Yousefi Zohreh, Khalilifar Hekmat, Jafarian Amir Hosein, Davachi Behrouz, Mousavi Seresh Leila, Babapour Nooshin, Shirinzadeh Laya, Baradaran Mina
Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Kosar IVF Center, Mashhad, Iran.
Int J Reprod Biomed. 2018 Jun;16(6):417-420.
Ovarian superovulation and increased follicle-stimulating hormone concentration for infertility treatment may be the risk factors of developed granulosa-cell tumor. The aim of this report is to introduce a case of granulosa-cell tumor which was discovered after ovarian stimulation.
A 31-yr-old woman with clinical presentation of massive abdominal distention was referred to the gynecology and oncology department of an academic hospital, Mashhad University of Medical Sciences in Aug 2017. She had the history of secondary infertility and was undergoing In Vitro Fertilization protocol and ovarian stimulation, but, the cycle was canceled. The patient suffered from gradual abdominal distention one month after the end of IVF procedure despite pregnancy failure. 2-3 months after management of the ovarian hyperstimulation syndrome, investigation revealed large ovarian mass and increased tumor marker inhibin. Exploratory laparotomy was performed and revealed stage III ovarian cancer. The final pathology report indicated juvenile granulosa cell tumor. So, optimal surgical staging and cytoreductive surgery without fertility preserving were perfumed. Chemotherapy was recommended due to the advanced stage of ovarian cancer. Unfortunately, she experienced metastatic diseases in pelvic and abdomen in less than six months; and currently is receiving the second and third line chemotherapy.
Persistent ovarian enlargement or ascites during or after infertility treatment should be carefully considered and managed.
用于不孕症治疗的卵巢超排卵和促卵泡激素浓度升高可能是颗粒细胞瘤发生的危险因素。本报告的目的是介绍一例在卵巢刺激后发现的颗粒细胞瘤病例。
一名31岁女性，临床表现为腹部大量膨隆，于2017年8月转诊至马什哈德医科大学学术医院的妇科和肿瘤科。她有继发性不孕症病史，正在接受体外受精方案和卵巢刺激，但该周期被取消。尽管体外受精程序结束后一个月患者未受孕，但仍出现了逐渐加重的腹部膨隆。在处理卵巢过度刺激综合征2 - 3个月后，检查发现卵巢有大肿块且肿瘤标志物抑制素升高。进行了剖腹探查，结果显示为III期卵巢癌。最终病理报告显示为青少年颗粒细胞瘤。因此，进行了最佳分期手术和减瘤手术，未保留生育功能。由于卵巢癌处于晚期，建议进行化疗。不幸的是，她在不到6个月的时间里出现了盆腔和腹部转移；目前正在接受二线和三线化疗。
在不孕症治疗期间或之后，应仔细考虑并处理持续存在的卵巢肿大或腹水情况。
