Clear-Cell Carcinoma Developing in Remnant Ovary After Hysterectomy and Bilateral Salpingo-Oophorectomy for Endometriosis

Abstract

Background: Ovarian remnant syndrome is a rare gynecologic complication, most induced by difficult bilateral salpingo-oophorectomy (BSO) with the residual ovarian tissue on the pelvic wall. The residual ovarian tissue may eventually cause malignant development with mostly endometrioid adenocarcinoma. This is the first report of a case with a primary ovarian clear cell carcinoma developing in the ovarian remnant. Case: A 48-year-old woman, gravida 2, para 2, developed a primary ovarian clear cell carcinoma diagnosed through a routine gynecologic examination 3 years and 5 months after total abdominal hysterectomy and BSO for endometriosis. Results: The patient received six additional courses of systemic chemotherapy and, as of this writing, is still receiving intensive care. Conclusions: On BSO after pelvic inflammatory disease, multiple previous surgery, or endometriosis, the possibility of ovarian remnant syndrome should be borne in mind, and particular care must be taken to prevent the development of pelvic masses. When managing pelvic masses suspected of malignancy after BSO, one must be aware of the possible role of endometriosis in the development of a malignancy. (J GYNECOL SURG 30:114)