title: [Transvaginal ultrasound-guided core needle biopsy for residual potentially malignant ovarian tumors in cases with severe peritoneal adhesion and frozen pelvis requiring polysurgery].
abstract: A multiparous woman in her 40s had advanced peritoneal adhesions and frozen pelvis from 3 previous surgeries. Endometrial ovarian cysts also remained. After the last surgery, imaging showed cysts with a septum and enhanced moieties in the Douglas pouch. Highly invasive surgery was anticipated, and the patient underwent a transvaginal ultrasound-guided core needle biopsy(TVCNB, 16-gauge needle)with full awareness of the risks involved. The histopathological diagnosis was adenocarcinoma. We inserted a ureteral stent and performed an S-shaped colon resection and standard ovarian cancer surgery after preoperative chemotherapy. TVCNB in this case was less invasive and easier to perform than other exploratory procedures, and has a low risk of iatrogenic intraperitoneal dissemination even if the tumor is malignant. Chemotherapy can be administered before surgery if malignancy is detected. In summary, TVCNB is a useful alternative method for conducting exploratory operations.
authors.affiliation: Dept. of Gynecology, Osaka City General Hospital.
authors.forename: Rie
authors.initials: R
authors.lastname: Kitayama
authors.forename: Minako
authors.initials: M
authors.lastname: Nishizawa
authors.forename: Reiko
authors.initials: R
authors.lastname: Tasaka
authors.forename: Ikuko
authors.initials: I
authors.lastname: Mita
authors.forename: Osamu
authors.initials: O
authors.lastname: Tokuyama
authors.forename: Masato
authors.initials: M
authors.lastname: Miyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawamura
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery; D062005:Biopsy, Large-Core Needle; D004312:Douglas' Pouch / Q000473:pathology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010388:Pelvis / Q000473:pathology* / Q000601:surgery
chemical_list: D007987:Gonadotropin-Releasing Hormone