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, G.F. Zannoni, L. Valentin, G. Scambia, A.C. Testa

Research output: Contribution to journalArticle

Abstract

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. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Original languageEnglish
Pages (from-to)792-800
Number of pages9
JournalUltrasound in Obstetrics and Gynecology
Volume52
Issue number6
DOIs
Publication statusPublished - 2018

Fingerprint

Endometriosis
Carcinoma
Neoplasms
Cyst Fluid
Nuclear Family
Glass
Databases
Terminology
Ovary
Histology
Retrospective Studies

Keywords

  • ovarian neoplasm
  • pure clear cell ovarian carcinoma
  • ultrasonography

Cite this

Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma. / Pozzati, F.; Moro, F.; Pasciuto, T.; Gallo, C.; Ciccarone, F.; Franchi, D.; Mancari, R.; Giunchi, S.; Timmerman, D.; Landolfo, C.; Epstein, E.; Chiappa, V.; Fischerova, D.; Fruscio, R.; Zannoni, G.F.; Valentin, L.; Scambia, G.; Testa, A.C.

In: Ultrasound in Obstetrics and Gynecology, Vol. 52, No. 6, 2018, p. 792-800.

Research output: Contribution to journalArticle

Pozzati, F, Moro, F, Pasciuto, T, Gallo, C, Ciccarone, F, Franchi, D, Mancari, R, Giunchi, S, Timmerman, D, Landolfo, C, Epstein, E, Chiappa, V, Fischerova, D, Fruscio, R, Zannoni, GF, Valentin, L, Scambia, G & Testa, AC 2018, 'Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma', Ultrasound in Obstetrics and Gynecology, vol. 52, no. 6, pp. 792-800. https://doi.org/10.1002/uog.19171
Pozzati, F. ; Moro, F. ; Pasciuto, T. ; Gallo, C. ; Ciccarone, F. ; Franchi, D. ; Mancari, R. ; Giunchi, S. ; Timmerman, D. ; Landolfo, C. ; Epstein, E. ; Chiappa, V. ; Fischerova, D. ; Fruscio, R. ; Zannoni, G.F. ; Valentin, L. ; Scambia, G. ; Testa, A.C. / Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma. In: Ultrasound in Obstetrics and Gynecology. 2018 ; Vol. 52, No. 6. pp. 792-800.
@article{455664eee6cb468f85536e22203fb18c,
title = "Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma",
abstract = "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 {\circledC} 2018 ISUOG. Published by John Wiley & Sons Ltd. Copyright {\circledC} 2018 ISUOG. Published by John Wiley & Sons Ltd.",
keywords = "ovarian neoplasm, pure clear cell ovarian carcinoma, ultrasonography",
author = "F. Pozzati and F. Moro and T. Pasciuto and C. Gallo and F. Ciccarone and D. Franchi and R. Mancari and S. Giunchi and D. Timmerman and C. Landolfo and E. Epstein and V. Chiappa and D. Fischerova and R. Fruscio and G.F. Zannoni and L. Valentin and G. Scambia and A.C. Testa",
note = "Export Date: 5 February 2019 CODEN: UOGYF Correspondence Address: Pozzati, F.; Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCSItaly; email: federica.pozzati@gmail.com References: Ye, S., You, Y., Yang, J., Cao, D., Bai, H., Huang, H., Wu, M., Shen, K., Comparison of pure and mixed-type clear cell carcinoma of the ovary: a clinicopathological analysis of 341 Chinese patients (2014) Int J Gynecol Cancer, 24, pp. 1590-1596; Anglesio, M.S., Carey, M.S., K{\"o}bel, M., Mackay, H., Huntsman, D.G., Clear cell carcinoma of the ovary: a report from the first Ovarian Clear Cell Symposium, June 24th, 2010 (2011) Gynecol Oncol, 121, pp. 407-415; Annual report of the patients with ovarian cancers (2010) Acta Obstet Gynecol Jpn, 62, pp. 827-910; Chan, J.K., Teoh, D., Hu, J.M., Shin, J.Y., Osann, K., Kapp, D.S., Do clear cell ovarian carcinomas have poorer prognosis compared to other epithelial cell types? A study of 1411 clear cell ovarian cancers (2008) Gynecol Oncol, 109, pp. 370-376; Crozier, M.A., Copeland, L.J., Silva, E.G., Gershenson, D.M., Stringer, C.A., Clear cell carcinoma of the ovary: a study of 59 cases (1989) Gynecol Oncol, 35, pp. 199-203; Kennedy, A.W., Biscotti, C.V., Hart, W.R., Webster, K.D., Ovarian clear cell adenocarcinoma (1989) Gynecol Oncol, 32, pp. 342-349; Jenison, E.L., Montag, A.G., Griffiths, C.T., Welch, W.R., Lavin, P.T., Greer, J., Knapp, R.C., Clear cell adenocarcinoma of the ovary: a clinical analysis and comparison with serous carcinoma (1989) Gynecol Oncol, 32, pp. 65-71; Stern, R.C., Dash, R., Bentley, R.C., Snyder, M.J., Haney, A.F., Robboy, S.J., Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types (2001) Int J Gynecol Pathol, 20, pp. 133-139; Veras, E., Mao, T.L., Ayhan, A., Ueda, S., Lai, H., Hayran, M., Shih, I., Kurman, R.J., Cystic and adenofibromatous clear cell carcinomas of the ovary: distinctive tumors that differ in their pathogenesis and behavior: a clinicopathologic analysis of 122 cases (2009) Am J Surg Pathol, 33, pp. 844-853; Kurman, R.J., Shih, I., The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded (2016) Am J Pathol, 186, pp. 733-747; Sampson, J.A., Endometrial carcinoma of the ovary arising in endometrial tissue in that organ (1925) Arch Surg, 10, pp. 1-72; Seidman, J.D., Cho, K.R., Ronnett, B.M., Kurman, R.J., Surface epithelial tumors of the ovary (2011) Blaustein's Pathology of the Female Genital Tract, pp. 679-784. , 6th edn, Kurman RJ, Ellenson LH, Ronnet BM, (eds)., Springer, Boston, MA; Kurman, R.J., Carcangiu, M.L., Herrington, C.S., Young, R.H., (2014) WHO Classification of tumours of female reproductive organs, , (eds)., IARC, Lyon; Sugiyama, T., Kamura, T., Kigawa, J., Terakawa, N., Kikuchi, Y., Kita, T., Suzuki, M., Taguchi, K., Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy (2000) Cancer, 88, pp. 2584-2589; K{\"o}bel, M., Kalloger, S.E., Huntsman, D.G., Santos, J.L., Swenerton, K.D., Seidman, J.D., Gilks, C.B., Vancouver, B.C., Differences in tumor type in low-stage versus high-stage ovarian carcinomas (2010) Int J Gynecol Pathol, 29, pp. 203-211; Omura, G.A., Brady, M.F., Homesley, H.D., Yordan, E., Major, F.J., Buchsbaum, H.J., Park, R.C., Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience (1991) J Clin Oncol, 9, pp. 1138-1150; Pectasides, D., Fountzilas, G., Aravantinos, G., Kalofonos, C., Efstathiou, H., Farmakis, D., Skarlos, D., Dimopoulos, M.A., Advanced stage clearcell epithelial ovarian cancer: the Hellenic Cooperative Oncology Group experience (2006) Gynecol Oncol, 102, pp. 285-291; Timmerman, D., Testa, A.C., Bourne, T., Ferrazzi, E., Ameye, L., Konstantinovic, M.L., Van Calster, B., Valentin, L., Logistic regression model to distinguish between the benign and malignant adnexal mass before surgery: a multicenter study by the International Ovarian Tumor Analysis Group (2005) J Clin Oncol, 23, pp. 8794-8801; Timmerman, D., Van Calster, B., Testa, A.C., Guerriero, S., Fischerova, D., Lissoni, A.A., Van Holsbeke, C., Valentin, L., Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group (2010) Ultrasound Obstet Gynecol, 36, pp. 226-234; Van Holsbeke, C., Van Calster, B., Testa, A.C., Domali, E., Lu, C., Van Huffel, S., Valentin, L., Timmerman, D., Prospective internal validation of mathematical models to predict malignancy in adnexal masses: results from the international ovarian tumor analysis study (2009) Clin Cancer Res, 15, pp. 684-691; Van Calster, B., Van Hoorde, K., Valentin, L., Testa, A.C., Fischerova, D., Van Holsbeke, C., Savelli, L., Timmerman, D., Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: prospective multicentre diagnostic study (2014) BMJ, 349, p. g5920; Timmerman, D., Valentin, L., Bourne, T.H., Collins, W.P., Verrelst, H., Vergote, I., Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group (2000) Ultrasound Obstet Gynecol, 16, pp. 500-505; Valentin, L., Pattern recognition of pelvic masses by gray-scale ultrasound imaging: the contribution of Doppler ultrasound (1999) Ultrasound Obstet Gynecol, 14, pp. 338-347; Kandukuri, S.R., Rao, J., FIGO 2013 staging system for ovarian cancer: what is new in comparison to the 1988 staging system? (2015) Curr Opin Obstet Gynecol, 27, pp. 48-52; Scarfone, G., Bergamini, A., Noli, S., Villa, A., Cipriani, S., Taccagni, G., Vigano', P., Mangili, G., Characteristics of clear cell ovarian cancer arising from endometriosis: a two center cohort study (2014) Gynecol Oncol, 133, pp. 480-484; Alcazar, J.L., Guerriero, S., Pascual, M.{\'A}., Ajossa, S., Olartecoechea, B., Hereter, L., Clinical and sonographic features of uncommon primary ovarian malignancies (2012) J Clin Ultrasound, 40, pp. 323-329; Testa, A.C., Timmerman, D., Van Holsbeke, C., Zannoni, G.F., Fransis, S., Moerman, P., Vellone, V., Ferrandina, G., Ovarian cancer arising in endometrioid cysts: ultrasound findings (2011) Ultrasound Obstet Gynecol, 38, pp. 99-106; Moro, F., Magoga, G., Pasciuto, T., Mascilini, F., Moruzzi, M.C., Fischerova, D., Savelli, L., Testa, A.C., Imaging in gynecological disease (13): clinical and ultrasound characteristics of endometrioid ovarian cancer (2018) Ultrasound Obstet Gynecol, 52, pp. 535-543; Moro, F., Baima Poma, C., Zannoni, G.F., Vidal Urbinati, A., Pasciuto, T., Ludovisi, M., Moruzzi, M.C., Testa, A.C., Imaging in gynecological disease (12): clinical and ultrasound features of invasive and non-invasive malignant serous ovarian tumors (2017) Ultrasound Obstet Gynecol, 50, pp. 779-788; Fruscella, E., Testa, A.C., Ferrandina, G., De Smet, F., Van Holsbeke, C., Scambia, G., Zannoni, G.F., Timmerman, D., Ultrasound features of different histopathological subtypes of borderline ovarian tumors (2005) Ultrasound Obstet Gynecol, 26, pp. 644-650; Moro, F., Zannoni, G.F., Arciuolo, D., Pasciuto, T., Amoroso, S., Mascilini, F., Mainenti, S., Testa, A.C., Imaging in gynecological disease (11): clinical and ultrasound features of mucinous ovarian tumors (2017) Ultrasound Obstet Gynecol, 50, pp. 261-270; Nasioudis, D., Chapman-Davis, E., Frey, M.K., Witkin, S.S., Holcomb, K., Could fertility-sparing surgery be considered for women with early stage ovarian clear cell carcinoma? (2017) J Gynecol Oncol, 28; Guerriero, S., Testa, A.C., Timmerman, D., Van Holsbeke, C., Ajossa, S., Fischerova, D., Franchi, D., Valentin, L., Imaging of gynecological disease (6): clinical and ultrasound characteristics of ovarian dysgerminoma (2011) Ultrasound Obstet Gynecol, 37, pp. 596-602; Ludovisi, M., De Blasis, I., Virgilio, B., Fischerova, D., Franchi, D., Pascual, M.A., Savelli, L., Testa, A.C., Imaging in gynecological disease (9): clinical and ultrasound characteristics of tubal cancer (2014) Ultrasound Obstet Gynecol, 43, pp. 328-335; Franchi, D., Boveri, S., Fruscio, R., Fischerova, D., Guerriero, S., Moruzzi, M.C., Colombo, N., Testa, A.C., Imaging in gynecological disease (8): ultrasound characteristics of recurrent borderline ovarian tumors (2013) Ultrasound Obstet Gynecol, 41, pp. 452-458; Van Holsbeke, C., Domali, E., Holland, T.K., Achten, R., Testa, A.C., Valentin, L., Jurkovic, D., Timmerman, D., Imaging of gynecological disease (3): clinical and ultrasound characteristics of granulosa cell tumors of the ovary (2008) Ultrasound Obstet Gynecol, 31, pp. 450-456; Demidov, V.N., Lipatenkova, J., Vikhareva, O., Van Holsbeke, C., Timmerman, D., Valentin, L., Imaging of gynecological disease (2): clinical and ultrasound characteristics of Sertoli cell tumors, Sertoli-Leydig cell tumors and Leydig cell tumors (2008) Ultrasound Obstet Gynecol, 31, pp. 85-91; Testa, A.C., Ferrandina, G., Timmerman, D., Savelli, L., Ludovisi, M., Van Holsbeke, C., Malaggese, M., Valentin, L., Imaging in gynecological disease (1): ultrasound features of metastases in the ovaries differ depending on the origin of the primary tumor (2007) Ultrasound Obstet Gynecol, 29, pp. 505-511",
year = "2018",
doi = "10.1002/uog.19171",
language = "English",
volume = "52",
pages = "792--800",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

TY - JOUR

T1 - Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma

AU - Pozzati, F.

AU - Moro, F.

AU - Pasciuto, T.

AU - Gallo, C.

AU - Ciccarone, F.

AU - Franchi, D.

AU - Mancari, R.

AU - Giunchi, S.

AU - Timmerman, D.

AU - Landolfo, C.

AU - Epstein, E.

AU - Chiappa, V.

AU - Fischerova, D.

AU - Fruscio, R.

AU - Zannoni, G.F.

AU - Valentin, L.

AU - Scambia, G.

AU - Testa, A.C.

N1 - Export Date: 5 February 2019 CODEN: UOGYF Correspondence Address: Pozzati, F.; Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCSItaly; email: federica.pozzati@gmail.com References: Ye, S., You, Y., Yang, J., Cao, D., Bai, H., Huang, H., Wu, M., Shen, K., Comparison of pure and mixed-type clear cell carcinoma of the ovary: a clinicopathological analysis of 341 Chinese patients (2014) Int J Gynecol Cancer, 24, pp. 1590-1596; Anglesio, M.S., Carey, M.S., Köbel, M., Mackay, H., Huntsman, D.G., Clear cell carcinoma of the ovary: a report from the first Ovarian Clear Cell Symposium, June 24th, 2010 (2011) Gynecol Oncol, 121, pp. 407-415; Annual report of the patients with ovarian cancers (2010) Acta Obstet Gynecol Jpn, 62, pp. 827-910; Chan, J.K., Teoh, D., Hu, J.M., Shin, J.Y., Osann, K., Kapp, D.S., Do clear cell ovarian carcinomas have poorer prognosis compared to other epithelial cell types? A study of 1411 clear cell ovarian cancers (2008) Gynecol Oncol, 109, pp. 370-376; Crozier, M.A., Copeland, L.J., Silva, E.G., Gershenson, D.M., Stringer, C.A., Clear cell carcinoma of the ovary: a study of 59 cases (1989) Gynecol Oncol, 35, pp. 199-203; Kennedy, A.W., Biscotti, C.V., Hart, W.R., Webster, K.D., Ovarian clear cell adenocarcinoma (1989) Gynecol Oncol, 32, pp. 342-349; Jenison, E.L., Montag, A.G., Griffiths, C.T., Welch, W.R., Lavin, P.T., Greer, J., Knapp, R.C., Clear cell adenocarcinoma of the ovary: a clinical analysis and comparison with serous carcinoma (1989) Gynecol Oncol, 32, pp. 65-71; Stern, R.C., Dash, R., Bentley, R.C., Snyder, M.J., Haney, A.F., Robboy, S.J., Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types (2001) Int J Gynecol Pathol, 20, pp. 133-139; Veras, E., Mao, T.L., Ayhan, A., Ueda, S., Lai, H., Hayran, M., Shih, I., Kurman, R.J., Cystic and adenofibromatous clear cell carcinomas of the ovary: distinctive tumors that differ in their pathogenesis and behavior: a clinicopathologic analysis of 122 cases (2009) Am J Surg Pathol, 33, pp. 844-853; Kurman, R.J., Shih, I., The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded (2016) Am J Pathol, 186, pp. 733-747; Sampson, J.A., Endometrial carcinoma of the ovary arising in endometrial tissue in that organ (1925) Arch Surg, 10, pp. 1-72; Seidman, J.D., Cho, K.R., Ronnett, B.M., Kurman, R.J., Surface epithelial tumors of the ovary (2011) Blaustein's Pathology of the Female Genital Tract, pp. 679-784. , 6th edn, Kurman RJ, Ellenson LH, Ronnet BM, (eds)., Springer, Boston, MA; Kurman, R.J., Carcangiu, M.L., Herrington, C.S., Young, R.H., (2014) WHO Classification of tumours of female reproductive organs, , (eds)., IARC, Lyon; Sugiyama, T., Kamura, T., Kigawa, J., Terakawa, N., Kikuchi, Y., Kita, T., Suzuki, M., Taguchi, K., Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy (2000) Cancer, 88, pp. 2584-2589; Köbel, M., Kalloger, S.E., Huntsman, D.G., Santos, J.L., Swenerton, K.D., Seidman, J.D., Gilks, C.B., Vancouver, B.C., Differences in tumor type in low-stage versus high-stage ovarian carcinomas (2010) Int J Gynecol Pathol, 29, pp. 203-211; Omura, G.A., Brady, M.F., Homesley, H.D., Yordan, E., Major, F.J., Buchsbaum, H.J., Park, R.C., Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience (1991) J Clin Oncol, 9, pp. 1138-1150; Pectasides, D., Fountzilas, G., Aravantinos, G., Kalofonos, C., Efstathiou, H., Farmakis, D., Skarlos, D., Dimopoulos, M.A., Advanced stage clearcell epithelial ovarian cancer: the Hellenic Cooperative Oncology Group experience (2006) Gynecol Oncol, 102, pp. 285-291; Timmerman, D., Testa, A.C., Bourne, T., Ferrazzi, E., Ameye, L., Konstantinovic, M.L., Van Calster, B., Valentin, L., Logistic regression model to distinguish between the benign and malignant adnexal mass before surgery: a multicenter study by the International Ovarian Tumor Analysis Group (2005) J Clin Oncol, 23, pp. 8794-8801; Timmerman, D., Van Calster, B., Testa, A.C., Guerriero, S., Fischerova, D., Lissoni, A.A., Van Holsbeke, C., Valentin, L., Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group (2010) Ultrasound Obstet Gynecol, 36, pp. 226-234; Van Holsbeke, C., Van Calster, B., Testa, A.C., Domali, E., Lu, C., Van Huffel, S., Valentin, L., Timmerman, D., Prospective internal validation of mathematical models to predict malignancy in adnexal masses: results from the international ovarian tumor analysis study (2009) Clin Cancer Res, 15, pp. 684-691; Van Calster, B., Van Hoorde, K., Valentin, L., Testa, A.C., Fischerova, D., Van Holsbeke, C., Savelli, L., Timmerman, D., Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: prospective multicentre diagnostic study (2014) BMJ, 349, p. g5920; Timmerman, D., Valentin, L., Bourne, T.H., Collins, W.P., Verrelst, H., Vergote, I., Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group (2000) Ultrasound Obstet Gynecol, 16, pp. 500-505; Valentin, L., Pattern recognition of pelvic masses by gray-scale ultrasound imaging: the contribution of Doppler ultrasound (1999) Ultrasound Obstet Gynecol, 14, pp. 338-347; Kandukuri, S.R., Rao, J., FIGO 2013 staging system for ovarian cancer: what is new in comparison to the 1988 staging system? (2015) Curr Opin Obstet Gynecol, 27, pp. 48-52; Scarfone, G., Bergamini, A., Noli, S., Villa, A., Cipriani, S., Taccagni, G., Vigano', P., Mangili, G., Characteristics of clear cell ovarian cancer arising from endometriosis: a two center cohort study (2014) Gynecol Oncol, 133, pp. 480-484; Alcazar, J.L., Guerriero, S., Pascual, M.Á., Ajossa, S., Olartecoechea, B., Hereter, L., Clinical and sonographic features of uncommon primary ovarian malignancies (2012) J Clin Ultrasound, 40, pp. 323-329; Testa, A.C., Timmerman, D., Van Holsbeke, C., Zannoni, G.F., Fransis, S., Moerman, P., Vellone, V., Ferrandina, G., Ovarian cancer arising in endometrioid cysts: ultrasound findings (2011) Ultrasound Obstet Gynecol, 38, pp. 99-106; Moro, F., Magoga, G., Pasciuto, T., Mascilini, F., Moruzzi, M.C., Fischerova, D., Savelli, L., Testa, A.C., Imaging in gynecological disease (13): clinical and ultrasound characteristics of endometrioid ovarian cancer (2018) Ultrasound Obstet Gynecol, 52, pp. 535-543; Moro, F., Baima Poma, C., Zannoni, G.F., Vidal Urbinati, A., Pasciuto, T., Ludovisi, M., Moruzzi, M.C., Testa, A.C., Imaging in gynecological disease (12): clinical and ultrasound features of invasive and non-invasive malignant serous ovarian tumors (2017) Ultrasound Obstet Gynecol, 50, pp. 779-788; Fruscella, E., Testa, A.C., Ferrandina, G., De Smet, F., Van Holsbeke, C., Scambia, G., Zannoni, G.F., Timmerman, D., Ultrasound features of different histopathological subtypes of borderline ovarian tumors (2005) Ultrasound Obstet Gynecol, 26, pp. 644-650; Moro, F., Zannoni, G.F., Arciuolo, D., Pasciuto, T., Amoroso, S., Mascilini, F., Mainenti, S., Testa, A.C., Imaging in gynecological disease (11): clinical and ultrasound features of mucinous ovarian tumors (2017) Ultrasound Obstet Gynecol, 50, pp. 261-270; Nasioudis, D., Chapman-Davis, E., Frey, M.K., Witkin, S.S., Holcomb, K., Could fertility-sparing surgery be considered for women with early stage ovarian clear cell carcinoma? (2017) J Gynecol Oncol, 28; Guerriero, S., Testa, A.C., Timmerman, D., Van Holsbeke, C., Ajossa, S., Fischerova, D., Franchi, D., Valentin, L., Imaging of gynecological disease (6): clinical and ultrasound characteristics of ovarian dysgerminoma (2011) Ultrasound Obstet Gynecol, 37, pp. 596-602; Ludovisi, M., De Blasis, I., Virgilio, B., Fischerova, D., Franchi, D., Pascual, M.A., Savelli, L., Testa, A.C., Imaging in gynecological disease (9): clinical and ultrasound characteristics of tubal cancer (2014) Ultrasound Obstet Gynecol, 43, pp. 328-335; Franchi, D., Boveri, S., Fruscio, R., Fischerova, D., Guerriero, S., Moruzzi, M.C., Colombo, N., Testa, A.C., Imaging in gynecological disease (8): ultrasound characteristics of recurrent borderline ovarian tumors (2013) Ultrasound Obstet Gynecol, 41, pp. 452-458; Van Holsbeke, C., Domali, E., Holland, T.K., Achten, R., Testa, A.C., Valentin, L., Jurkovic, D., Timmerman, D., Imaging of gynecological disease (3): clinical and ultrasound characteristics of granulosa cell tumors of the ovary (2008) Ultrasound Obstet Gynecol, 31, pp. 450-456; Demidov, V.N., Lipatenkova, J., Vikhareva, O., Van Holsbeke, C., Timmerman, D., Valentin, L., Imaging of gynecological disease (2): clinical and ultrasound characteristics of Sertoli cell tumors, Sertoli-Leydig cell tumors and Leydig cell tumors (2008) Ultrasound Obstet Gynecol, 31, pp. 85-91; Testa, A.C., Ferrandina, G., Timmerman, D., Savelli, L., Ludovisi, M., Van Holsbeke, C., Malaggese, M., Valentin, L., Imaging in gynecological disease (1): ultrasound features of metastases in the ovaries differ depending on the origin of the primary tumor (2007) Ultrasound Obstet Gynecol, 29, pp. 505-511

PY - 2018

Y1 - 2018

N2 - 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. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

AB - 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. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

KW - ovarian neoplasm

KW - pure clear cell ovarian carcinoma

KW - ultrasonography

U2 - 10.1002/uog.19171

DO - 10.1002/uog.19171

M3 - Article

VL - 52

SP - 792

EP - 800

JO - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 6

ER -