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.
Primary Language | English |
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Subjects | Health Care Administration |
Journal Section | Case Reports |
Authors | |
Publication Date | June 30, 2019 |
Acceptance Date | June 29, 2019 |
Published in Issue | Year 2019Volume: 41 Issue: 2 |