Acta Medica (Hradec Kralove, Czech Republic)

Prognostic Impact of Baseline Serum Creatinine in Patients with Advanced High-Grade Serous Ovarian Carcinoma Undergoing Neoadjuvant Chemotherapy

Objective: To evaluate whether baseline serum creatinine is associated with survival outcomes in patients with advanced high-grade serous ovarian carcinoma undergoing neoadjuvant chemotherapy. Methods: We retrospectively analyzed 77 patients treated between 2009 and 2018. Patients were stratified by baseline serum creatinine levels (<84 vs. ≥84 µmol/L), and survival outcomes were assessed using Kaplan-Meier analysis. Results: No statistically significant differences in progression-free or overall survival were observed between groups. A trend toward shorter OS in the elevated creatinine group did not reach significance. Conclusion: Baseline serum creatinine was not found to be a statistically significant prognostic marker in this cohort. These results highlight the need for adjusted analyses incorporating established prognostic factors in future research.

Spotlight on Carcinosarcoma of the Ovary: A Scoping Review

Ovarian carcinosarcoma, also referred as malignant mixed Mullerian tumour, is an uncommon, highly aggressive and malignant neoplasm which makes up 1 to 4% of all ovarian tumours. It is biphasic involving both malignant sarcomatous (mesenchymal) and carcinomatous (epithelial) cells. There are various subtypes such as serous and endometrioid. However, the mesenchymal part is sarcomatous. About 90% of cases of ovarian carcinosarcoma spread outside the ovary. The two most accepted theories of origin for carcinosarcoma of the ovary are the collision and conversion theories. A third theory is the combination theory. Prognosis remains poor even when still localised in the ovary. In the last few years, there has been no change in the survival rate. The median survival rate is lower than 2 years. Clinical features mainly include lower abdominal pain and a palpable abdominal mass. Ovarian carcinosarcoma remains poorly understood and understudied. Being a rare tumour, elaborate therapeutic consensus is not available for ovarian carcinosarcoma. The main treatment involves cytoreductive surgery and then chemotherapy. The type of chemotherapy, role of radiotherapy and novel therapies need to be further studied. The main objective of this article is to review the current literature on carcinosarcoma of the ovary.

Bilateral Mature Ovarian Teratoma with Torsion in a Premenarchal Girl

Mature cystic teratoma is the most common type of ovarian tumor in children. Adnexal torsion is the main complication of mature ovarian teratoma. The synchronous bilateral incidence of mature cystic teratoma in premenarchal girls is known to be rare. However, the incidence of adnexal torsion is higher in young girls. A 10-year-old girl presenting with acute abdomen was managed by emergency laparotomy. Bilateral mature ovarian teratoma with adnexal torsion of the right ovary was found. The right ovarian tissue was not viable due to torsion and an oophorectomy was necessary. Cystectomy with preservation of the ovarian tissue of the left ovary was performed. Histopathological diagnosis was bilateral synchronous mature teratoma with necrosis of the right adnexa. Although the risk of malignancy of torsed ovaries and mature teratomas in premenarchal girls is low, their removal is recommended to prevent adnexal torsion. Decision between ovarian tissue sparing surgery or oophorectomy depends on the risk of malignancy, fertility preservation and the avoidance of early menopause.