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Transvaginal Sonography-Guided Core Biopsy of Adnexal Masses as a Useful Diagnostic Alternative Replacing Cytologic Examination or Laparoscopy in Advanced Ovarian Cancer Patients
  1. Tae-Wook Kong, MD,
  2. Suk-Joon Chang, MD, PhD,
  3. Jiheum Paek, MD,
  4. Hana Cho, MD,
  5. Yonghee Lee, MD, PhD,
  6. Eun Ju Lee, MD, PhD and
  7. Hee-Sug Ryu, MD, PhD
  1. * Gynecologic Cancer Center; Departments of
  2. Obstetrics and Gynecology,
  3. Pathology, and
  4. § Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
  1. Address correspondence and reprint requests to Suk-Joon Chang, MD, PhD, Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Ajou University School of Medicine, San 5, Wonchon-dong, Youngtong-gu, Suwon 443–721, Republic of Korea. E-mail: drchang{at}


Objective 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.

Materials and Methods 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.

Results 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.

Conclusions 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.

  • Transvaginal sonography-guided core biopsy
  • Advanced ovarian cancer
  • Neoadjuvant chemotherapy

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  • The authors declare no conflicts of interest.