Hasegawa Akiko, Koga Kaori, Asada Kayo, Wada-Hiraike Osamu, Osuga Yutaka, Kozuma Shiro
Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.
J Obstet Gynaecol Res. 2013 Dec;39(12):1610-3. doi: 10.1111/jog.12107. Epub 2013 Jul 22.
Ovarian fibroma can occur in young women of reproductive age. Despite its benign feature, most surgical removals are done in open surgery with oophorectomy. However, an ovarian-sparing tumor resection can be an option, especially for an exophytic type of fibroma, which accounts for more than half of ovarian fibromas. Here we report a case of exophytic ovarian fibroma in a young woman treated by laparoscopic ovarian-sparing surgery. A 27-year-old woman presented with a pelvic mass. Magnetic resonance imaging revealed an 11 cm × 8 cm solid mass connected to the normal-appearing left ovary by a pedicle-like structure. A clinical diagnosis of an exophytic ovarian fibroma was made, and laparoscopic ovarian-sparing surgery with an intraoperative pathological examination was planned. The tumor was resected by cutting the pedicle, morcellated in a pouch and removed. All procedures were performed laparoscopically and the affected ovary was completely preserved. Having confirmation of its benign characteristics by the intraoperative examination, no further excision was performed. The patient conceived 3 months after the surgery and no recurrence was reported. We propose that gynecologists should consider laparoscopic ovarian-sparing surgery for exophytic ovarian fibroma in women of reproductive age.
卵巢纤维瘤可发生于育龄期年轻女性。尽管其具有良性特征,但大多数手术切除是通过开放性手术并进行卵巢切除术完成的。然而,保留卵巢的肿瘤切除术也是一种选择,特别是对于外生性纤维瘤,这种类型占卵巢纤维瘤的一半以上。在此,我们报告一例年轻女性外生性卵巢纤维瘤经腹腔镜保留卵巢手术治疗的病例。一名27岁女性因盆腔肿块就诊。磁共振成像显示一个11厘米×8厘米的实性肿块,通过蒂状结构与外观正常的左卵巢相连。临床诊断为外生性卵巢纤维瘤,并计划进行腹腔镜保留卵巢手术及术中病理检查。通过切断蒂部切除肿瘤,在袋中切碎并取出。所有操作均在腹腔镜下进行,患侧卵巢得以完全保留。术中检查证实其具有良性特征后,未进一步切除。患者术后3个月受孕,未报告复发情况。我们建议妇科医生应考虑为育龄期女性的外生性卵巢纤维瘤行腹腔镜保留卵巢手术。