Background: Regarding the prevalence and high mortality rate of OVARIAN cancers, importance of markers to determine OVARIAN malignancies earlier, considerable experimental evidence about serum Gonadotropins to cyst FLUID ratio with pathology of OVARIAN TUMORs and finally not enough experiments in our country, the present study was performed in Imam Hossein hospital between 2008 and 2010.Methods: This study was cross-sectional and performed in patients operated because of OVARIAN mass. Their serum samples and cyst FLUID obtained at the time of laparotomy and histopathologic diagnosis was established after removal of the TUMOR. FSH and LH concentration were measured in serum and TUMOR FLUID based on Micro particle Enzyme Immunoassay technology in Imam Hossein laboratory. Ratios of them were determined in four pathologic groups (simple cyst, benign, borderline and malignant) and statistical comparison was done with the Kruskal-Wallis and Mann-Whitney U-test.Results: We studied 100 patients with OVARIAN mass but pathology of 79 patients was epithelial TUMORs and simple cysts. The most common mass were simple cysts (48.1%) and then benign TUMORs (27.8%), malignant TUMORs (16.5%) and borderline TUMORs (7.6%). Serum FSH / TUMOR FLUID ratios were in simple cysts (21.1±53.8), benign TUMORs (50.7±174.9), borderline TUMORs (1.5±0.7) and malignant TUMORs (1.9±1.9) (P<0.001) and serum LH/TUMOR FLUID ratios were in simple cysts (12.1±26.5), benign TUMORs (20.0±29.1), borderline TUMORs (2.6±2.3) and malignant TUMORs (2.8±3.7) (P<0.002).Conclusion: Our findings suggest that serum gonadotropins / TUMOR FLUID ratio can be used as a TUMOR marker for identification of OVARIAN TUMORs. Also serum gonadotropins / TUMOR FLUID ratio could be of value in differential diagnosis of OVARIAN TUMORs after determination normal and abnormal cut off point and ratios of them.

The development of germ cell carcinoma of the ovary during pregnancy is a rare occurrence. The use of chemotherapeutic drugs in pregnancy is also rare. Recent advances in chemotherapy have improved significantly the prognosis. We describe a pregnant patient who found to have endodermal sinus TUMOR (EST) of the ovary stage IIIc at 14 weeks of gestational age. She received five courses of post-operative adjuvant multiagent bleomycin, etoposide and platinum chemotherapy and delivered a normal infant, at 35 weeks of gestation by cesarean section. No residual TUMOR was found at cesarean section. After delivery, she received an additional course of chemotherapy. The infant is developmentally normal at 1-year follow-up. 

Objective: Borderline OVARIAN TUMORs (BOT) constitute 15% of all epithelial OVARIAN cancers. The aim of this study is to analyze and discuss the management dilemmas associated with BOT. The purpose of this article was to collect and review the data on management dilemmas of BOT from numerous articles published since 1995. Additionally, the data of four patients with BOT, who were treated in our Institute, are presented and analyzed.Materials and Methods: For literature review we performed a literature search of relevant articles that were based on management dilemmas. Additionally, the data of 4 patients with BOT, who were treated in our Institute, are reported and reviewed by medical data information and patient interview, to establishing a database for a better understanding of the management dilemmas of BOT.Results: All the four cases were of reproductive age group. In three cases conservative fertility sparing surgery was done and in one patient radical surgery was done. All the four cases did not require adjuvant therapy. BOTs did not affect the outcome of pregnancy. Follow up of all the four cases is uneventful with no evidence of recurrence.Conclusion: Surgical management to excise all visible TUMOR tissue remains the keystone of therapy. Fertility being an important issue; conservative laparoscopic surgery is also a viable treatment option. Progression free survival is not influenced by the type of surgical approach (laparoscopic v/s laparotomy). Overall survival does not depend on the type of surgery (fertility sparing v/s non-sparing surgery). Even in advanced disease there is no proven benefit of adjuvant chemotherapy or radiotherapy.

OVARIAN sex cord-stromal TUMORs are relatively infrequent neoplasms that account for approximately 8% of all primary OVARIAN neoplasm. Sex cord-stromal TUMORs of the ovary include granulosa cell TUMORs, fibrothecomas, Sertoli-Leydigcell TUMORs, steroid cell TUMORs, and sclerosing stromal TUMORs (SST). Sclerosing stromal TUMORs account for 2% to 6% of OVARIAN stromal TUMORs. Despite the rarity of this particular neoplasm, it is not always possible to predict the presence of this TUMOR preoperatively on the basis of clinical and sonographic findings. Histopathological and immunohistochemical (IHC) examinations confirm the diagnosis. Herein, the clinical findings and histopathological features of SST are described in a 24-year-old female.

Introduction: The genesis of cancer appears to be a complex matter, which is not simply based upon few genetic abnormalities/alteration. In fact, irregular microvasculature and aberrant interstitium of solid TUMORs impose significant pathophysiologic barrier functions against cancer treatment modalities, hence novel strategies should holistically target bioelements of TUMOR microenvironment (TME). In this study, we provide some overview and insights on TME and important strategies used to control the impacts of such pathophysiologic barriers.Methods: We reviewed all relevant literature for the impacts of TUMOR interstitium and microvasculature within the TME as well as the significance of the implemented strategies.Results: While TUMORigenesis initiation seems to be in close relation with an emergence of hypoxia and alterations in epigenetic/genetic materials, large panoplies of molecular events emerge as intricate networks during oncogenesis to form unique lenient TME in favor of TUMOR progression. Within such irregular interstitium, immune system displays defective surveillance functionalities against malignant cells. Solid TUMORs show multifacial traits with coadaptation and self-regulation potentials, which bestow profound resistance against the currently used conventional chemotherapy and immunotherapy agents that target solely one face of the disease.Conclusion: The cancerous cells attain unique abilities to form its permissive microenvironment, wherein (a) extracellular pH is dysregulated towards acidification, (b) extracellular matrix (ECM) is deformed, (c) stromal cells are cooperative with cancer cells, (d) immune system mechanisms are defective, (e) non-integrated irregular microvasculature with pores (120-1200 nm) are formed, and (h) interstitial FLUID pressure is high. All these phenomena are against cancer treatment modalities. As a result, to control such abnormal pathophysiologic traits, novel cancer therapy strategies need to be devised using multifunctional nanomedicines and theranostics.

Background: Steroid cell TUMOR is one of the rare OVARIAN TUMORs and forms 0.1% of all OVARIAN TUMORs, divided to three subgroups. Steroid cell TUMOR that are not otherwise specified (NOS) are the most common type and represent 60% of steroid cell TUMORs.One of the most known signs of this TUMOR is hormonal function, especially androgenic effects of it. Primary treatment consists of eradication of TUMOR via surgery.Case presentation: The patient is a 29 years old female with history of poly cystic OVARIAN syndrome since 10 years ago, who attended to the clinic of General Women Hospital of Tehran in January 2011. In pelvic ultrasonography, there was a 64´49mm mass in the right adnexa consisting of homogeneous component. She underwent laparotomy and unilateral salpingoophorectomy was done. Pathological report was steroid cell TUMOR of ovary.Conclusion: The aim of this study is reporting one of the rare TUMORs of ovary and assessment of the correct way of diagnosis and treatment of it.

A previously healthy 8-year-old girl was referred with abdominal pain for the past three months. Physical examination was only suspicious for an ill-defined mass palpable deeply in the flank area. An ultrasound examination of the abdomen and pelvis had shown a pelvic mass for which the patient was referred. Blood hormone tests and alpha-fetoprotein were within the normal range...

Background: A variety of presentations may be manifested by retained sponge, including intestinal obstruction, intestinal fistula, malabsorption syndrome and chronic pain from adhesions,in some cases, it may have an asymptomatic clinical course. Case report: In a 41-year-old female, gravida 4 para 4, with a history of laparotomy performed for an OVARIAN adenocarcinoma three years prior to her referral, a gossypiboma was incidentally detected on follow up imaging. The gossypiboma was safely excised by a midline laparotomy. Conclusion: Asymptomatic gossypiboma should be considered in patients presenting with a mass, who have undergone laparotomy in the past.