Department of Gynaecology, Wuxi Maternity and Child Health Care Hospital, Affiliated Women's Hospital of Jiangnan University, Jiangsu, 214002, China.
BMC Womens Health. 2023 Oct 27;23(1):559. doi: 10.1186/s12905-023-02695-4.
Ovarian remnant syndrome (ORS) is a rare complication that occurs after oophorectomy, characterized by residual ovarian tissue causing pelvic pain, masses, and various symptoms. The clinical manifestations of ORS are nonspecific, and its diagnosis relies on histological examination. Since ORS typically represents a benign ovarian lesion, there have been few reported cases of malignant transformation. In this report, we presented a unique case of ovarian clear cell carcinoma (OCCC) arising from an ovarian remnant following salpingo-oophorectomy.
Our patient was a 47-year-old female initially diagnosed with uterine myoma. She had previously undergone cesarean section and unilateral salpingo-oophorectomy. Transvaginal ultrasound and computed tomography (CT) scans revealed a soft tissue mass adjacent to the right lateral wall of the myometrium. The patient opted for transabdominal hysterectomy, left adnexal resection, laparoscopic omentectomy, appendectomy, and pelvic and abdominal lymphadenectomy. The final pathology results confirmed the diagnosis of OCCC, consistent with ORS. The patient subsequently received six cycles of intravenous chemotherapy using the carboplatin/paclitaxel (TC) regimen (paclitaxel liposomes 175 mg/m², carboplatin AUC 5). After 3 years of follow-up, the patient's condition remained normal.
ORS can significantly impact patients' quality of life and pose challenges for clinicians. Complete excision of ovarian tissue during the initial surgery is crucial in preventing ORS recurrence and potential malignant transformation of ovarian remnants.
卵巢残馀症候群（ORS）是一种罕见的在卵巢切除术后发生的并发症，其特征为残留的卵巢组织导致盆腔疼痛、肿块和各种症状。ORS 的临床表现是非特异性的，其诊断依赖于组织学检查。由于 ORS 通常代表良性卵巢病变，恶性转化的报道病例较少。在本报告中，我们提出了一个独特的卵巢透明细胞癌（OCCC）病例，该病例起源于单侧输卵管卵巢切除术后的卵巢残馀。
我们的患者是一名 47 岁女性，最初诊断为子宫肌瘤。她曾行剖宫产术和单侧输卵管卵巢切除术。经阴道超声和计算机断层扫描（CT）显示子宫肌层右侧外侧壁附近有一个软组织肿块。患者选择行经腹子宫切除术、左侧附件切除术、腹腔镜网膜切除术、阑尾切除术和盆腔及腹部淋巴结切除术。最终的病理结果证实为 OCCC，符合 ORS。患者随后接受了六周期的卡铂/紫杉醇（TC）方案静脉化疗（紫杉醇脂质体 175mg/m²，卡铂 AUC 5）。随访 3 年后，患者情况正常。
ORS 会显著影响患者的生活质量，并对临床医生构成挑战。在初次手术中彻底切除卵巢组织对于预防 ORS 复发和卵巢残馀恶性转化至关重要。
