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Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma

F. Pozzati, F. Moro, T. Pasciuto, C. Gallo, F. Ciccarone, D. Franchi, R. Mancari, S. Giunchi, D. Timmerman, C. Landolfo, E. Epstein, V. Chiappa, D. Fischerova, R. Fruscio, GF. Zannoni, L. Valentin, G. Scambia, AC. Testa,

. 2018 ; 52 (6) : 792-800. [pub] -

Language English Country England, Great Britain

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc19028339

OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure clear cell carcinoma. METHODS: This was a retrospective study involving data from 11 ultrasound centers. From the International Ovarian Tumor Analysis (IOTA) database, 105 patients who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016 were identified with a histologically confirmed pure clear cell carcinoma of the ovary. An additional 47 patients diagnosed with pure clear cell carcinoma between 1999 and 2016 and with available complete preoperative ultrasound reports were identified retrospectively from the databases of the departments of gynecological oncology in the participating centers. The ultrasound images of all tumors were described using IOTA terminology. Clinical and ultrasound characteristics were analyzed for the whole group, and separately, for patients with and those without histologically confirmed endometriosis, and for patients with evidence of tumor developing from endometriosis. RESULTS: Median age of the 152 patients was 53.5 (range, 28-92) years and 92/152 (60.5%) tumors were FIGO Stage I. Most tumors (128/152, 84.2%) were unilateral. On ultrasound examination, all tumors contained solid components and 36/152 (23.7%) were completely solid masses. The median largest diameter of the lesion was 117 (range, 25-310) mm. Papillary projections were present in 58/152 (38.2%) masses and, in most of these (51/56, 91.1%), vascularized papillary projections were seen. Information regarding the presence, site and type of pelvic endometriosis at histology was available for 130/152 patients. Endometriosis was noted in 54 (41.5%) of these. In 24/130 (18.6%) patients, the tumor was judged to have developed from endometriosis. Patients with, compared to those without, evidence of tumor developing from endometriosis were younger (median 47.5 vs 55.0 years, respectively), and ground-glass echogenicity of cyst fluid was more common in pure clear cell cancers developing from endometriosis (10/20 vs 13/79 (50.0% vs 16.5%), respectively). CONCLUSIONS: Ovarian pure clear cell carcinoma is usually diagnosed at an early stage and typically appears as a large unilateral mass with solid components. Patients with clear cell carcinoma developing from endometriosis are younger than other patients with clear cell carcinoma, and clear cell cancers developing from endometriosis more often manifest ground-glass echogenicity of cyst fluid. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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$a Pozzati, F $u Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
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$a Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma / $c F. Pozzati, F. Moro, T. Pasciuto, C. Gallo, F. Ciccarone, D. Franchi, R. Mancari, S. Giunchi, D. Timmerman, C. Landolfo, E. Epstein, V. Chiappa, D. Fischerova, R. Fruscio, GF. Zannoni, L. Valentin, G. Scambia, AC. Testa,
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$a OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure clear cell carcinoma. METHODS: This was a retrospective study involving data from 11 ultrasound centers. From the International Ovarian Tumor Analysis (IOTA) database, 105 patients who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016 were identified with a histologically confirmed pure clear cell carcinoma of the ovary. An additional 47 patients diagnosed with pure clear cell carcinoma between 1999 and 2016 and with available complete preoperative ultrasound reports were identified retrospectively from the databases of the departments of gynecological oncology in the participating centers. The ultrasound images of all tumors were described using IOTA terminology. Clinical and ultrasound characteristics were analyzed for the whole group, and separately, for patients with and those without histologically confirmed endometriosis, and for patients with evidence of tumor developing from endometriosis. RESULTS: Median age of the 152 patients was 53.5 (range, 28-92) years and 92/152 (60.5%) tumors were FIGO Stage I. Most tumors (128/152, 84.2%) were unilateral. On ultrasound examination, all tumors contained solid components and 36/152 (23.7%) were completely solid masses. The median largest diameter of the lesion was 117 (range, 25-310) mm. Papillary projections were present in 58/152 (38.2%) masses and, in most of these (51/56, 91.1%), vascularized papillary projections were seen. Information regarding the presence, site and type of pelvic endometriosis at histology was available for 130/152 patients. Endometriosis was noted in 54 (41.5%) of these. In 24/130 (18.6%) patients, the tumor was judged to have developed from endometriosis. Patients with, compared to those without, evidence of tumor developing from endometriosis were younger (median 47.5 vs 55.0 years, respectively), and ground-glass echogenicity of cyst fluid was more common in pure clear cell cancers developing from endometriosis (10/20 vs 13/79 (50.0% vs 16.5%), respectively). CONCLUSIONS: Ovarian pure clear cell carcinoma is usually diagnosed at an early stage and typically appears as a large unilateral mass with solid components. Patients with clear cell carcinoma developing from endometriosis are younger than other patients with clear cell carcinoma, and clear cell cancers developing from endometriosis more often manifest ground-glass echogenicity of cyst fluid. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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$a Moro, F $u Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
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$a Pasciuto, T $u Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
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$a Gallo, C $u Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy.
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$a Ciccarone, F $u Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
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$a Franchi, D $u Preventive Gynecology Unit, Division of Gynecology, European Institute of Oncology, Milan, Italy.
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$a Mancari, R $u Preventive Gynecology Unit, Division of Gynecology, European Institute of Oncology, Milan, Italy.
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$a Giunchi, S $u Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
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$a Timmerman, D $u Department of Development and Regeneration, KU Leuven, Leuven, Belgium. Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
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$a Landolfo, C $u Department of Development and Regeneration, KU Leuven, Leuven, Belgium. Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
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$a Epstein, E $u Departments of Obstetrics and Gynecology at Karolinska University Hospital, Stockholm, Sweden.
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$a Chiappa, V $u Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
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$a Fischerova, D $u Gynecological Oncology Center, Department of Obstetrics and Gynecology, Charles University, Prague, Czech Republic.
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$a Fruscio, R $u Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy.
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$a Zannoni, G F $u Institute of Histopathology, Catholic University of the Sacred Heart, Rome, Italy.
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$a Valentin, L $u Skåne University Hospital Malmö, Lund University, Malmö, Sweden.
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$a Scambia, G $u Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.
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