Pregnancy after conservative surgical treatment of ovarial mucinous adenocarcinoma

Abstract

Background. Epithelial ovarian cancer (EOC) accounts for 25% of all malignancies in the female genital tract and it is the most common cause of death among women who develop gynecologic malignancies. According to recent reports at least 20% of EOC are diagnosed at stage I of the disease. Because women tend to give birth to their first child at an older age, and due to the usage of more sensitive diagnostic procedures, the diagnosis of EOC during reproductive age has become more frequent. Therefore, the demand for fertility-sparing surgery in early-stage of EOC is increased. Case report. We presented the case of accomplished reproduction at 41 after the conservative treatment of mucinous ovarian cancer. In the absence of a complete surgical staging, her decision was to spare her fertility capacities opposed to the treatment recommendations of the oncological council. The bottom-line of this report was to give its contribution to the ongoing controversies in the decision to recommend the conservative surgical treatment of the EOC and also to reveal the need of reconsideration of the necessity of a complete surgical staging in patients with stage I of mucinous ovarian cancer. Conclusion. The profile of EOC cases in which a conservative surgical approach is the appropriate one has not yet been defined. Correct surgical staging is still an indispensable guideline for that kind of clinical decision. In the case of stage I of mucinous ovarian cancer with the low tumor grade, the necessity of a complete surgical staging should be reconsidered.Uvod. Epitelni ovarijalni karcinomi (EOK) cine 25% svih malignih oboljenja zenskog genitalnog trakta i najcesci su uzrok smrti medju zenama obolelim od maligne bolesti genitalnog trakta. Prema dosadasnjim saopstenjima, bar 20% EOK dijagnostikuje se u stadijumu I bolesti. Usled tendencije da zene danas radjaju svoje prvo dete u poznijim reproduktivnim godinama i vece dostupnosti razlicitih dijagnostickih metoda, dijagnoza EOK pre ostvarivanja reprodukcije postaje sve cesca. Shodno tome, sve su veci zahtevi za hirurgijom ocuvanja fertiliteta u ranim stadijumima EOK. Prikaz bolesnice. Prikazali smo slucaj ostvarivanja reprodukcije u 41. godini zivota nakon konzervativnog lecenja mucinoznog adenokarcinoma ovarijuma prema odluci bolesnice, suprotno lecenju koje je predlozio Konzilijum za ginekologiju u odsustvu kompletnog hirurskog stadiranja. Prodiskutovani su kriterijumi za donosenje odluke o konzervativnom hirurskom lecenju EOK i razmotrena neophodnost kompletiranja hirurskog stadiranja kod bolesnica sa stadijumom I mucinoznog adenokarcinoma. Zakljucak. Jos uvek nisu precizno definisani slucajevi EOK kod kojih je moguce primeniti konzervativni hirurski tretman. Preduslov za donosenje ovakve odluke je adekvatno hirursko stadiranje. Kod mucinoznog adenokarcinoma stadijuma I bolesti, niskog gradusa tumora, mogla bi se razmotriti neophodnost kompletiranja hirurskog stadiranja.