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Management of borderline ovarian tumors |
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| รหัสดีโอไอ | |
| Creator | Chuenkamon Charakorn |
| Title | Management of borderline ovarian tumors |
| Publisher | PIMDEE Co., Ltd. |
| Publication Year | 2561 |
| Journal Title | Thai Journal of Obstetrics and Gynaecology |
| Journal Vol. | 26 |
| Journal No. | 2 |
| Page no. | 70-74 |
| Keyword | borderline ovarian tumors |
| URL Website | https://tci-thaijo.org/index.php/tjog/index |
| Website title | www.tci-thaijo.org |
| ISSN | 0857-6084 |
| Abstract | Borderline ovarian tumors are similar to the other adnexal masses in terms of clinical presentation. Surgery is the main treatment. Because of the young age of the patients and early stage of diseases at the time of diagnosis, fertility-sparing surgery is favorable. If the intraoperative frozen section reports a borderline tumor, surgical staging should be performed. The surgical staging includes cytologic washing or ascites fluid collection, omentectomy and peritoneal biopsies. The routine lymphadenectomy is not recommended. In terms of fertility-sparing surgery, the unilateral salpingo-oophorectomy is preferred if the other site of ovary is not affected. However, if there are bilateral ovarian involvements, unilateral salpingo-oophorectomy with ovarian cystectomy or bilateral ovarian cystectomy can be considered. The prognostic factors include the stage of disease, the presence of micropapillary in serous tumor, the presence of microinvasion, and the presence of peritoneal implants. Post-operative chemotherapy should be discussed and administrated, similar to the treatment of low grade serous epithelial ovarian cancer if the invasive implantation is detected. Thalassemia syndromes and hemoglobinopathy cost signifiant health and economic burdenand sometimes maternal morbidity and mortality. The present strategy to reduce new cases ispopulation screening, prenatal genetic diagnosis (PND) and the option for termination of affectedpregnancy (TOP) following thoroughly genetic counselling. The advances of reproductivetechnology and molecular genetics facilitate genetic testing of the embryos prior to transfer intothe womb, therefore, embryo selection is possible. Pre-implantation genetic diagnosis (PGD)consists of sampling techniques from the embryos and molecular genetic analysis techniques.Polar body biopsy, cleavage stage embryo biopsy or blastocyst biopsy can be used for samplingDNA material from the embryos. Polymerase chain reaction (PCR) is employed for the analysisof thalassemia mutations. PGD is an alternative to the traditional PND, providing the couplesat risk of having severe thalassemia babies an opportunity to get pregnant with a healthy onewithout the need for TOP. Since 2004, a total of 64 PGD cycles have been performed at theDepartment of Obstetrics and Gynaecology, Faculty of Medicine, Chiang Mai University, including37 alpha-thalassemia, 5 beta-thalassemia and 22 beta-thalassemia-Hb E disease, giving riseto 24 healthy pregnancies (27 babies). |
