Sigit Purbadi

Rapidly recurring ovarian fibrosarcoma after optimal debulking surgery in a 46-year-old woman

Ovarian fibrosarcoma is an extremely rare tumour with no universally accepted guidelines for treatment. We present a 46-year-old nulliparous woman with ovarian fibrosarcoma who mainly presented with a painful abdominal enlargement. Optimal debulking surgery was performed, and a specimen of the tumour was examined. A frozen section examined during surgery revealed spindle cell morphology, raising the suspicion of ovarian fibrosarcoma, which was later confirmed by immunohistochemistry staining. Our patient refused to undergo chemotherapy and died 3 months after surgery due to tumour recurrence. Although no clear consensus exists for administering chemotherapy for fibrosarcoma, some published case reports have shown a lower chance of recurrence and better prognosis in patients who undergo chemotherapy compared with our patient.

Early stage epithelial ovarian cancer metastasis through peritoneal fluid circulation

Abstract Background Although epithelial ovarian cancer (EOC) spreads through peritoneal circulation, all patients with clinical early-stage ovarian cancer (OC) benefit from routine surgical staging is still unclear. Methods This cross-sectional study used data from medical records of patients with clinical early-stage EOC who received complete surgical staging from 2006 to 2016 at our hospital. We excluded patients with non-epithelial OC or with stage IV disease. Results Among 50 patients with clinical early-stage EOC who underwent surgical staging, biopsies showed EOC cells in peritoneal fluid for 12 patients (24%), in peritoneal tissue for ten patients (20%), and omental tissue for eight patients (16%). Of those 50 patients, 40 patients had undergone peritoneal biopsies, and the other five patients also had omental biopsies. The results showed that only one (2.5%) from 40 patients with peritoneal biopsy and three (6.7%) from 45 patients with omental biopsy had no visible nodules. From cytology examination, 3 out of 26 patients (11.5%) showed positive cytology from peritoneal washing. Conclusions Routine peritoneal biopsies do not seem advantageous for patients with clinical early-stage EOC as negative visible nodules with positive biopsy results were only 1 in 40 cases. However, further study with a larger cohort is needed to obtain more information on peritoneal fluid metastasis patterns.