[ Tumeur séreuse borderline sur ovaires restants à propos d'un cas avec revue de la littérature ]
Volume 7, Issue 1, July 2014, Pages 103–110
Y. Benabdjalil1, Saida Mezane2, Mouna Achenani3, R. Hafidi4, Abdellah Babahabib5, M. EL hassani6, J. Kaouach7, Driss Moussaoui8, and Mohammed Dehayni9
1 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
2 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
3 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
4 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
5 Service gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohamed V, Rabat, Morocco
6 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
7 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
8 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
9 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2014 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The definition of borderline ovarian tumors is pathological. It is based on the combination of several histological criteria established by Hart and Norris and reviewed by Scully et al. : pluristratification and epithelial budding, increased mitotic activity which can be very variable, cytonuclear atypia (differential diagnosis with benign tumors), absence of stromal invasion (differential diagnosis of malignant tumors). Serous tumors represent approximately 55% of borderline tumors. They are bilateral in 28-50% of cases. This histological type is, however, more often associated with extra-ovarian locations, as found in 30% of cases on average peritoneal implants whose detection is fundamental because the class tumor stage III. These can be invasive or non-invasive, the prognostic value of invasiveness is controversial. Pre and intraoperative diagnosis of borderline ovarian tumors is difficult and requires a multidisciplinary approach, involving surgeons, pathologists, radiologists and medical oncologists trained as much as possible with this type of lesion border. Staging should be as complete as possible and should be as far as possible during the initial surgical resection. A restaging should be made when the initial staging is incomplete. Restaging does not affect patient survival but used to evaluate the prognosis of the initial tumor. Its indication still remains controversial: it is recommended for early-stage tumors, for which the treatment is now well codified. The authors discuss the issue of keeping the ovaries during hysterectomy for benign lesions throught the case of a patient of 50 years who benefited 9 years ago a subtotal hysterectomy for polymyomatous uterus and presented a bilateral serous tumor borderline on remaining ovary.
Author Keywords: Hysterectomy, Adnexectomy, Conservation ovarian, Ovary remaining, ovarian cancer.
Volume 7, Issue 1, July 2014, Pages 103–110
Y. Benabdjalil1, Saida Mezane2, Mouna Achenani3, R. Hafidi4, Abdellah Babahabib5, M. EL hassani6, J. Kaouach7, Driss Moussaoui8, and Mohammed Dehayni9
1 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
2 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
3 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
4 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
5 Service gynécologie-obstétrique, Hôpital Militaire d’Instruction Mohamed V, Rabat, Morocco
6 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
7 Service Gynéco-Obstétrique Hôpital Militaire d'Instruction Mohamed V, CHU Rabat-Salé, Université Mohamed V Souissi, Rabat, Morocco
8 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
9 Department of Gynecology-Obstetric, Military Training Hospital Med V, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Original language: French
Copyright © 2014 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The definition of borderline ovarian tumors is pathological. It is based on the combination of several histological criteria established by Hart and Norris and reviewed by Scully et al. : pluristratification and epithelial budding, increased mitotic activity which can be very variable, cytonuclear atypia (differential diagnosis with benign tumors), absence of stromal invasion (differential diagnosis of malignant tumors). Serous tumors represent approximately 55% of borderline tumors. They are bilateral in 28-50% of cases. This histological type is, however, more often associated with extra-ovarian locations, as found in 30% of cases on average peritoneal implants whose detection is fundamental because the class tumor stage III. These can be invasive or non-invasive, the prognostic value of invasiveness is controversial. Pre and intraoperative diagnosis of borderline ovarian tumors is difficult and requires a multidisciplinary approach, involving surgeons, pathologists, radiologists and medical oncologists trained as much as possible with this type of lesion border. Staging should be as complete as possible and should be as far as possible during the initial surgical resection. A restaging should be made when the initial staging is incomplete. Restaging does not affect patient survival but used to evaluate the prognosis of the initial tumor. Its indication still remains controversial: it is recommended for early-stage tumors, for which the treatment is now well codified. The authors discuss the issue of keeping the ovaries during hysterectomy for benign lesions throught the case of a patient of 50 years who benefited 9 years ago a subtotal hysterectomy for polymyomatous uterus and presented a bilateral serous tumor borderline on remaining ovary.
Author Keywords: Hysterectomy, Adnexectomy, Conservation ovarian, Ovary remaining, ovarian cancer.
Abstract: (french)
La définition des tumeurs borderline de l'ovaire est anatomo-pathologique et repose sur l'association de plusieurs critères histologiques établis par Hart et Norris puis revus par Scully et al. : pluristratification et bourgeonnement épithélial, augmentation de l'activité mitotique pouvant être très variable, atypies cytonucléaires (diagnostic différentiel avec les tumeurs bénignes), absence d'invasion stromale (diagnostic différentiel des tumeurs malignes). Les tumeurs séreuses représentent approximativement 55 % des tumeurs borderline. Elles sont bilatérales dans 28 à 50 % des cas. Ce type histologique est toutefois plus souvent associé à des localisations extra-ovariennes, puisque l'on retrouve dans 30 % des cas en moyenne des implants péritonéaux dont la détection est fondamentale puisqu'elle classe la tumeur en stade III. Ceux-ci peuvent être invasifs ou non invasifs, la valeur pronostique de leur caractère invasif étant controversé. Le diagnostic pré et per-opératoire des tumeurs borderline de l'ovaire est difficile et implique une prise en charge multidisciplinaire, associant chirurgiens, anatomopathologistes, radiologues et oncologues médicaux formés autant que possible à ce type de lésion frontière. La stadification doit être la plus complète possible et doit se faire autant que possible au cours de la chirurgie initiale d'exérèse. Une restadification sera pratiquée lorsque la stadification initiale est incomplète. Cette restadification ne modifie pas la survie des patientes mais permet d'évaluer le pronostic de la tumeur initiale. Son indication reste encore aujourd'hui controversée : elle est recommandée pour des tumeurs de stade précoce, pour lesquelles le traitement est actuellement bien codifié. Les auteurs discutent sur la question de conserver les ovaires au cours des hystérectomies pour lésions bénignes en rapportant le cas d'une patiente de 50 ans ayant bénéficiée il y a 9 ans d'une hystérectomie subtotale interannexielle pour utérus polymyomateux et qui a présenté une tumeur séreuse borderline bilatérale sur ovaires restants.
Author Keywords: Hystérectomie, Annexectomie, Conservation ovarienne, Ovaire restant, Cancer de l'ovaire.
How to Cite this Article
Y. Benabdjalil, Saida Mezane, Mouna Achenani, R. Hafidi, Abdellah Babahabib, M. EL hassani, J. Kaouach, Driss Moussaoui, and Mohammed Dehayni, “Serous borderline tumor of ovary remaining a propos one case and review of the literature,” International Journal of Innovation and Applied Studies, vol. 7, no. 1, pp. 103–110, July 2014.
