不妊治療中に発見し腹腔鏡下手術後に生児を得た卵巣性索間質性腫瘍の2例

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Two cases with ovarian sex cord stromal tumors and successful pregnancy outcomes after laparoscopic surgery for infertility are described. Case 1 was a 33-year-old primipara with a history of ovulation induction for the first pregnancy. The evaluation for secondary amenorrhea after the birth demonstrated an elevated level of estradiol (161 pg/ml) and a decreased level of FSH and LH. A solid tumor of the left ovary, 2.5 cm in a diameter, was detected by trans-vaginal ultrasonography and MRI. A left salpingo-oophorectomy was performed laparoscopically. The histology of the tumor was a sex cord tumor with annular tubules. The patient conceived 9 months after the surgery and delivered a second baby. There has been no tumor recurrence for 4 years. Case 2 was a 33-year-old nullipara. She had a 4 year history of infertility and 2 years of amenorrhea. The testosterone level was elevated (297 ng/dl), but no adrenal massed were detected on CT scan. A solid tumor of the right ovary, 3 cm in a diameter, was detected by trans-vaginal ultrasonography and MRI, and removed laparoscopically. The histology of the tumor was a stromal Leydig cell tumor. She conceived spontaneously 3 months post-operatively and delivered a baby uneventfully. These tumors were both small; however, the MRI finding ( a solid mass surrounded by small follicles) was very helpful in establishing an accurate diagnosis, and laparoscopic surgery was quite useful for prompt recovery of fertility.
日本産科婦人科内視鏡学会の論文
2009-09-01

不妊治療中に発見し腹腔鏡下手術後に生児を得た卵巣性索間質性腫瘍の2例

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