Fabbri Raffaella, Vicenti Rossella, Paradisi Roberto, Rossi Stefania, De Meis Lucia, Seracchioli Renato, Macciocca Maria
a Gynecology and Physiopathology of Human Reproductive Unit , University of Bologna, S. Orsola-Malpighi Hospital of Bologna , Bologna , Italy.
Gynecol Endocrinol. 2018 Jul;34(7):558-562. doi: 10.1080/09513590.2017.1423468. Epub 2018 Jan 10.
In this case report, the outcomes of cryopreserved ovarian tissue transplantation performed in a patient affected by struma-ovarii associated with mature cystic teratoma, recurrent endometriotic cysts and diffuse peritoneal malignant struma-ovarii implants were described. Before cryopreservation, the patient underwent two left ovarian surgeries for enucleation cysts 8 years after righ salpingo-oophorectomy for struma-ovarii. Ovarian biopsy was collected in another hospital and transported to our laboratory for cryopreservation. The patient was submitted to radioiodine-therapy for metastases from malignant struma-ovarii. After treatment she experienced premature ovarian failure. Ten years after cryopreservation, a first orthotopic transplantation was performed in the left ovary and in a peritoneal pocket. Before transplantation, ovarian samples were analyzed to assess neoplastic contamination and tissue quality. Three years later, a second transplantation was heterotopically performed in abdominal subcutaneous sites. The analysis on thawed ovarian tissue did not reveal micrometastasis and they showed follicle and stroma damages. After transplantation few small follicles were observed at ultrasound examination and hormonal levels remained at menopausal values. To date no ovarian function recovery has been observed. The report highlights that ovarian tissue cryopreservation after multiple ovarian surgery may have some limitations. An accurate counseling should be offered to patients who wish to preserve fertility.
在本病例报告中，描述了对一名患有卵巢甲状腺肿并伴有成熟囊性畸胎瘤、复发性子宫内膜异位囊肿和弥漫性腹膜恶性卵巢甲状腺肿种植转移的患者进行冷冻保存卵巢组织移植的结果。在冷冻保存之前，该患者在因卵巢甲状腺肿行右侧输卵管卵巢切除术后8年，接受了两次左侧卵巢囊肿剥除手术。卵巢活检组织在另一家医院采集，并转运至我们实验室进行冷冻保存。该患者因恶性卵巢甲状腺肿转移接受了放射性碘治疗。治疗后，她出现了卵巢早衰。冷冻保存10年后，首次在左侧卵巢和一个腹膜囊袋中进行了原位移植。移植前，对卵巢样本进行分析以评估肿瘤污染情况和组织质量。三年后，在腹部皮下部位进行了第二次异位移植。对解冻后的卵巢组织分析未发现微转移，且显示有卵泡和基质损伤。移植后，超声检查观察到少量小卵泡，激素水平维持在绝经状态。迄今为止，未观察到卵巢功能恢复。该报告强调，多次卵巢手术后进行卵巢组织冷冻保存可能存在一些局限性。对于希望保留生育能力的患者，应提供准确的咨询服务。
