Oh Ha Kyung, Park Seong Nam, Kim Byoung Ryun
Department of Obstetrics and Gynecology, Wonkwang University Hospital, Iksan 54645, Jeollabuk-do, South Korea.
World J Clin Cases. 2021 May 6;9(13):3212-3218. doi: 10.12998/wjcc.v9.i13.3212.
Endodermal sinus tumors (ESTs), which arise primarily in children and adolescents, account for 20% of malignant ovarian germ cell tumors, but constitute only 1% of all ovarian malignancies. Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.
A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital. Exploratory laparotomy; total abdominal hysterectomy, right salpingo-oophorectomy, and lymphadenectomy were performed with optimal debulking, and surgical stage 3C was assigned to the patient.
In 2014, the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue. Furthermore, the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor. This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.
内胚窦瘤（ESTs）主要发生于儿童和青少年，占卵巢恶性生殖细胞肿瘤的20%，但仅占所有卵巢恶性肿瘤的1%。ESTs的治疗包括保留生育功能的手术分期和化疗。
一名15岁未育患者在另一家医院因使用未封闭的动力旋切术治疗破裂的实性附件包块而接受腹腔镜单侧输卵管卵巢切除术后，被诊断为播散性卵巢ESTs。进行了剖腹探查术；行全腹子宫切除术、右侧输卵管卵巢切除术和淋巴结清扫术，达到最佳减瘤效果，患者被分期为手术3C期。
2014年，美国食品药品监督管理局指出，动力旋切术可能与播散可疑癌组织的风险相关。此外，由于存在恶性肿瘤的可能性，使用动力旋切术切除实性附件包块被视为禁忌。本病例报告旨在警示使用未封闭的动力旋切术治疗实性附件包块的危险性。
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