Differential Diagnosis Of Ovarian Tumors Research Articles

High-throughput viable circulating tumor cell isolation using tapered-slit membrane filter-based chipsets in the differential diagnosis of ovarian tumors.

To evaluate the diagnostic performance of circulating tumor cells (CTCs) using tapered-slit membrane filter (TSF)-based chipsets for the differential diagnosis of adnexal tumors. A total of 230 women with indeterminate adnexal tumors were prospectively enrolled. The sensitivity, specificity, and accuracy of the CTC-detecting chipsets were analyzed according to postoperative pathological results and compared with those of cancer antigen (CA)-125 and imaging tests. Eighty-one (40.3%) benign tumors, 31 (15.4%) borderline tumors, and 89 (44.3%) ovarian cancers were pathologically confirmed. The sensitivity, specificity, and accuracy of CTC-detecting chipsets (75.3%, 58.0%, and 67.1%) for differentiating ovarian cancer from benign tumors were similar to CA-125 (78.7%, 53.1%, and 66.5%), but lower than CT/MRI (94.2%, 77.9%, and 86.5%). "CTC or CA125" showed increased sensitivity (91.0%) and "CTC and CA-125" revealed increased specificity (77.8%), comparable to CT/MRI. CTC detection rates in stage I/II and stage III/IV ovarian cancers were 69.6% and 81.4%, respectively. The sensitivity to detect high-grade serous (HGS) cancer from benign tumors (84.6%) was higher than that to detect non-HGS cancers (68.0%). Although the diagnostic performance of the TSF platform to differentiate between ovarian cancer and benign tumors did not yield significant results, the combination of CTC and CA-125 showed promising potential in the diagnostic accuracy of ovarian cancer.

Exosomal biomarkers in the differential diagnosis of ovarian tumors: the emerging roles of CA125, HE4, and C5a

ObjectiveInvestigating the utility of serum exosomal markers CA125, HE4, and C5a, both individually and in combination, for distinguishing between benign and malignant ovarian tumors.MethodsIn this study, we selected a total of 234 patients diagnosed with ovarian tumors, including 34 with malignant tumors, 10 with borderline ovarian tumors, and 190 with benign tumors. This study conducted comparisons of exosomal levels of CA125, HE4, and C5a among distinct groups, as well as making comparisons between serum and exosomal levels of CA125 and HE4. Furthermore, the diagnostic performance was assessed through Receiver Operating Characteristic (ROC) curve analysis. The Area Under the Curve (AUC) was computed, and a comparative evaluation of sensitivity and specificity was conducted to ascertain their effectiveness in determining the nature of ovarian tumors across different markers.ResultsSerum CA125 and HE4 levels, the ROMA index, exosomal CA125, HE4, C5a levels, and their combined applied value (OCS value) were notably elevated in the ovarian non-benign tumor group compared to the benign tumor group, with statistical significance (P < 0.05). Exosomal and serum levels of CA125 and HE4 exhibited a positive correlation, with concentrations of these markers in serum surpassing those in exosomes. The combined OCS (AUC = 0.871) for CA125, HE4, and C5a in exosomes demonstrated superior sensitivity (0.773) and specificity (0.932) compared to serum tumor markers (CA125, HE4) and the ROMA index. The tumor stage represents an autonomous risk factor influencing the prognosis of individuals with ovarian malignancies.ConclusionThe stage of ovarian malignancy is an independent risk factor for its prognosis. The combination of exosomal CA125, HE4 and C5a has a higher clinical value for the identification of the nature of ovarian tumours.

Sulfur hexafluoride microbubbles combined with serology distinguish benign and malignant ovarian tumors

To explore the value of contrast-enhanced ultrasound with Sulfur hexafluoride microbubbles, serum carbohydrate antigen 125, carcinoembryonic antigen and human epididymis protein 4 joint inspection in the differential diagnosis of ovarian tumors. A total of 56 patients with ovarian tumors were chosen as research materials from June 2018 to October 2021. Result show 24 patients of benign tumors and 32 patients of malignant tumors were confirmed by pathological diagnosis. The rise time and time to peak values of malignant tumors were lower than those of benign tumors (p&lt;0.001). However, peak intensity, Time intensity curve -Area under Curve and serum human epididymis protein 4, carcinoembryonic antigen, carbohydrate antigen 125 levels joint inspection in malignant tumors were higher than those in benign tumors (p &lt; 0.001). Rise time, peak intensity and time to peak in benign and malignant ovarian tumors were 0.895 (0.802–0.999, 95% CI), 0.852 (0.804–0.916, 95% CI), 0.907 (0.829–0.925, 95% CI), respectively. Area under Curve were 0.909 (0.846–1.012, 95% CI) and serum carbohydrate antigen 125 and carcinoembryonic antigen and human epididymis protein 4 for diagnosis of benign and malignant ovarian tumors were 0.865 (0.838–0.991, 95% CI), 0.816 (0.702–0.930, 95% CI), 0.903 (0.850–1.007, 95% CI). Contrast-enhanced Ultrasound unite to serum carbohydrate antigen 125 and carcinoembryonic antigen and human epididymis protein 4, the accuracy rate 92.86% (52/56) significantly higher than Contrast-enhanced Ultrasound or serum v diagnosis benign and malignant of ovarian tumor (p&lt;0.01, 92.86% vs. 82.14%, p&lt;0.001, 92.86% vs. 73.21%). Conclusion Contrast-enhanced Ultrasound, carbohydrate antigen 125, carcinoembryonic antigen, human epididymis protein 4 joint inspection can improve the accuracy of early ovarian cancer.

OP07.07: The value of O‐RADS‐based logistic regression models in the differential diagnosis of ovarian tumours

OP07.07: The value of O‐RADS‐based logistic regression models in the differential diagnosis of ovarian tumours

The Value of IOTA Simple Rules Combined With CEUS Scoring System in the Diagnosis of Benign and Malignant Ovarian Masses and Its Correlation With MVD and VEGF: A Preliminary Study.

To investigate the diagnostic value of International Ovarian Tumor Analysis (IOTA) simple rules combined with contrast-enhanced ultrasound (CEUS) scoring system in the differential diagnosis of ovarian tumors, and the correlations of the scoring system with microvessel density (MVD) and vascular endothelial growth factor (VEGF). One hundred eighty-nine patients with ovarian tumors were examined by routine ultrasound and CEUS. The enhanced characteristics of CEUS were observed, and the masses were classified by IOTA simple rules. To compare the diagnostic value of IOTA simple rules combined with CEUS scoring system and IOTA simple rules in the diagnosis of ovarian tumors. Immunohistochemistry was used to detect the expression of MVD and VEGF in postoperative tissue samples. The correlations between the new scoring system with MVD and VEGF were analyzed. The sensitivity (93.98%), specificity (94.34%), positive predictive value (92.86%), negative predictive value (95.24%), and accuracy (94.18%) of IOTA simple rules combined with CEUS scoring system in the diagnosis of ovarian tumors were higher than those of IOTA simple rules alone (all P < .05). The score system was significantly positively correlated with MVD and VEGF, and the r values were 0.77 and 0.63, respectively (P < .001). IOTA simple rules combined with CEUS scoring system was helpful to improve the accuracy of ultrasound diagnosis of ovarian tumors, which was significantly correlated with MVD and VEGF. It could provide important reference information for treatment scheme formulation and prognosis evaluation.

Chelation-Tamoxifen Conjugates for Imaging of Estrogen Receptors.

Background: The differential diagnosis of estrogen receptor-positive (ER+) pathway-activated systems by using a labeled antiestrogen helps to select the patients for optimal response to endocrine therapy and to discontinue the treatment when resistance occurs. The authors' purpose was to synthesize chelator-tamoxifen conjugates for imaging ER (+) diseases. Materials and Methods: A hydroxypropyl linker was incorporated between either cyclam or cyclam diacetic acid and tamoxifen analog to produce SC-05-L-1 (Z-1-(1,4,8,11-tetraazacyclotetradecan-1-yl)-3-((5-(4-(2-(diethylamino)ethoxy)phenyl)-4,5-diphenylpent-4-en-1-yl)oxy)propan-2-ol) and SC-05-N-1 (Z-2,2'-(4-(3-((5-(4-(2-(diethylamino)ethoxy)phenyl)-4,5-diphenylpent-4-en-1-yl)oxy)-2-hydroxy-propyl)-1,4,8,11-tetraazacyclotetradecane-1,8-diyl)diacetic acid), respectively. In vitro cell uptake and cell/media ratios of 99mTc-SC-05-L-1 and 99mTc- SC-05-N-1 in ER (+) ovarian cancer cells (TOV-112D and OVCAR3) were performed. To ascertain the specificity of cell uptake, the cell uptake was blocked with estrone. In vivo 99mTc-SC-05-L-1 or 99mTc-SC-05-N-1 single-photon emission computed tomography/computed tomography was conducted in tumor-bearing rodents and compared to 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/magnetic resonance imaging (a reference technology). Results: The radiochemical purities of 99mTc-SC-05-L-1 and 99mTc-SC-05-N-1 were greater than 99% (n = 10). 99mTc-SC-05-L-1 had higher cell/media ratios than 99mTc-SC-05-N-1 in OVCAR-3 ER (+) cells. The cell uptake of 99mTc-SC-05-L-1 was blocked 80% by estrone indicating an ER-mediated process occurred. 99mTc-SC-05-N-1 was further selected for in vivo imaging studies due to higher maximum tolerated dose and superior water solubility than 99mTc-SC-05-L-1. 99mTc-SC-05-N-1 showed higher tumor uptake and tumor/muscle count density ratios than 18F-FDG in tumor-bearing rodents. Conclusion: 99mTc-SC-05-N-1 showed better differential diagnosis of ovarian tumors than 18F-FDG, indicating great promising in chelator-tamoxifen conjugate for ER pathway-directed systems imaging.

Ovarian dlbcl presenting as a very large ovarian mass in a young woman – a case report (and potential frozen section pitfall)

While ovarian involvement as a late manifestation of disseminated non-Hodgkin lymphoma (NHL) is not uncommon, primary ovarian NHL, or NHL presenting for the first time as an ovarian mass, is rare, having a reported incidence of around 0.5% of all untreated NHL and 1.5% of untreated ovarian neoplasms. This case study reports a 27-year-old woman who underwent a unilateral salpingo-ophorectomy and staging for a very large, rapidly enlarging, right ovarian mass, suspected clinically of being a dysgerminoma. On frozen section, the tumour was favoured to be a germ cell tumour, with juvenile granulosa cell tumour also not excluded. On permanent section, however, the tumour more clearly demonstrated morphological features and immunological features in keeping with a large B-cell non-Hodgkin lymphoma. Coupled with FISH analysis showing no evidence of a MYC gene rearrangement, a diagnosis of DLBCL, NOS, double expressor phenotype, was ultimately made. This case serves as a reminder that, although rare as an initial presentation in the ovary, lymphoma should be considered by pathologists in the differential diagnosis of ovarian tumours, including at frozen section, where consideration should also be given to obtaining fresh tissue for flow cytometry. 1.Dimopoulos MA, Daliani D, Pugh W, et al. Primary ovarian non-Hodgkin's lymphoma: outcome after treatment with combination chemotherapy. Gynecol Oncol 1997; 64: 446–50.

Chemokine expression in patients with ovarian cancer or benign ovarian tumors.

IntroductionChemokines play a crucial role in tumor growth and progression according to proangiogenic and immunosuppressive action. The aim of this study was to investigate the serum levels of selected chemokines in patients with ovarian cancer or benign ovarian tumors to assess their role in tumorigenesis and their potential use in preoperative diagnosis of an adnexal mass.Material and methodsThe study group consisted of 59 women with ovarian cancer: 17 epithelial ovarian cancer (EOC) patients and 42 women with benign ovarian tumors. We measured in sera obtained preoperatively the level of CA125 and a panel of 5 chemokines – CX3CL1/fractalkine, CXCL1/GRO-α, CXCL12/SDF-1, CCL20/MIP-3α and IL-17F – using the chemiluminescence method with multiplexed bead based immunoassay.ResultsCX3CL1 was significantly elevated in sera of advanced ovarian cancer patients compared to women with benign ovarian tumors. The significant elevation of CXCL1 was also observed (both early and advanced stages). A similar pattern was present with the standard ovarian cancer marker CA125. In our patients with endometriotic cysts CA125 levels were significantly higher than in women with other benign tumors, whereas all analyzed chemokines had similar serum titers in patients with endometriotic vs. other benign ovarian cysts.ConclusionsCX3CL1 and CXCL1 are elevated in sera of EOC patients, which indicates their role in cancer development. Moreover, they might be useful in preoperative differential diagnosis of ovarian tumors, especially as they were not elevated in cases of endometriosis.

Assessment of different NEoplasias in the adneXa model for differentiation of benign and malignant adnexal masses in Korean women.

ObjectiveUltrasonographic differential diagnosis of ovarian tumors is important for appropriate management. We conducted study to compare the performance of the Assessment of Different NEoplasias in the adneXa (ADNEX) model with a subjective assessment (SA) in differentiating between benign and malignant adnexal masses in Korean women.MethodsA total of 353 patients who underwent adnexal surgery with abnormal pelvic ultrasonographic findings from August 2016 to August 2017 were included in study. The presumptive diagnosis of adnexal malignancy was determined by both SA and the ADNEX model to be >10% calculated risk of malignancy. The area under the curve (AUC) comparison between the SA and ADNEX models was performed using DeLong’s method.Results340 patients with benign tumors and 13 with malignant adnexal tumors among 292 (82.72%) premenopausal and 61 (17.28%) postmenopausal women were included. The AUCs of SA and the ADNEX model for discrimination between benign and malignant tumors were 0.79 and 0.92, respectively (P=0.10). The sensitivity and specificity of SA and the ADNEX model were 83.5% and 97.0%, and 90.0% and 82.0%, respectively. Comparison of the ADNEX model regarding menopausal status revealed that the predictability was not different. The AUCs of SA and the ADNEX model in premenopausal women were 0.74 and 0.89, respectively (P=0.12). The AUCs of SA and the ADNEX model in postmenopausal women were 0.86 and 0.94, respectively (P=0.60).ConclusionThe ADNEX model offers excellent discrimination between benign and malignant ovarian tumors with similar sensitivity and specificity to SA in both premenopausal and postmenopausal Korean women.

Serum Free Amino Acid Profiling in Differential Diagnosis of Ovarian Tumors-A Comparative Study with Review of the Literature.

Proper preoperative ovarian cancer (OC) diagnosis remains challenging. Serum free amino acid (SFAA) profiles were investigated to identify potential novel biomarkers of OC and assess their performance in ovarian tumor differential diagnosis. Serum samples were divided based on the histopathological result: epithelial OC (n = 38), borderline ovarian tumors (n = 6), and benign ovarian tumors (BOTs) (n = 62). SFAA profiles were evaluated using aTRAQ methodology based on high-performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS). Levels of eleven amino acids significantly differed between OC+borderline and BOTs. The highest area under the receiver operating characteristic curve (AUC of ROC) (0.787) was obtained for histidine. Cystine and histidine were identified as best single markers for early stage OC/BOT and type I OC. For advanced stage OC, seven amino acids differed significantly between the groups and citrulline obtained the best AUC of 0.807. Between type II OC and BOTs, eight amino acids differed significantly and the highest AUC of 0.798 was achieved by histidine and citrulline (AUC of 0.778). Histidine was identified as a potential new biomarker in differential diagnosis of ovarian tumors. Adding histidine to a multimarker panel together with CA125 and HE4 improved the differential diagnosis between OC and BOTs.

Diagnostic Efficiency of Gynecologic Imaging Reporting and Data System Combined With 3-dimensional Contrast-enhanced Ultrasound Scoring System in Evaluating Ovarian Tumor.

To estimate the value of gynecologic imaging reporting and data system (GI-RADS) combined with 3-dimensional contrast-enhanced ultrasound (3D-CEUS) scoring system in the differential diagnosis of ovarian tumor. Both of 2-dimensional ultrasound (2D-US) and 3D-CEUS were performed on 114 patients with ovarian masses by Voluson E8 with SonoVue (Bracco, Italy). Besides, dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) (Siemens Magneton Verio 3.0T, Germany) was performed on the patients. There were totally 62 benign and 52 malignant ovarian tumors in all patients. The ability of GI-RADS combined with 3D-CEUS scoring system to distinguish benign and malignant ovarian tumors was superior to conventional ultrasound GI-RADS classification. The sensitivity, specificity, and accuracy of GI-RADS combined with 3D-CEUS scoring system were 96.2% and 98.1%, 87.10%, whereas those of MRI were 87.10%, 91.23%, and 92.11% respectively, indicating that there was high concordance in ovarian tumors assessment between the 2 diagnostic methods. The new scoring system has a good correlation with microvessel density (P = 0.000, r = 0.73), estrogen receptor (P = 0.000, r = 0.59), progesterone receptor (P = 0.000, r = 0.56), and matrix metalloproteinase-9 (P = 0.000, r = 0.61). The GI-RADS combined with 3D-CEUS scoring system was valuable in clinical diagnosis and differential diagnosis of ovarian tumor and show good agreement with MRI.

MALDI-MSI-A Step Forward in Overcoming the Diagnostic Challenges in Ovarian Tumors.

This study presents the use of matrix-assisted laser desorption and ionization mass spectrometry imaging (MALDI-MSI) directly on the tissue of two ovarian tumors that often present a diagnostic challenge, a low-grade serous borderline ovarian tumor and ovarian fibrothecoma. Different spatial distribution of m/z values within the tissue samples was observed, and regiospecific peaks were identified. Among the 106 peaks in the borderline ovarian tumor five, regiospecific peaks (m/z: 2861.35; 2775.79; 3368.34; 3438.43; 4936.37) were selected using FlexImaging software. Subsequently, the distribution of those selected peaks was visualized on the fibrothecoma tissue section, which demonstrated the differences in the tissue homo-/heterogeneous structure of both tumors. The comparison with the histopathological staining of the ovarian borderline tumor tissue section, obtained during serial sectioning, showed a close correlation of the molecular map with the morphological and histopathological features of the tissue and allowed the identification of different tissue types within the sample. This study highlights the potential significance of MSI in enabling morphological characterization of ovarian tumors as well as correct diagnosis and further prognosis than thus far seen in the literature. Osteopontin, tropomyosin and orosomucoid are only a couple of the molecules investigated using MALDI-MSI in ovarian cancer research. This study, in line with the available literature, proves the potential of MALDI-MSI to overcome the current limitations of classic histopathological examination giving a more in-depth insight into the tissue structure and thus lead to the more accurate differential diagnosis of ovarian tumors, especially in the most challenging cases.

Comparison of the clinical significance of serum HE4, CA125 and ROMA in the differential diagnosis of ovarian tumor

Objective To compare the clinical significance of human epididymis protein 4(HE4), CA125, ROMA in the differential diagnosis of ovarian cancer. Methods From May 2016 to October 2017, 240 patients with ovarian tumor in Xuzhou Cancer Hospital were selected.According to the result of postoperative pathology, the patients were divided into benign ovarian disease group(n=120) and ovarian cancer group(n=120). And 100 healthy women from medical examination center were selected as control group.The electrochemiluminescence (ECLIA) technique was used to assess the serum levels of CA125, HE4, and ROMA was calculated.The clinical significance of HE4, CA125, ROMA in the differential diagnosis of ovarian cancer was analyzed by statistic methods. Results The CA125, HE4 concentrations and ROMA in the ovarian cancer group[(370.9±213.2)U/mL, (364.4±227.0)pmpl/L, (80.2±26.1)%]were higher than those in the benign ovarian disease group and the health control group(all P<0.01), there were no statistically significant differences between the benign ovarian disease group and the healthy control group(P=0.356, P=0.321, P=0.292). The sensitivity, specificity, positive and negative predictive values, accuracy of ROMA were higher than those of HE4 and CA125.By using the ROC analysis, the AUC for CA125, HE4, ROMA were 0.832, 0.888, 0.960, respectively, AUC(CA125)<AUC(HE4)<AUC(ROMA). Conclusion CA125 and HE4 have important value in the diagnosis of ovarian cancer, but the ROMA shows the best diagnostic performance and actual value. Key words: Ovarian neoplasms; CA-125 antigen; Human epididymis protein 4; ROC curve; Diagnosis, differential; ROMA

Evolution of a corpus luteum cyst: how to avoid a pitfall due to its varying appearance

Ultrasound is a useful tool in the differential diagnosis of ovarian tumours (Guerriero et al. 2015). Specific sonographic characteristics may either reassure or ignite further action (Timmerman et...

Application Value of Color Doppler Ultrasound and Ultrasound Contrast in the Differential Diagnosis of Ovarian tumor.

Objective:To study the value of color Doppler ultrasound and ultrasound contrast in differential diagnosis of ovarian tumors.Methods:Ninety-six patients with ovarian tumors who were treated in our hospital from May 2017 to July 2018 and confirmed by pathological examination were selected as the research subjects. All patients were examined by color Doppler ultrasound and ultrasound contrast. The sensitivity, specificity and accuracy of the two methods were compared, and the parameters of ultrasound contrast in the diagnosis of benign and malignant tumors were observed and compared.Results:The sensitivity, specificity and accuracy of ultrasound contrast in the diagnosis of ovarian tumors were higher than those of color Doppler ultrasound (P<0.05). There were significant differences in the time of initiation enhancement, time to peak and perfusion intensity in the diagnosis of benign and malignant lesions by ultrasound contrast (P<0.05).Conclusion:In the differential diagnosis of ovarian tumors, ultrasound contrast has more advantages than color Doppler ultrasound in displaying the blood perfusion information of tumors. It has high diagnostic accuracy and clinical application value.

Assessment of diagnostic utility of multivariate diagnostic models in differential diagnosis of ovarian tumors.

Ovarian cancer (OC) diagnosis remains a clinical challenge due to lack of early symptoms and insufficient accuracy of the available diagnostic methods. The purpose of this study was to determine whether osteopontin could be useful in differential diagnosis of ovarian tumors. Serum samples from 92 patients qualified for surgical treatment due to ovarian mass were divided into 2 groups according to the histopathological result: OC including borderline ovarian tumors (n = 39) and benign ovarian tumors (BOTs) (n = 53). CA125, HE4 and osteopontin concentrations were measured in all patients. Areas under the receiver operating characteristic curves (AUC of ROC) were used to compare the discriminative ability of the univariate and multivariate diagnostic models. The addition of osteopontin to ROMA significantly improved the diagnostic performance of the test in 3 of the 5 analyses: 1) in the OC vs BOT group (from AUC of 0.955 to 0.975), 2) in premenopausal women OC vs BOT (from AUC of 0.828 to 0.892) and 3) in the FIGO I-II stage OC vs BOT (from AUC of 0.865 to 0.895). It did not alter the diagnostic performance of multifactor tests in the group of postmenopausal women nor in OC FIGO III-IV stage group. Osteopontin was also the best single marker to differentiate between early stage OC and BOTs (AUC of 0.863). Osteopontin improves the diagnostic performance of a multimarker OC diagnostic test and could be useful in differential diagnosis of ovarian tumors, especially in pre-menopausal women and for early stage OC.

MALIGNANT NEOPLASMS OF OVARIES IN CHILDREN AND ADOLESCENTS

Tumors of the ovaries in girls represent an actual problem in modern gynecology. First of all, this is due to diagnostic difficulties, due to the absence of characteristic complaints, asymptomatic course and the complexity of the gynecological examination, which leads to the establishment of an erroneous diagnosis, the lack of correct and timely treatment and, as a consequence, the occurrence of complications that often negatively affect the reproductive function of the patient in further. The differential diagnosis of ovarian tumors in girls is still one of the most important problems of modern practical gynecology. The presence of a combined pathology in many patients, which is in 30-40% according to the WHO, puts the problem of the possibility of the simultaneous correction by surgeon and gynecologist. In connection with the difficulty of diagnosing, the diagnosis of such patients must necessarily include an examination by a pediatric surgeon and gynecologist with ultrasound examination of the retroperitoneal space, abdominal cavity organs, and small pelvis. Errors in the differential diagnosis of genital and extragenital diseases occur quite often and are mainly due to the similarity of clinical symptoms. This article presents a clinical case of the diagnosis and management of a 14-year-old patient with an adjacent diagnosis, as well as diagnostic search criteria for the differential diagnosis of gynecological and surgical pathologies.

FEATURES OF THE DIFFERENTIAL DIAGNOSIS OF OVARIAN TUMORS IN GIRLS

Tumors of the ovaries in girls represent an actual problem in modern gynecology. First of all, this is due to diagnostic difficulties, caused by the absence of characteristic complaints, asymptomatic course and the complexity of the gynecological examination, which leads to making of an erroneous diagnosis, the lack of correct and timely treatment and, as a result, complications that often negatively affect the reproductive function of the female patient in further. The differential diagnosis of ovarian tumors in girls is still one of the most important problems of modern practical gynecology. In many patients, the presence of a combined pathology, which is 30-40% according to WHO data, puts the problem of the possibility of simultaneous correction of such pathology by both surgeons and gynecologists. In connection with the difficulty of diagnosing, the diagnosis of such patients must necessarily include an examination of a pediatric surgeon and a children’s gynecologist with ultrasound examination of the retroperitoneal space, abdominal cavity organs, and small pelvis. Errors in the differential diagnosis of genital and extragenital diseases occur quite often and are mainly due to the similarity of clinical symptoms. This article presents a clinical case of the diagnosis and management of a 14-year-old female patient with an adjacent diagnosis, as well as criteria for the diagnostic search for the differential diagnosis of gynecological and surgical pathologies.

FEATURES OF THE DIFFERENTIAL DIAGNOSIS OF OVARIAN TUMORS IN GIRLS (OBSERVATION FROM THE PRACTICE)

Tumors of the ovaries in girls represent an actual problem in modern gynecology. First of all, this is due to diagnostic difficulties, caused by the absence of characteristic complaints, asymptomatic course and the complexity of the gynecological examination, which leads to making of an erroneous diagnosis, the lack of correct and timely treatment and, as a result, complications that often negatively affect the reproductive function of the female patient in further. The differential diagnosis of ovarian tumors in girls is still one of the most important problems of modern practical gynecology. In many patients, the presence of a combined pathology, which is 30-40% according to WHO data, puts the problem of the possibility of simultaneous correction of such pathology by both surgeons and gynecologists. In connection with the difficulty of diagnosing, the diagnosis of such patients must necessarily include an examination of a pediatric surgeon and a children’s gynecologist with ultrasound examination of the retroperitoneal space, abdominal cavity organs, and small pelvis. Errors in the differential diagnosis of genital and extragenital diseases occur quite often and are mainly due to the similarity of clinical symptoms. This article presents a clinical case of the diagnosis and management of a 14-year-old female patient with an adjacent diagnosis, as well as criteria for the diagnostic search for the differential diagnosis of gynecological and surgical pathologies.

Evaluation of the Four-dimensional “Spatiotemporal Image Correlation” Technology with High-definition Color Doppler as Third Step for Preoperative Differential Diagnosis of Ovarian Tumors: A Prospective Study

Evaluation of the Four-dimensional “Spatiotemporal Image Correlation” Technology with High-definition Color Doppler as Third Step for Preoperative Differential Diagnosis of Ovarian Tumors: A Prospective Study