title: Laparoscopic adnexectomy with peritonectomy for an ovarian tumor adhered to the pelvic sidewall.
abstract: Laparoscopic adnexectomy is one of the most commonly used surgical techniques for the treatment of ovarian tumor. However, many physicians find it difficult to conduct the resection without rupturing the ovarian tumor, especially in cases with tumor adhesions. In the case we are presenting, we unexpectedly encountered an ovarian tumor adherent to the pelvic sidewall. Because the possibility of a malignancy could not be completely excluded, we decided to concomitantly resect the ovary and its adherent peritoneum, to avoid any potential tumor rupture due to its manipulation. We were successfully able to laparoscopically retrieve the intact ovarian tumor, without its rupture. The pathological diagnosis was of a Grade 2, FIGO stage IIb endometrioid adenocarcinoma of both ovaries. As a result of this diagnosis, we performed a comprehensive staging laparoscopy. Following the completion of adjuvant chemotherapy, the patient has showed no signs of recurrent malignancy after 3 years. This case report describes our technique for the surgical management of an ovarian tumor adherent to the pelvic wall. To avoid spillage of the tumor contents, the simultaneous resection of the tumor with its adhered peritoneum is a useful method to consider.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan. ekobayashi@gyne.med.osaka-u.ac.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Kobayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kanao
authors.forename: Masaaki
authors.initials: M
authors.lastname: Andou
mesh_terms: D000328:Adult; D018269:Carcinoma, Endometrioid / Q000188:drug therapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery*; D010537:Peritoneum / Q000601:surgery*; D000267:Tissue Adhesions / Q000601:surgery; D016896:Treatment Outcome