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Hum. Reprod. Advance Access originally published online on April 22, 2004
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Human Reproduction, Vol. 19, No. 6, 1472-1475, June 2004
© 2004 European Society of Human Reproduction and Embryology

Evolutive peritoneal disease after conservative management and the use of infertility drugs in a patient with stage IIIC borderline micro-papillary serous carcinoma (MPSC) of the ovary: Case report

Erkut Attar1,4, Sinan Berkman2, Samet Topuz2, Bulent Baysal1, Suleyman Akhan2 and Joseph T. Chambers3

1 Division of Reproductive Endocrinology and Infertility and 2 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Istanbul University, School of Medicine, 34093 Istanbul, Turkey and 3 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, St. Luke’s-Roosevelt Hospital Center, New York, NY 10019, USA

4 To whom correspondence should be addresssed. e-mail: attar{at}superonline.com

A young nulliparous woman with stage IIIC bilateral borderline micro-papillary serous carcinoma (MPSC) of the ovary underwent conservative surgery with optimal preservation of future fertility. The left ovary and a substantial portion of the right ovary were removed. The patient became pregnant at the first IVF cycle attempted after conservative management. A Cesarean section was performed in the 37th week of pregnancy and combined with very precise exploration; there were multiple non-invasive implants on the peritoneal surface and liver, and contra-lateral ovarian tissue was of normal appearance. Abdominal hysterectomy and right oophorectomy were done as a definitive treatment 3 months after the Caesarean section. The patient showed a rapid progression to invasive ovarian carcinoma in this period of time. MPSC has the greatest risk of malignant transformation among the advanced stage serous borderline tumours. Fertility-sparing surgery is an option for young, childless women who would like to preserve their fertility. However, the treatment must be taken very cautiously and requires rigorous surveillance.

Key words: borderline ovarian tumour/conservative surgery/fertility


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