Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
Gynecol Obstet Invest. 2013;75(4):250-4. doi: 10.1159/000349894. Epub 2013 Mar 28.
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.
腹腔镜附件切除术是治疗卵巢肿瘤最常用的手术技术之一。然而，许多医生发现很难在不破裂卵巢肿瘤的情况下进行切除，特别是在肿瘤粘连的情况下。在我们报告的病例中，我们意外地遇到了一个附着在骨盆侧壁上的卵巢肿瘤。由于不能完全排除恶性肿瘤的可能性，我们决定同时切除卵巢及其附着的腹膜，以避免因操作而导致任何潜在的肿瘤破裂。我们成功地通过腹腔镜取出了完整的卵巢肿瘤，没有破裂。病理诊断为双侧卵巢 2 级、FIGO 分期 IIb 型子宫内膜样腺癌。由于这一诊断，我们进行了全面的分期腹腔镜检查。辅助化疗完成后，患者在 3 年后未出现恶性肿瘤复发迹象。本病例报告描述了我们对附着在骨盆壁上的卵巢肿瘤的手术治疗技术。为了避免肿瘤内容物溢出，同时切除肿瘤及其附着的腹膜是一种有用的方法。
