Therapeutic management of uterine tumors resembling ovarian sex cord tumors: Systematic Review

Abstract

Objective: Uterine tumors resembling ovarian sex cord tumors (UTROSCTs) are extremely rare, and most cases have a benign clinical course. We report the first review of treatment and prognosis, including a focus on fertility. Methods: We conducted a systematic review of UTROSCT case reports and case series in English till June 2022 and compared initial treatment and recurrence rates. The following was extracted: age; symptom; initial therapy; metastasis at diagnosis; recurrence. Results: In total, 122 cases (61 articles) reporting the clinical course of UTROSCTs were analyzed. The median age at diagnosis was 50.0 years, and 26 (21.3%) patients were aged < 40 years. Most patients (n=103) underwent hysterectomy as the initial surgery, with a recurrence rate of 19.4% (n=20). Recurrence occurred in 29.4% (n = 5) of patients who underwent mass resection (n=17). Among the patients, 13 were under 40 years of age, seven had achieved pregnancy (53.8%), and six had successful deliveries (46.2%). Conclusion: While total hysterectomy is the recommended treatment for UTROSCTs based on recurrence rates, mass resection as fertility-preserving surgery is an acceptable treatment option for patients who desire childbearing.