Preservation of fertility in non-Peutz–Jegher syndrome-associated ovarian sex cord tumour with annular tubules

Abstract

We report the successful conservative management of a non-Peutz-Jegher syndrome-associated ovarian sex cord tumour with annular tubules in a 32-year-old patient. The patient underwent a unilateral salpingo-oophorectomy by laparoscopy, and conceived spontaneously approximately 6 months after the diagnosis. After a normal term pregnancy, she underwent a contralateral laparoscopic salpingo-oophorectomy with hysterectomy. The patient is now on hormone replacement therapy and, after 30 months of follow-up, continues to present no sign of disease recurrence

Fertility Sparing Management in Non-Epithelial Ovarian Cancer. Which Patients, What Procedure and What Outcome?

“…15 patients achieved pregnancy after the operation 41. In the case of Sertoli-Leydig tumors and sex cord tumors with annular tubules there are not solid data about the pregnancy outcomes after conservative management but there are case reports which mention pregnancies achieved after fertility sparing operations 42, 43…”

Non-Peutz–Jeghers syndrome-associated ovarian sex cord tumor with annular tubules treated by radiotherapy: a case report and literature review

“…Therefore, the clinical manifestations of SCTAT are mainly associated with aberrant estrogen-progesterone secretion, such as irregular menstrual bleeding, postmenopausal bleeding, precocious puberty, premature ovarian failure, fibroadenoma, and endometriosis. 7 , 8 Serum estradiol and progesterone concentrations are usually elevated from disease onset, and decline dramatically after surgery. Concentrations may increase with tumor recurrence.…”

“…Therefore, the clinical manifestations of SCTAT are mainly associated with aberrant estrogen-progesterone secretion, such as irregular menstrual bleeding, postmenopausal bleeding, precocious puberty, premature ovarian failure, fibroadenoma, and endometriosis. 7,8 There are currently no standards for the treatment of SCTAT owing to its rarity; surgery is still the preferred treatment for affected patients. Recurrent tumors are generally ipsilateral to the primary tumor, and appear to spread mainly via the lymphatic route.…”

Approaches to the Diagnosis and Management of Ovarian Cancer in Pregnancy

“…There are several publications in the form of case studies that describe pregnancies after sparing surgeries. 41 , 42 Summing up, modern medicine makes it possible to perform fertility-preserving surgery even in more aggressive types of cancer. Based on the clinical staging and histopathology of the malignancy, chemotherapy is often required as a complementary treatment.…”