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      Tumores metastásicos al ovario. Estudio clínicomorfológico


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          Objetivo: Precisar las caracteristicas clinicas y morfologicas de los tumores metastasicos al ovario. Metodos: Estudio retrospectivo descriptivo, de 25 pacientes operados en el Hospital Clinico Universitario de Caracas, y diagnosticados en la Seccion de Ginecopatologia del Instituto Anatomopatologico �gDr. Jose A. O�LDaly�h, clasificados segun el origen tumoral, en ginecologicos y no ginecologicos. Se evaluaron caracteristicas clinicas y morfologicas. En los casos de origen digestivo, se realizo determinacion de mucopolisacaridos, glicogeno, y un panel inmunohistoquimico que incluyo citoqueratina (CK)7, citoqueratina (CK)20, α inhibina y CA125. En el resto de los casos, se realizo el panel inmunohistoquimico de acuerdo al origen tumoral. Resultados: El grupo de origen ginecologico represento el 36 % de los casos examinados, edad promedio de 49,66 anos, los motivos de consulta mas frecuentes fueron dolor abdominal y perdida de peso, se comprobo el tumor primario en cada uno de los casos examinados y todos tenian dimension menor de 10 cm. El grupo no ginecologico represento el 64 % de los casos, con edad promedio de 42,68 anos, y los motivos de consulta mas frecuentes fueron aumento de volumen abdominal, dolor abdominal y trastornos gastrointestinales, 10/16 casos alcanzaron dimensiones mayores de 10 cm. El estudio inmunohistoquimico de los casos de origen digestivo fue: CK7-/CK20+ en 4 adenocarcinomas (ADC) mucinosos originados en el colon y 4 tumores de Krukenberg; CK7+/CK20+ en 3 tumores de Krukenberg y 1 adenocarcinoma (ADC) originado en la vesicula biliar; CK7+/CK20- en el adenocarcinoma (ADC) originado en el pancreas. Conclusion: El estudio inmunohistoquimico, orienta en la histogenesis del tumor. La correlacion clinicomorfologica es determinante para el diagnostico definitivo.

          Translated abstract

          Objective: To determine the clinical and morphological characteristics of metastatic tumors to the ovary. Methods: A descriptive retrospective study of 25 patients who underwent surgery at the University Hospital in Caracas, and diagnosed at the gynecological pathology section of the Anatompathological Institute “Dr. José A. O´Daly”. Tumors were classified according to their anatomic origin in gynecologic and nongynecologic. Clinical and morphologic features were evaluated. Determination of mucopolysaccharides and glycogen and an immunohistochemical panel including cytokeratin 7, cytokeratin 20, alfa inhibin and CA125 antigen, was performed. In the remaining cases, immunohistochemistry was done according to tumor origin. Results: The group of gynecological origin represented 36 % of the cases, median age 49,66 years. The most frequent motives for consultation were abdominal pain and weight loss. Primary tumor was confirmed in all the cases and they all measured less than 10 cm in diameter. The non-gynecologic group represented 64 % of the cases with a median age of 42,68 years. Consultation was due to increased abdominal girth, abdominal pain and gastrointestinal disturbances. 10/19 cases measured over 10 cm in diameter. The immunohistochemical study of digestive cases were CK7-/CK20+ in four mucinous adenocarcinomas originated in the colon and four Krukenberg tumors. The other three Krukenberg tumors were CK7+/ CK20+ as was a tumor originated in the gall bladder. A pancreatic originated tumor was CK7+/CK20-. Conclusion: Immunohistochemical studies are useful to orient hystogenesis of metastatic ovarian tumors. Clinical-morphologic correlation is determinant for the definitive diagnosis.

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          Immunohistochemical biomarkers of value in distinguishing primary ovarian carcinoma from gastric carcinoma: a systematic review with statistical meta-analysis.

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          To compare the relative risk of antigen expression being detected immunohistochemically in ovarian and gastric carcinoma aggregated from studies performed for diagnostic purposes, with the relative risks of their expression in all patients in the English literature. Both types of series indicated that cytokeratin (CK) 7 expression was greater and that of CK20 and carcinoembryonic antigen less in ovarian than in gastric carcinoma (P < 0.05). Synthesis of all data available for MUC-2 suggested it was more commonly expressed in ovarian carcinoma, whereas the relative risk in papers that directly compared its expression suggested that it was more common in the gastric carcinoma (P = 0.2, NS). Aggregating all possible data suggested villin was more likely to be expressed in ovarian cancers, whereas studies in which its expression was compared directly in both tumours suggested the opposite. Although statistically significant, patient numbers were small. Provided sufficient numbers of cases are studied, analysis of studies comparing antigen expression for diagnostic purposes in tumours from two body sites is likely to be supported in the wider literature. The design of such comparative studies is informed by aggregating data from single tumour studies.
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                Author and article information

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                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela
                March 2015
                : 75
                : 1
                : 041-048
                [1 ] Universidad Central de Venezuela Venezuela
                [2 ] Universidad Central de Venezuela Venezuela
                [3 ] Universidad Central de Venezuela Venezuela



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en

                Obstetrics & Gynecology
                Obstetrics & Gynecology
                Metastasis, Ovary, Clinical, Morphologic, Ovario, Clinica, Morfologia, Inmunohistoquimica


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