Seracchioli R, Mabrouk M, Solfrini S, Savelli S, Caprara G, Facchini C, Geraci E, Del Forno S, Venturoli S
Minimally Invasive Gynecological Surgery Center, Gynecology and Reproductive Medicine Unit, University of Bologna, Bologna, Italy.
Case Rep Oncol. 2010 Nov 24;3(3):428-433. doi: 10.1159/000322204.
We report a case of female adnexal tumor of Wolffian origin (FATWO), a rare neoplasm arising from the mesonephric ducts. A 48-year-old woman came first to our center for a recent discovery of a pelvic mass. Transvaginal ultrasonographic findings suggested a solid right para-ovarian mass suspected to be malignant. After thorough counseling, the patient underwent operative laparoscopy for excision of the para-ovarian mass with frozen section (FS) examination resulting in the diagnosis of a poorly differentiated adenocarcinoma. In this case, FS results allowed performing a comprehensive oncological staging, through a totally laparoscopic extrafascial hysterectomy, bilateral adnexectomy, total omentectomy, pelvic wall peritonectomy, and pelvic, parasacral and para-aortic lymphadenectomy. Final pathological and immunohistochemical results confirmed the diagnosis of FATWO. To our knowledge, this is the first case of FATWO managed entirely by a minimally invasive laparoscopic approach in a single surgical session.
我们报告一例源自中肾管的女性肾上腺皮质起源肿瘤（FATWO），这是一种罕见的肿瘤，起源于中肾管。一名48岁女性首次因近期发现盆腔肿块前来我们中心就诊。经阴道超声检查结果提示右侧卵巢旁实性肿块，怀疑为恶性。经过充分的咨询后，患者接受了腹腔镜手术，切除卵巢旁肿块并进行冰冻切片（FS）检查，结果诊断为低分化腺癌。在本病例中，FS结果使得能够通过全腹腔镜筋膜外子宫切除术、双侧附件切除术、全大网膜切除术、盆腔壁腹膜切除术以及盆腔、骶旁和腹主动脉旁淋巴结切除术进行全面的肿瘤分期。最终的病理和免疫组化结果证实了FATWO的诊断。据我们所知，这是首例在单次手术中完全通过微创腹腔镜方法治疗的FATWO病例。
