title: Unexpected ovarian malignancy following laparoscopic excision of adnexal masses.
abstract: OBJECTIVE
  What are the frequency of, and the prognosis for, ovarian malignancies among patients who have undergone laparoscopic surgery for an adnexal mass?
  
  
  CONCLUSIONS
  The rate of unexpected ovarian malignancy resected by laparoscopy was 1.5%, and the presence of an early-stage unexpected ovarian malignancy did not alter patient prognosis.
  
  
  BACKGROUND
  Even when laparoscopic surgery is used for the resection of an adnexal mass that is most likely benign, some patients are found to have malignant tumors post-operatively.
  
  
  METHODS
  The pathologic reports of 884 women who underwent laparoscopic resection of an adnexal mass between May 2007 and September 2013 at the Department of Obstetrics and Gynecology of Aichi Medical University Hospital, Nagakute, Japan, were reviewed retrospectively.
  
  
  METHODS
  We conducted a systematic review of the medical records of patients diagnosed post-operatively with ovarian malignancies and abstracted their demographic, clinical and pathologic data.
  
  
  RESULTS
  A total of 1128 adnexal masses were resected, and 13 patients (1.5%) had ovarian malignancies: 6 ovarian cancer (1 mucinous, 1 endometrioid G1, 1 granulosa cell and 3 carcinoid) and 7 borderline tumors (BOTs; 5 mucinous and 2 serous). Of these, two patients with mucinous BOTs underwent fertility-sparing surgery and six patients underwent staging laparotomy. Due to cyst rupture during surgery, nine patients (69.2%) were upgraded to tumor stage IC. Secondary surgeries were performed in eight patients, with a mean interval of 88.9 days (range, 39-182 days) between the surgeries. All patients were alive and without evidence of disease at follow-up (mean follow-up, 38 months; range, 6-80 months).
  
  
  CONCLUSIONS
  This was a retrospective study with a small case number and a short follow-up period.
  
  
  CONCLUSIONS
  The presence of an early-stage unexpected ovarian malignancy did not alter the patient's prognosis, even if there was a significant delay in surgical staging after the finding of an unexpected malignancy during laparoscopy.
  
  
  BACKGROUND
  No funding was obtained for this study and the authors report no conflicts of interest.
authors: Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan hirosm@aichi-med-u.ac.jp.
authors: H
authors: H
authors: Matsushita
authors: Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
authors: K
authors: K
authors: Watanabe
authors: Department of Diagnostic Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
authors: T
authors: T
authors: Yokoi
authors: Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
authors: A
authors: A
authors: Wakatsuki
mesh_terms: D000291:Adnexal Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: adnexal mass; laparoscopy; malignancy; ovary; prognosis