Preoperative diagnosis in gynecologic oncology often remains a significant challenge for the medical team, even today, when imaging techniques have reached an advanced stage of development. These difficulties are particularly evident in rare tumors and in locally advanced disease, where establishing the tumor’s origin is complex. Multidisciplinary collaboration in such cases is essential for improving prognosis and optimizing therapeutic management. We present a series of three clinical cases in which the initial diagnosis was redefined after histopathological examination: two cases of ovarian neoplasm, one of which was ultimately identified as an ovarian neuroendocrine tumor – an extremely rare entity worldwide – and one case initially suspected clinically and radiologically as endometrial sarcoma, but postoperatively confirmed as a large benign endometrial polyp. We highlight the usefulness of performing cell block preparations from ascitic or pleural fluid rather than open biopsy in ovarian neoplasms, thereby reducing perioperative risks. This article emphasizes the importance of integrating clinical and paraclinical findings to minimize diagnostic errors, particularly in atypical presentations.

Peritoneal cancer (PPC), a rare and aggressive malignancy, can develop from the peritoneal lining or as a secondary peritoneal cancer caused by metastases from neighbouring organs such as the ovaries, gastrointestinal tract, or breast. Early identification is still difficult due to its ambiguous signs, ranging from bloating, distension, and stomach pain. Due to their comparable histological and clinical characteristics, PPC and ovarian cancer are frequently misdiagnosed. Advanced imaging, histological investigation, and immunohistochemical markers are essential for accurate diagnosis. In order to control any remaining disease and enhance results, treatment usually encompasses an assortment of therapeutic approaches, such as hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgical procedure (CRS). We present a 69-year-old woman who got diagnosed with PPC after first being suspected of having ovarian cancer. The current instance emphasizes how crucial a thorough diagnostic process is to differentiating PPC from related cancers.

Ovarian cancer is the seventh most commonly diagnosed cancer in women, with the highest mortality rate among female genital cancers. Due to the nonspecific symptoms and the lack of effective screening strategies, ovarian cancer is often diagnosed in an advanced stage of the disease, with a 5-year survival rate of 25%. The efforts of specialists are aimed at identifying screening methods, with the lowest possible rates of false positive or false negative results in order to diagnose the disease at an early stage, when the 5-year survival rate is 92%. In this study we analyzed the incidence of ovarian cancer in the last five years in the Bucharest University Emergency Hospital, being registered 153 cases of ovarian cancer. The aim of this paper is to analyze the correlation between the early diagnosis of ovarian cancer and the long-term prognosis.