title: Transvaginal Sonography-Guided Core Biopsy of Adnexal Masses as a Useful Diagnostic Alternative Replacing Cytologic Examination or Laparoscopy in Advanced Ovarian Cancer Patients.
abstract: The aim of this study was to evaluate transvaginal sonography (TVS)-guided core biopsy of the adnexal masses for neoadjuvant chemotherapy (NACT) in patients with advanced ovarian malignancies.
  
  
  
  We retrospectively reviewed the medical records of 52 patients who had undergone TVS-guided core biopsies in our gynecologic cancer center between May 2009 and October 2015. TVS-guided core biopsies were performed on patients with advanced ovarian malignancies who were considered as candidates for NACT and patients with adnexal masses who required a differential diagnosis of non-gynecologic tumors.
  
  
  
  Thirty-seven patients (71.2%) were scheduled to undergo NACT owing to the presence of coexisting illness, age, tumor burden, and location of metastatic sites. Fifteen patients (28.8%) underwent TVS-guided core biopsies to determine if they had primary or secondary ovarian tumors. Histopathologic examinations revealed primary ovarian tumors in 44 patients (84.6%). Nongynecologic tumors including gastrointestinal stromal tumor and metastatic tumor from gallbladder, gastric, and colorectal cancer were found to be the second most common disease (n = 5 [9.6%]). Findings in the samples were nondiagnostic in 4 patients (5.8%). With respect to the histological concordance rate between TVS-guided core biopsy and surgical specimen, diagnostic accuracy was 93.6%. There were no biopsy-related complications.
  
  
  
  TVS-guided core biopsy may be a feasible procedure to diagnose adnexal masses, particularly in patients with advanced ovarian malignancies who are more likely to benefit from NACT.
authors.affiliation: *Gynecologic Cancer Center; Departments of †Obstetrics and Gynecology, ‡Pathology, and §Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Tae-Wook
authors.initials: TW
authors.lastname: Kong
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.forename: Jiheum
authors.initials: J
authors.lastname: Paek
authors.forename: Hana
authors.initials: H
authors.lastname: Cho
authors.forename: Yonghee
authors.initials: Y
authors.lastname: Lee
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Lee
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods*