scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Primary psammocarcinoma of the ovary or peritoneum.

01 Jul 2009-International Journal of Gynecological Cancer (BMJ Specialist Journals)-Vol. 19, Iss: 5, pp 844-846
TL;DR: Peritoneal or ovarian PSC is a rare low-grade carcinoma characterized by a more favorable prognosis than classic carcinoma, and the place of debulking surgery at the time of initial or recurrent management is important.
Abstract: Background: The aim of this study was to assess the outcomes of patients treated for peritoneal or ovarian psammocarcinoma (PSC). Materials and Methods: Review of patients with PSC who underwent cytoreductive surgery in our institution with a follow-up of more than 18 months (the ovarian or peritoneal tumor was histologically reviewed by our reference pathologist). Results: From 1997 to 2006, 15 patients with PSC were histologically reviewed in our institution. Five of these patients fulfilled the inclusion criteria. Four patients had ovarian PSC, and 1 had peritoneal PSC. Four patients were surgically treated during initial management and another patient at the time of recurrence. All of them underwent complete cytoreductive surgery followed by intraperitoneal chemotherapy in 2 patients and by conventional adjuvant chemotherapy in 1. After a median follow-up of 42 months, 4 of them remain disease-free. Conclusions: Peritoneal or ovarian PSC is a rare low-grade carcinoma characterized by a more favorable prognosis than classic carcinoma. The place of debulking surgery at the time of initial or recurrent management is important.
Citations
More filters
Journal ArticleDOI
TL;DR: Patients with low-grade serous ovarian and primary peritoneal carcinomas are diagnosed at a younger age, have a longer overall survival and a lower response rate to platinum-based chemotherapy compared to women with high-grades ovarian carcinoma, and have high rates of persistent disease at the completion of primary treatment.

39 citations

Journal ArticleDOI
TL;DR: CRS and HIPEC may increases long-term survival in selected patients with peritoneal metastasis from rare ovarian tumors especially in mucinous, granulosa, or teratoma histological subtypes.
Abstract: Ovarian cancer is the most common deadly cancer of gynecologic origin. Patients often are diagnosed at advanced stage with peritoneal metastasis. There are many rare histologies of ovarian cancer; some have outcomes worse than serous ovarian cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can be considered for patients with recurrence. This study was designed to assess the impact of CRS and HIPEC on survival of patient with peritoneal metastasis from rare ovarian malignancy. A prospective, multicentric, international database was retrospectively searched to identify all patients with rare ovarian tumor (mucinous, clear cells, endometrioid, small cell hypercalcemic, and other) and peritoneal metastasis who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI) and BIG-RENAPE working group. The postoperative complications, long-term results, and principal prognostic factors were analyzed. The analysis included 210 patients with a median follow-up of 43.5 months. Median overall survival (OS) was 69.3 months, and the 5-year OS was 57.7%. For mucinous tumors, median OS and DFS were not reached at 5 years. For granulosa tumors, median overall survival was not reached at 5 years, and median DFS was 34.6 months. Teratoma or germinal tumor showed median overall survival and DFS that were not reached at 5 years. Differences in OS were not statistically significant between histologies (p = 0.383), whereas differences in DFS were (p < 0.001). CRS and HIPEC may increases long-term survival in selected patients with peritoneal metastasis from rare ovarian tumors especially in mucinous, granulosa, or teratoma histological subtypes.

26 citations


Cites result from "Primary psammocarcinoma of the ovar..."

  • ...These findings are consistent with a previously reported study of HIPEC in psammocarcinoma in which five patients had a median follow-up of 42 months and four were diseasefree after that period.(37) Mullerian tumor with peritoneal metastasis is associated with a poor prognosis; of the two patients with this type in this series, both are dead: one with recurrence and the other with an unknown status....

    [...]

Journal ArticleDOI
TL;DR: The decision to perform CCRS plus HIPEC for PC arising from unusual cancer origins remains difficult and patients should be prospectively entered into registries of rare tumors that involve the peritoneum in order to better define indications.

25 citations

Journal ArticleDOI
TL;DR: This is the rare case describing coexistence of this very rare malignant serous epithelial tumor with a benign serous cystadenofibroma of contralateral ovary in a 55 year old Asian Indian female.
Abstract: Introduction Psammocarcinoma of ovary is a rare serous neoplasm characterized by extensive formation of psammoma bodies, invasion of ovarian stroma, peritoneum or intraperitoneal viscera, and moderate cytological atypia. Extensive medlar search showed presence of only 28 cases of psammocarcinoma of ovary reported till date.

8 citations


Cites background from "Primary psammocarcinoma of the ovar..."

  • ...Extensive search showed presence of only 28 cases of psammocarcinoma of ovary reported till date [1-17] (Table 1)....

    [...]

  • ...Literature search showed presence of only 28 cases of psammocarcinoma of ovary reported till date (Table 1) [1-17]....

    [...]

  • ...Poujade et al [17] 2009 4 19-67 NA NA NA Y...

    [...]

Journal ArticleDOI
TL;DR: Psammocarcinoma is a rare low‐grade serous carcinoma arising either from ovary or peritoneum and is characterized by extensive psammomatous calcifications and invasion of surrounding structures.
Abstract: Psammocarcinoma is a rare low-grade serous carcinoma arising either from ovary or peritoneum and is characterized by extensive psammomatous calcifications and invasion of surrounding structures. Prognostically, psammocarcinoma resembles borderline serous tumor and has a much more favorable outcome than the common serous carcinoma of ovary and peritoneum.

3 citations

References
More filters
Journal ArticleDOI
TL;DR: The survival of patients with borderline tumors is higher than previously described in some retrospective studies, and Conservative surgery is safe and may be proposed to several patients with early and disseminated disease after thorough discussion of all therapeutic options.
Abstract: PURPOSE: Borderline tumors account for 10% to 20% of epithelial ovarian tumors, and their prognosis is outstanding; nevertheless, a mortality of up to 20% has been reported, particularly in earlier reports. There is a lack of information about the actual mortality and the rate of progression into invasive carcinoma in large and prospectively accrued populations. PATIENTS AND METHODS: All women with borderline ovarian tumors undergoing primary surgery in our department or referred within 3 months from surgery performed elsewhere from 1982 to 1997 were prospectively accrued and observed. RESULTS: We studied 339 women (83.4% stage I, 7.9% stage II, and 8.5% stage III). The median age at diagnosis was 39 years. A total of 150 women underwent radical surgery, and 189 underwent fertility-sparing surgery. After surgery, 13 women had macroscopic residual disease. With a median follow-up of 70 months, 317 women are alive with no clinical disease (eight with documented subclinical persistence of implants), three ar...

387 citations


"Primary psammocarcinoma of the ovar..." refers background in this paper

  • ...This is not illogical given that a conservative approach can be considered in advanced-stage borderline tumors if a complete resection of peritoneal spread can be achieved.(7,8) Nevertheless, only 1 patient with of similar management has been reported; it was a 27-year-old patient presenting with peritoneal PSC....

    [...]

Journal ArticleDOI
TL;DR: The clinical behavior of psammocarcinoma more closely resembles that of borderline serous tumors than of serous carcinomas of the usual type, following a protracted course and being associated with a relatively favorable prognosis.
Abstract: We report 11 cases of serous psammocarcinoma, a rare variant of serous carcinoma characterized by massive psammoma body formation and low-grade cytological features. The patients ranged in age from 36 to 76 (mean of 57) years. The tumors were stage three in every case (three stage IIIA, seven stage IIIB, and one stage IIIC). Eight of the patients had ovarian psammocarcinomas with ovarian tumors measuring 5-22 (mean of 11) cm in diameter; the other three patients had primary peritoneal psammocarcinomas. The surfaces of the ovarian tumors were smooth and intact in seven of eight ovarian psammocarcinomas. Cysts were present in six of eight ovarian tumors, and the solid portions were typically gritty or granular. Necrosis was not seen. Microscopically there was destructive invasion of ovarian stroma or vascular invasion in the ovarian tumors; the extraovarian tumor implants were invasive of intraperitoneal viscera in five cases. The epithelium was arranged in small nests with no areas of solid epithelial proliferation, and at least 75% of the epithelial nests were associated with psammoma body formation. No more than moderate nuclear atypicality was identified in any case. No mitotic figures were found in 10 of the tumors, with a single mitotic figure identified in the other tumor. Follow-up data for more than 1 year was available for six patients, with two patients lost to follow-up and three patients followed without evidence of recurrence for less than 1 year. One patient died of tumor 6 1/2 years after presentation, and five patients were alive without evidence of recurrent tumor 3-10 (mean of 8.3) years after presentation. Although based on a small number of cases, these data suggest that the clinical behavior of psammocarcinoma more closely resembles that of borderline serous tumors than of serous carcinomas of the usual type, following a protracted course and being associated with a relatively favorable prognosis.

120 citations


"Primary psammocarcinoma of the ovar..." refers background in this paper

  • ...Psammocarcinoma (PSC) is a rare low-grade serous carcinoma characterized by the formation of extensive psammoma bodies.(1,2) Very few specific studies have been devoted to this entity, and apart from the initial article by Gilks et al(1) involving 11 patients with of ovarian or peritoneal PSC and the recent comparative article by Weir et al(3) involving 7 PSCs (but in which only 3 were followed up), most of them are case reports of 1 or 2 patients....

    [...]

  • ...patients with a follow-up of more than 1 year, only 1 died of the disease.(1) In the series by Weir et al,(1) among 3 patients followed up, all of them were disease-free 1....

    [...]

Journal ArticleDOI
TL;DR: Assessment of the fertility of patients treated conservatively for a Stage II or III borderline ovarian tumour and the results show improvement in the ability to give birth to twins is reported.

100 citations

Journal ArticleDOI
TL;DR: Low-grade peritoneal serous carcinomas, psammocarcinoma, and serous borderline tumors ofPeritoneal origin share some clinicopathologic features that may be underrecognized at surgery and gross examination and Conservative therapy is merited for younger women with borderline tumors.
Abstract: Low-grade peritoneal serous carcinomas have been the subject of limited study, and their distinction from peritoneal serous psammocarcinomas and serous borderline tumors is not always easy. The clinicopathologic features of 14 low-grade serous carcinomas, 7 psammocarcinomas, and 19 serous borderline tumors of peritoneal origin were compared. Average ages were 58 years (low-grade serous carcinomas), 48 years (borderline tumors), and 40 years (psammocarcinomas). Typical clinical presentations were abdominal pain, abdominal mass, or both, with the tumors incidental in 37% (borderline tumors), 43% (psammocarcinomas), and 36% (low-grade serous carcinoma). Operative and gross findings varied from nodules to adhesions to a dominant mass. Treatment was surgical debulking in most cases, with biopsy alone for eight borderline tumors. Seven patients with low-grade serous carcinoma were alive when last seen, but follow-up duration is short (average, 1.2 years): five were without disease, one had recurrent disease and one persistent disease. One patient with serous carcinoma died of disease at 3.5 years, and two patients died of other causes. Three patients with psammocarcinoma were alive without disease (average 3.3 years). Fourteen patients with borderline tumors were alive (average 3 years): 10 were without disease, 2 had persistent disease, and serous carcinoma developed in 2. The low-grade serous carcinomas resembled the invasive implants of ovarian serous borderline tumors. lacked high-grade nuclear atypia, showed tissue, lymphovascular space invasion, or both and had appreciable solid epithelial proliferation. Some serous carcinomas showed abundant psammomatous calcification suggesting psammocarcinoma but had too much epithelial proliferation for that diagnosis. The psammocarcinomas showed at least 75% psammoma bodies, no more than moderate cytological atypia, tissue or lymphovascular space invasion, or both, and rare epithelial proliferation less than 15 cells across. Adequate sampling was necessary to identify invasion, with highest yields of invasive foci in omental samples; individual foci in some cases of carcinoma resembled borderline tumor. The serous borderline tumors resembled the noninvasive implants of ovarian serous borderline tumors, lacked invasion, and did not show nuclear atypia of the degree seen in grade 2 or grade 3 serous carcinoma. Low-grade serous carcinoma, psammocarcinoma, and serous borderline tumors of peritoneal origin share some clinicopathologic features and may be underrecognized at surgery and gross examination. Because of overlapping microscopic patterns, adequate sampling is mandatory to identify small foci of invasion that exclude a borderline tumor and identify significant cellularity that excludes a psammocarcinoma. Conservative therapy is merited for younger women with borderline tumors. Maximum debulking is recommended for bulky symptomatic borderline tumors, low-grade serous carcinoma, and psammocarcinoma. Although short-term outcomes for the carcinomas appear favorable, follow-up is too limited to determine long-term outcomes.

65 citations


"Primary psammocarcinoma of the ovar..." refers background in this paper

  • ...However, in that series of 7 patients, only 3 of them were followed up.(3) All the other articles were case reports of 1 or 2 patients....

    [...]

Journal ArticleDOI
TL;DR: Serous psammocarcinoma is a rare form of ovarian carcinoma with only 13 cases reported in literature, and prognostic factors suggest that this neoplasm has more favorable prognosis than usual serous carcinomas.

27 citations


"Primary psammocarcinoma of the ovar..." refers background in this paper

  • ...Very few specific studies have been devoted to this entity, and apart from the initial article by Gilks et al(1) involving 11 patients with of ovarian or peritoneal PSC and the recent comparative article by Weir et al(3) involving 7 PSCs (but in which only 3 were followed up), most of them are case reports of 1 or 2 patients.(4,5) The aim of this study was to report the outcomes of patients undergoing at least surgical cytoreduction for PSC in our institution....

    [...]

  • ...All the other articles were case reports of 1 or 2 patients.(4,5) In the present study, we decided to apply very strict criteria....

    [...]