Abstract
References
- 1. Nick AM, Schmeler K. Adnexal masses in pregnancy. Perinatology 2010; 1: 13- 9.
- 2. Roberts CL, Weston MJ, Bilateral massive ovarian edema: a case report. Ultrasound Obstet Gynecol 1998;11:65-7.
- 3. Studzinski , Filipczak A, Branicka D. Coexistence of ovarian epithelial tumor of borderline malignancy with pregnancy: a case report. Ginekol Pol. 1999;70(2):101-4.
- 4. Giuntoli RL 2nd, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol 2006; 49: 492.
- 5. Schmeler KM, Mayo-Smith WW, Peipert JF, et al. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 2005; 105:1098.
- 6. Sivanesaratnam V. Gynaecological malignancies in pregnancy. Rev Gynaecol Pract 2004; 4(3): 162-8.
- 7. Bakri YN, Ezzat A. Malignant germ cell tumors of the ovary. Pregnancy considerations. Eur J Obstet Gynecol Reprod Biol 2000; 90:87.
- 8. Dudkiewicz J, Kowalski T, Grzonka D, Czarnecki M. Ovarian tumors in pregnancy. Ginekol Pol. 2002;73(4):342-5.
- 9. Mendivil AA, Brown III JV, Abaid LN, Rettenmaier MA, Micha JP, Wabe MA, et al. Robotic-assisted surgery for the treatment of pelvic masses in pregnant patients: A series of four cases and literature review. Journal of Robotic Surgery 2013; 7: 333-337.
- 10. Leiserowitz GS. Managing ovarian masses during pregnancy. Obstet Gynecol Surv. 2006;61(7):463-70.
- 11. Gershenson DM, del Junco G, Silva EG, Copeland LJ, Wharton JT, Rutledge FN. Immature teratoma of the ovary. Obstet Gynecol 1986; 68: 624-9.
- 12. Mourali M, Ben Haj Hassine A, El Fekih C, EssoussiChikhaoui J, Binous N, Ben Zineb N, et al. Immature teratoma of the ovary and pregnancy. (In French). Tunis Med 2010; 88: 507-12.
- 13. Mangili G, Scarfone G, Gadducci A, Sigismondi C, Ferrandina G, Scibilia G, et al. Is adjuvant chemotherapy indicated in stage I pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9). Gynecol Oncol 2010; 119: 48-52.
- 14. Pectasides D, Pectasides E, Kassanos D. Germ cell tumors of the ovary. Cancer Treat Rev 2008; 34: 427-41
Abstract
Objective: The most common genital neoplasms in the
reproductive period are over tumors. Limitation of radiological examinations
done during pregnancy and the concentration of the examination on the fetus in
general may lead to missed malignancies. The purpose of the study is to discuss
the approach to adnexal masses seen in pregnancy.
Case: A 26-year-old woman with a 39-week
gestation had a groin pain. CA125 value: 60 U / ml, CA19-9: 385,5 U / ml, AFP:
115,1 U / ml. After birth with C / S, the right ovary was observed to have a
mass of approximately 15 cm It was followed. The mass was excised and a frozen section
was sent. It was reported to be compatible with the resultant mature teratoma.
Upon reporting the final pathologic outcome as immature teratoma grade 1, post-operative
positron emission tomography (PET-CT) imaging and tumor marker screening were
planned. PET CT imaging and tumor markers were negative.
Conclusions: 90% of adnexal masses below 6 cm are
functional cysts between the 16-18th gestational weeks. They usually fall back
on their own. Malignancy rate after operation is 4-6% in persistent. Except for
the presence of acute symptoms or the suspicion of serious malignancy; Surgical
intervention should be postponed to the middle of the 2nd trimester (16-18th week).
The presence of ovarian cysts with symptomatic ovarian mass presence,
overtorsion, overcyst rupture, acute abdomen, diffuse ascites, rapid growth
pattern in pregnancy requires urgent surgical intervention. Frozen section
should be sent during the operation if surgical intervention is required. The frozen section
determines intraoperative behavior. The number of cross sections during frozen
process is limited. In frozen conditions, as many as three sections can be
taken in the laboratory, large-diameter tumors have a higher rate of false
diagnosis in the frozen specimen. As in this case, inadequate sampling leads to
false negative results in borderline and malign lesions showing focal
development. Although this delay in diagnosis causes adjuvant delay in
treatment, ovarian cancer that is detected in pregnancy is usually over-limited
(stage 1), so the outcome is not badly affected. Most of them are germ cell
tumors and low malignant potential epithelial tumors. It usually shows early
stage, low grade, unilaterality. Often, unilateral oophorectomy and surgical
staging are sufficient.
References
- 1. Nick AM, Schmeler K. Adnexal masses in pregnancy. Perinatology 2010; 1: 13- 9.
- 2. Roberts CL, Weston MJ, Bilateral massive ovarian edema: a case report. Ultrasound Obstet Gynecol 1998;11:65-7.
- 3. Studzinski , Filipczak A, Branicka D. Coexistence of ovarian epithelial tumor of borderline malignancy with pregnancy: a case report. Ginekol Pol. 1999;70(2):101-4.
- 4. Giuntoli RL 2nd, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol 2006; 49: 492.
- 5. Schmeler KM, Mayo-Smith WW, Peipert JF, et al. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 2005; 105:1098.
- 6. Sivanesaratnam V. Gynaecological malignancies in pregnancy. Rev Gynaecol Pract 2004; 4(3): 162-8.
- 7. Bakri YN, Ezzat A. Malignant germ cell tumors of the ovary. Pregnancy considerations. Eur J Obstet Gynecol Reprod Biol 2000; 90:87.
- 8. Dudkiewicz J, Kowalski T, Grzonka D, Czarnecki M. Ovarian tumors in pregnancy. Ginekol Pol. 2002;73(4):342-5.
- 9. Mendivil AA, Brown III JV, Abaid LN, Rettenmaier MA, Micha JP, Wabe MA, et al. Robotic-assisted surgery for the treatment of pelvic masses in pregnant patients: A series of four cases and literature review. Journal of Robotic Surgery 2013; 7: 333-337.
- 10. Leiserowitz GS. Managing ovarian masses during pregnancy. Obstet Gynecol Surv. 2006;61(7):463-70.
- 11. Gershenson DM, del Junco G, Silva EG, Copeland LJ, Wharton JT, Rutledge FN. Immature teratoma of the ovary. Obstet Gynecol 1986; 68: 624-9.
- 12. Mourali M, Ben Haj Hassine A, El Fekih C, EssoussiChikhaoui J, Binous N, Ben Zineb N, et al. Immature teratoma of the ovary and pregnancy. (In French). Tunis Med 2010; 88: 507-12.
- 13. Mangili G, Scarfone G, Gadducci A, Sigismondi C, Ferrandina G, Scibilia G, et al. Is adjuvant chemotherapy indicated in stage I pure immature ovarian teratoma (IT)? A multicentre Italian trial in ovarian cancer (MITO-9). Gynecol Oncol 2010; 119: 48-52.
- 14. Pectasides D, Pectasides E, Kassanos D. Germ cell tumors of the ovary. Cancer Treat Rev 2008; 34: 427-41
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | June 30, 2019 |
| Acceptance Date | June 29, 2019 |
| Published in Issue | Year 2019 |