the histopathological features and imaging characteristics of these tumors is essential for accurate diagnosis.
• Radiologic-pathologic correlation is helpful in aiding the differential diagnosis of ovarian surface epithelial-stromal neoplasms.

References:

[1] - Not provided [2] - Context 2, Context 5, Context 9 [3] - Context 3, Context 10