The use of a panel of monoclonal antibodies can lower false-negative diagnoses of peritoneal washing in ovarian tumors

Article Abstract:

The examination of peritoneal washings is an important part of both the initial staging and follow-up of ovarian cancer. If cancerous cells have begun to spread from the ovary, they may be detected by rinsing the abdominal cavity and examining the fluid. In cases where there is no cancer spread large enough to be visible to the surgeon, these washings may provide the only indication that the cancer is advancing. Likewise, in the follow-up of patients who have already been treated for ovarian cancer, the presence of cancer cells in fluid rinsed from the abdominal cavity may provide the first indication of recurrence. The examination of the rinsing fluids is not straightforward, however. Normal cells will be recovered with this method, and even with careful examination cancerous cells may not be detected among the normal cells. A study was conducted to determine if monoclonal antibodies may be used to improve the examination of such washings. Monoclonal antibodies are highly specific and may be used to immunocytochemically stain cancer cells; the cells stained in this manner would then stand out noticeably against the background of normal cells, which stain little or not at all. Four different monoclonal antibodies were tested in the evaluation of 117 patients who were undergoing surgery for ovarian abnormalities and 121 patients who were undergoing a 'second-look' operation to observe for signs of recurrent cancer. The fluid used to rinse the abdomen was examined in the conventional way, and the cells were also stained with the monoclonal antibodies. For the patients undergoing their first surgical procedure, the traditional technique identified cancerous cells in 11 of 27 cases involving early cancer and 21 of 30 cases of advanced cancer. The antibodies, on the other hand, detected cancerous cells in the rinsing fluid in 15 of 27 early cancer cases and in 25 of 30 cases of advanced cancer. Similarly, for the patients being followed-up, traditional examination revealed cancerous cells in 39 of 121 cases while the antibodies revealed cancerous cells in 61 of 121 cases. These results indicate that the use of monoclonal antibodies to stain cells in fluid rinsed from the abdomen can increase the chances for the detection of ovarian cancer cells. (Consumer Summary produced by Reliance Medical Information, Inc.)

Monoclonal antibodies

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Alveolar rhabdomyosarcoma metastatic to the ovary: A report of two cases and a discussion of the differential diagnosis of small cell malignant tumors of the ovary

Article Abstract:

Little information exists about the spread (metastasis) of sarcomas (cancer arising from connective tissue) to the ovaries, which rarely occurs except in late stages of the disease. Usually this type of metastasis is not difficult to identify because of the patient's clinical history and the distinct structural features of the ovarian metastasis of rhabdomyosarcoma. Researchers report two cases of alveolar rhabdomyosarcoma (originates in the hollow space of skeletal muscle) metastatic to the ovary in young patients, 17 and 27 years of age, which were difficult to diagnose because the cancer was first identified as a small cell malignant tumor of the ovary that had similar characteristics to many other small cell malignant tumors involving the ovaries. The primary tumor had not been identified or made known to the pathologist in either case. Alveolar rhabdomyosarcoma is more difficult to identify than more common sarcomas; diagnosis of this type of sarcoma is rarely made when small cell malignant tumors of the ovary are being evaluated. The prognosis for patients with metastatic alveolar rhabdomyosarcoma is poor because of the aggressive nature of the disease and the difficulty in making a diagnosis of the cancer in its early stages.

Care and treatment, Rhabdomyosarcoma

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Primary carcinoma of the broad ligament: report of four cases and review of the literature

Article Abstract:

The broad ligament is an important supporting structure which extends from the uterus towards the ovaries. Tumors that originate in the broad ligament, especially those of epithelial (surface) cells, are uncommon. Four new cases and eight cases from the literature are analyzed in this report. The medical presentation of the cases is discussed, and the cell types in each tumor are described. The extent of surgery varied among the patients, four of whom received postoperative radiation therapy or chemotherapy. Eight patients were free of disease at 6 months to 7 years following surgery, one patient with metastasis (spread of tumor from original site) survived 27 months, while follow-up data for three patients were not available. In the current group of four patients, three had endometriosis (growth of cells of the uterine lining outside the uterus), and three of the carcinomas had endometrioid characteristics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer, Pelvic cancer

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