Laparoscopical management ovarian early sex cord-stromal tumors in postmenopausal women: a proposal method.
BACKGROUND
Ovarian sex-cord stromal tumor (SCST) comprises 5% of the ovarian neoplasm; it occurs as an ovarian mass or hemoperitoneum, and the surgical management of SCST is not well defined at early stage and in adult patients.


OBJECTIVE
The authors tested to test the total not radical laparoscopic management of SCST in postmenopausal women at early stage.


METHODS
Three postmenopausal women were admitted in University-affiliated hospitals for pelvic pain, ovarian complex mass and genital bleeding. Preoperative clinical and instrumental examination suspected an ovarian tumor; therefore, a total laparoscopic approach was attempted. All patients underwent laparoscopic oophorectomy with the frozen section, who suggested for ovarian SCST; one woman received a total laparoscopic hysterectomy plus other oophorectomy, two received only the complementary oophorectomy, all without intensive surgical staging by with pelvic and para-aortic lymphadenectomy, appendectomy, peritoneal biopsies, and omentectomy.


RESULTS
All patients completed surgery without intrasurgical and postsurgical complications, with a fast dismissal. They are, currently, in long-term follow-up, with a 100% of survival after 3 years and with none morbility and morbidity.


CONCLUSIONS
In order to fast restore and preserve women's integrity, total laparoscopic approach of early SCST in adult age, without intensive radical staging, could be an appropriate clinical choice, since these tumors at slow growth, recurring locally and only a long time after initial treatment. This minimally invasive management could be suggested in association with a long-term follow-up, as possible "wait and see" postoperative option.
Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, P.zza Muratore, 73100, Lecce, Italy. andreatinelli@gmail.com
Andrea
A
Tinelli
Marcello
M
Pellegrino
Antonio
A
Malvasi
Vito
V
Lorusso
D000368:Aged; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000601:surgery*; D010052:Ovariectomy; D017698:Postmenopause; D018312:Sex Cord-Gonadal Stromal Tumors / Q000175:diagnosis / Q000601:surgery*