Laparoendoscopic single-site oophorectomy for a right ovarian borderline serous tumor of stage IC2, a literature review

Abstract

Background: Ovarian cancer represents approximately 30% of all female reproductive organ cancers and is the leading cause of death for gynecological cancer in the United States. Borderline ovarian tumors comprise approximately 15-20% of all epithelial ovarian tumors and within that group, serous borderline ovarian tumors comprise 53%. Serous borderline tumors (SBT) display atypical epithelial proliferation of serous type cells, outnumbering benign epithelial cells but have a low malignancy potential (borderline). By definition SBT has no gross stromal invasion but it can be subcategorized to those with or without microinvasion. Carcinomas make up 90% of ovarian tumors and differentiating between the distinct types of tumors via unique features is important for treatment. Case:The patient was a 29-year-old G0P0, who presented to our clinic for evaluation of intermenstrual bleeding. Upon physical exam, a palpable, 5cm x 4cm non-tender, mobile mass in the right adnexa was noted. Pelvic ultrasound revealed a 4.9cm x 3.7cm hypoechoic mass in the right adnexa. The mass was noted to be heterogeneous with smooth borders and a preliminary diagnosis of ovarian cystadenoma was made. The patient in this case presented with a stage 1C2 ovarian cancer and was treated with single incision laparoscopic surgery (SILS) right salpingo-oophorectomy. Conclusion:Ovarian cancer is the leading cause of gynecological cancers in women in the US and early diagnosis/staging is important in predicting progression-free survival. Instead of laparotomy, we utilized single-incision laparoscopic surgery to drain the patient's pelvic effusion and excise the right ovary and fallopian tube, which revealed an ovarian borderline serous tumor. This technique was conservative and fertility-sparing because it left the uterus, left ovary and left fallopian tube.