内視鏡下および開腹手術に至った卵巣腫瘍合併妊娠症例の検討

概要

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Objective It has been reported that an ovarian tumor is diagnosed during pregnancy in 0.21-1.24% of cases. Patients with ovarian tumor who underwent surgery in pregnancy from 2004 to 2008 were reviewed.Design During these 5-years, there were 3,837 deliveries in our hospital, and 16 of which underwent surgery due to an ovarian tumor. A retrospective analysis of these cases was performed.Results Laparoscopic surgery was performed in 9 patients, while the remaining 7 patients underwent open abdominal surgery. The tumor was determined to be malignant in 2 patients. The mean patient age at the time of surgery was 31.4 years, and the median number of gestational age at surgery was 16 weeks. The median value for the maximal tumor diameter was 9 cm. Overall, among the patients with ovarian tumors complicating their pregnancy, the pathological diagnosis was a mature cystic teratoma in 9 patients, which was the predominant type, followed by an endometriotic cyst in 3 patients and a malignant tumor in 2 patients. These malignant tumors consisted of an immature teratoma (G2) and a yolk sac tumor, and these patients are currently undergoing chemotherapy.Conclusion Patients should be examined for the possible presence of an ovarian tumor early in gestation. Once a tumor is present and indication of operation is judged to be appropriate, it is necessary to carefully determine the best time and method for the surgery in each individual patient.