Case Reports
Uterine and Ovarian Conservation in Advanced Small Cell Carcinoma of the Ovary

https://doi.org/10.1016/S0029-7844(98)00025-8Get rights and content

Abstract

Background: The decision to recommend removal or conservation of a normal ovary and uterus in a young woman with advanced ovarian cancer is difficult and controversial.

Case: A 21-year-old patient with a large-cell variant of small-cell carcinoma of the ovary stage IIIc underwent optimal debulking surgery with preservation of the normal appearing uterus and opposite adnexa followed by aggressive multi-agent chemotherapy. She is menstruating normally and is free of disease, more than 2 years since completion of chemotherapy.

Conclusion: In selected cases, conservation of the uninvolved ovary and uterus in patients with advanced-stage, small-cell carcinoma of the ovary may not compromise survival.

Section snippets

Case

The patient was a 21-year-old white female, gravida 0, para 0, who presented with right lower quadrant abdominal pain of 2 weeks’ duration. A sonogram revealed a 12-cm solid right ovarian neoplasm. On March 23, 1995, she underwent a right oophorectomy at Onslow County Hospital for a 12.0 cm × 12.5 cm × 6.5 cm solid right ovarian neoplasm that was classified as malignant. The mass was ruptured in the process of removal through a Pfannenstiel incision. Tumor markers drawn 4 days postoperatively

Comment

The decision to recommend removal or conservation of a normal ovary and uterus in a young woman with advanced ovarian cancer is controversial and presents a difficult choice for the thoughtful gynecologic surgeon. The golden rule of pelvic surgery is the conservation of useful organ function provided it does not compromise the patient’s survival. Historically, this approach was considered only in young women with stage I invasive epithelial, borderline, and stromal- and germ-cell tumors with

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