Abstract
Background: Approximately 11% of cancer cases are diagnosed in people of childbearing age. Borderline ovarian tumors (BOTs) make up 10%-15% of all ovarian epithelial malignancies. More than one-third of all BOTs occur in women under 40 years of age. Maintaining the fertility of cured patients is the common goal of both oncologists and reproductologists. Aim: Giving young women diagnosed with a prognostically worse type of BOT and after bilateral adnexectomy the possibility to have their genetically own children by the method of ex vivo oocyte collection. Case Presentation: A 34-year-old nulligravid woman with BOT underwent right laparoscopic salpingo-oophorectomy. Histologically, a serious borderline tumor with a micropapillary pattern and a tumor locus on the ovarian surface were found. Due to histopathology, the oncologist recommended re-staging surgery: laparotomy, left salpingo-oophorectomy, omentectomy and hysterectomy. The patient refused a hysterectomy as she was planning to get pregnant with her partner. To maintain her fertility, controlled hormonal hyperstimulation and ex vivo aspiration of follicles from the ovary after salpingo-oophorectomy was performed. Ex vivo follicle expiration yielded 10 oocytes. 9 mature oocytes were fertilized by ICSI. The 6 embryos of the highest quality were individually frozen by vitrification. Cryoembryotransfer will be scheduled with the consent of the oncologist. Conclusion: This method is suitable for young women with BOT after bilateral salpingo-oophorectomy in whom ex vivo oocyte collection prevents possible leakage of tumor cells into the abdominal cavity, unlike during the conventional in vivo collection prior to surgery.
Highlights
Every year, more than 200,000 malignancies are diagnosed in women and men under the age of 45
This method is suitable for young women with Borderline ovarian tumors (BOTs) after bilateral salpingo-oophorectomy in whom ex vivo oocyte collection prevents possible leakage of tumor cells into the abdominal cavity, unlike during the conventional in vivo collection prior to surgery
Surgery is the primary treatment for BOTs, as in the treatment of malignant ovarian cancer, hysterectomy, bilateral salpingo-oophorectomy, omentectomy, peritoneal lavage with multiple biopsies, and appendectomy are standard procedures
Summary
More than 200,000 malignancies are diagnosed in women and men under the age of 45. In an effort to help the young people, who were successfully treated for cancer, to have their genetically own children, the medical subspecialization “oncofertility” has been created. Borderline ovarian tumors (BOTs) account for 10% - 15% of all ovarian epithelial malignancies Their annual prevalence in Europe is approximately 4.8/100,000 new cases. Surgery is the primary treatment for BOTs, as in the treatment of malignant ovarian cancer, hysterectomy, bilateral salpingo-oophorectomy, omentectomy, peritoneal lavage with multiple biopsies, and appendectomy (in the case of mucinous BOT) are standard procedures. The method is suitable for young women in whom bilateral salpingo-oophorectomy for BOTs is indicated and where ex vivo collection of oocytes prevents possible leakage of. Tumor cells into the abdominal cavity during conventional in vivo collection before surgery [10]
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