Rare Epithelial Tumors Arising in or near the Ovary: A Review of the Risk Factors, Presentation, and Future Treatment Direction for Ovarian Clear Cell and Mucinous Carcinoma

AbstractThis study aimed to construct convention-radiomics CT nomogram containing conventional CT characteristics and radiomics signature for distinguishing fat-poor angiomyolipoma (fp-AML) from clear-cell renal cell carcinoma (ccRCC). 29 fp-AML and 110 ccRCC patients were enrolled and underwent CT examinations in this study. The radiomics-only logistic model was constructed with selected radiomics features by the analysis of variance (ANOVA)/Mann–Whitney (MW), correlation analysis, and Least Absolute Shrinkage and Selection Operator (LASSO), and the radiomics score (rad-score) was computed. The convention-radiomics logistic model based on independent conventional CT risk factors and rad-score was constructed for differentiating. Then the relevant nomogram was developed. Receiver operation characteristic (ROC) curves were calculated to quantify the accuracy for distinguishing. The rad-score of ccRCC was smaller than that of fp-AML. The convention-radioimics logistic model was constructed containing variables of enhancement pattern, VUP, and rad-score. To the entire cohort, the area under the curve (AUC) of convention-radiomics model (0.968 [95% CI 0.923–0.990]) was higher than that of radiomics-only model (0.958 [95% CI 0.910–0.985]). Our study indicated that convention-radiomics CT nomogram including conventional CT risk factors and radiomics signature exhibited better performance in distinguishing fp-AML from ccRCC.

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Immunoexpression of Inhibin α Subunit, Inhibin/Activin βA Subunit and CD99 in Ovarian Tumors

Archives of Pathology & Laboratory Medicine ◽

10.5858/2000-124-0563-ioisia ◽

2000 ◽

Vol 124 (4) ◽

pp. 563-569 ◽

Cited By ~ 6

Author(s):

Yoon-La Choi ◽

Hy-Sook Kim ◽

Geunghwan Ahn

Keyword(s):

Differential Diagnosis ◽

Granulosa Cell ◽

Mucinous Carcinoma ◽

Ovarian Tumors ◽

Serous Carcinoma ◽

Α Subunit ◽

Stromal Tumors ◽

Epithelial Tumors ◽

Krukenberg Tumors ◽

Sex Cord Stromal Tumors

Abstract Objective.—Anti–inhibin α and inhibin/activin βA subunit and anti-CD99 monoclonal antibodies (mAbs) have recently been demonstrated to be able to label ovarian granulosa cells; thus, they may be of value in the diagnosis of granulosa cell tumors. The present study aimed to determine what combination of these mAbs may be useful for the differential diagnosis of sex cord–stromal tumors of ovary. Design.—Immunohistochemical analyses with anti–inhibin α and inhibin/activin βA subunit antibody and anti-CD99 mAb were performed on 42 ovarian tumors, including sex cord–stromal tumors (29), ovarian epithelial cancers (10), and Krukenberg tumors (3). Results.—All sex cord–stromal tumors were positive for inhibin α subunit, and 17 cases (58.6%) of sex cord–stromal tumors were immunoreactive for inhibin/activin βA subunit. Epithelial tumors and Krukenberg tumors were all negative for inhibin/activin βA subunit except mucinous carcinoma, which showed strong cytoplasmic immunoreactivity. All sex cord–stromal tumors except one granulosa cell tumor showed membranous staining for CD99. A case of serous carcinoma and a case of mucinous carcinoma were positive for CD99, and the remaining epithelial tumors and Krukenberg tumor were all negative for CD99. Conclusions.—The results of immunohistochemical analysis, together with literature review, suggest that inhibin α subunit may be a useful diagnostic marker for sex cord–stromal tumor of the ovary. In addition, anti-CD99 antibody may be useful for the differential diagnosis between ovarian tumors. Inhibin/activin βA subunit has a limited usefulness in the differential diagnosis of ovarian tumor because of its wider immunoreactivity for both sex cord–stromal tumors and mucinous carcinomas. The differential diagnosis of sex cord–stromal tumors of the ovary would be better made with a combined use of both anti–inhibin α subunit and anti-CD99 mAbs.

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Management of a patient with primary mucinous testicular adenocarcinoma as a rare case with adjuvant and metastatic sequential treatments

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220903374 ◽

2020 ◽

Vol 26 (6) ◽

pp. 1520-1523

Author(s):

Ozgur Tanriverdi ◽

Mehmet Levent Tarimer ◽

Ceren Deniz Pak ◽

Selcuk Uylas ◽

Ali Alkan ◽

...

Keyword(s):

Treatment Options ◽

Mucinous Carcinoma ◽

Response To Treatment ◽

Limited Information ◽

Epithelial Tumors ◽

Review Management ◽

First Relapse ◽

Lung Metastasectomy ◽

Sequential Treatments ◽

Mucinous Cystadenomas

Introduction Mucinous adenocarcinomas of the testicular surface epithelial tumors are very rare and are similar to malignant ovarian-type surface epithelial tumors. Although only 32 cases have been reported to date, there are only five cases of primary testicular mucinous carcinoma with access to literature in English. So there is still limited information about clinical, etiopathogenesis and treatment options. Case report In this article, we discuss a 56-year-old male patient diagnosed with testicular mucinous adenocarcinoma due to its rarity in the light of literature review. Management and outcome: We preferred cisplatin-paclitaxel regimen for adjuvant treatment. We then used sequential treatments including oxaliplatin, 5-fluorourasil, etoposide, gemcitabine, and docetaxel to treat metastatic disease. The patient underwent lung metastasectomy for the first relapse. The patient was diagnosed in November 2013 and the response to treatment was evaluated in December 2019 and stable disease was detected. The patient, who has a total survival of 73 months, is still under treatment. Discussion Excluding malign transformation and borderline mucinous testicular tumors from mucinous cystadenomas of the testis, the knowledge on carcinogenesis, clinical course, and treatment of primary testicular mucinous adenocarcinomas is very limited.

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Comprehensive Immunoprofiles of Renal Cell Carcinoma Subtypes

Cancers ◽

10.3390/cancers12030602 ◽

2020 ◽

Vol 12 (3) ◽

pp. 602 ◽

Cited By ~ 3

Author(s):

Moonsik Kim ◽

Jin Woo Joo ◽

Seok Joo Lee ◽

Yoon Ah Cho ◽

Cheol Keun Park ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Collecting Duct ◽

Cathepsin K ◽

Renal Tumors ◽

Duct Carcinoma ◽

Epithelial Tumors ◽

Papillary Type

In recent years, renal epithelial tumors have been among the fastest reclassifying tumors, requiring updates to the tumor classification system. Nonetheless, immunohistochemistry (IHC) remains the most widely used tool for renal epithelial tumors. In this proposal, we aimed to create the most efficient IHC panel for categorizing the diverse subtypes of renal tumors, and to find out more specific immunohistochemical results in each subtype or each antibody. A total of 214 renal tumors were analyzed using 10 possible IHC markers to differentiate subtypes, including three major renal cell carcinoma (RCC) subtypes, clear-cell type (50 cases), papillary type (50 cases), and chromophobe type (20 cases), and minor subtypes (MiT RCC, 13 cases; collecting duct carcinoma, 5 cases; and oncocytoma, 10 cases). A triple immunomarker (cytokeratin 7 (CK7)-carbonic anhydrase IX (CAIX)- alpha-methylacyl-CoA racemase (AMACR)) panel is useful in particular high-grade clear-cell tumors. If IHC remains ambiguous, the use of an adjunctive panel can be suggested, including CD10, epithelial membrane antigen, cathepsin K, c-kit, hepatocyte nuclear factor 1-β, and E-cadherin. For an efficient immunohistochemical strategy for subtyping of RCC, we conclude that the CK7-CAIX-AMACR panel is the best primary choice for screening subtyping.

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Association of De Ritis Ratio and Neutrophil Lymphocyte Ratio with renal functional decline and all-cause mortality in renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.741 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 741-741

Author(s):

Cathrine Keiner ◽

Margaret Meagher ◽

Dattatraya Patil ◽

Kazutaka Saito ◽

Devin Patel ◽

...

Keyword(s):

Risk Factors ◽

Renal Cell Carcinoma ◽

Clear Cell ◽

De Novo ◽

Functional Decline ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Factors Associated ◽

All Cause Mortality ◽

Independent Risk Factors

741 Background: We sought to investigate utility of pre-operative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De Ritis Ratio as predictors of all-cause mortality (ACM) and renal functional decline renal cell carcinoma (RCC). Methods: Multi-institutional retrospective analysis of patients undergoing surgery for RCC. Multivariable analysis (MVA) was conducted to elucidate independent risk factors for ACM, de novo estimated glomerular filtration rate (eGFR)<45 ml/min/1.73m2 and eGFR<30 ml/min/1.73m2. Kaplan-Meier analysis (KMA) was used to investigate ACM, and de novo CKD. Results: 2928 patients were analyzed [1850 Male/1078 Female, median follow up 30.5 months, median tumor size 4.5 cm, 1741 partial nephrectomy (PN)/1187 radical nephrectomy (RN)]. 690 patients had NLR ≥ 3, while 208 patients had NLR ≥ 6; 110 patients had PLR ≥ 3; and 474 patients had De Ritis Ratio ≥ 3. MVA for risk factors associated with worsened ACM showed male sex (OR 1.6, p=0.02), HTN (OR 2.1, p=0.001), increasing tumor size (OR 1.12, p<0.001), clear cell RCC (OR 2.0, p=0.001), RN (OR 1.6, p=0.048), NLR≥ 6 (OR=2.4, p=0.001), Di Ritis Ratio≥3 (OR 2.4, p<0.001), and de novo eGFR<45 (OR=1.6, p=0.015) to be independent risk factors. MVA for factors associated with development of eGFR<45 included increasing age (OR 1.03, p<0.001), male (OR 1.5, p=0.01), HTN (OR 2.3, p<0.001), clear cell RCC (OR 2.2, p<0.001), RN (OR 6.8, p=0.03), NLR≥6 (OR 2.0, p=0.002), and Di Ritis Ratio≥3 (OR 2.3, p<0.001) to be independently associated. Variables associated with development of eGFR<30 included age (OR 1.05, p<0.001), DM (OR=3.01, p<0.001), black race (OR 1.9, p=0.005), Di Ritis Ratio≥3 (OR 2.0, p=0.001), and NLR≥6 (OR 2.1, p=0.002). PLR was not associated with OS, de novo eGFR<45, or de novo eGFR<30. On KMA, NLR≥6 was associated with worse OS (p<0.001). Di Ritis ratio ≥1.5 was associated with worse OS p<0.001 and Di Ritis ratio (≥3) was associated decreased freedom from of de novo eGFR<45 (p=0.026). Conclusions: Elevated NLR and De Ritis Ratio were associated with functional decline and worsened OS, while PLR was not predictive. These markers may be helpful in identifying high-risk patients.

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Influence of clear cell carcinoma on the post-hepatectomy prognosis of patients with hepatocellular carcinoma

Future Oncology ◽

10.2217/fon-2021-0381 ◽

2021 ◽

Author(s):

Yongheng Deng ◽

Shaoliang Zhu ◽

Wen Yan ◽

Lunan Qi ◽

Zushun Chen ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Cell Carcinoma ◽

Tumor Size ◽

Protective Factor ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Disease Free Survival ◽

Ki 67 ◽

Cox Analysis

Aim: The authors aimed to identify factors that independently influence the survival of patients with primary clear cell carcinoma of the liver (PCCCL). Methods: A total of 470 patients with hepatocellular carcinoma were retrospectively analyzed. Multivariate Cox analysis was used to identify potential factors associated with prognosis of PCCCL. Results: Patients with PCCCL showed significantly higher disease-free survival (DFS) and overall survival (OS) compared with patients with non-clear cell hepatocellular carcinoma. Multivariate analysis revealed that AFP level, tumor size, liver cirrhosis and portal vein tumor thrombosis were risk factors for DFS. Tumor size, capsule formation and Ki-67 were risk factors for OS. Satellite nodules acted as a protective factor for DFS and OS. Conclusion: PCCCL is associated with better prognosis in hepatocellular carcinoma. Tumor size and satellite nodules may be independent predictors of OS and DFS.

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