Evolutive peritoneal disease after conservative management and the use of infertility drugs in a patient with stage IIIC borderline micro-papillary serous carcinoma (MPSC) of the ovary: case report.
A young nulliparous woman with stage IIIC bilateral borderline micro-papillary serous carcinoma (MPSC) of the ovary underwent conservative surgery with optimal preservation of future fertility. The left ovary and a substantial portion of the right ovary were removed. The patient became pregnant at the first IVF cycle attempted after conservative management. A Cesarean section was performed in the 37th week of pregnancy and combined with very precise exploration; there were multiple non-invasive implants on the peritoneal surface and liver, and contra-lateral ovarian tissue was of normal appearance. Abdominal hysterectomy and right oophorectomy were done as a definitive treatment 3 months after the Caesarean section. The patient showed a rapid progression to invasive ovarian carcinoma in this period of time. MPSC has the greatest risk of malignant transformation among the advanced stage serous borderline tumours. Fertility-sparing surgery is an option for young, childless women who would like to preserve their fertility. However, the treatment must be taken very cautiously and requires rigorous surveillance.
Attar
Erkut
E
Division of Reproductive Endocrinology and Infertility, Istanbul University, School of Medicine, Istanbul, Turkey. attar@superonline.com
Berkman
Sinan
S
Topuz
Samet
S
Baysal
Bulent
B
Akhan
Suleyman
S
Chambers
Joseph T
JT
D000328:Adult; D002585:Cesarean Section; D003536:Cystadenocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D006801:Humans; D007044:Hysterectomy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*; D010537:Peritoneum / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D012086:Reoperation
D005300:Fertility Agents, Female