Ovarian remnant syndrome: a retrospective evaluation of surgical management

Abstract

The objective of the study is to report on patient characteristics, surgical findings, pathology, and recurrence of ovarian remnants. This is a retrospective case series completed at an academic tertiary care hospital. Seventeen patients were identified between September 2005 and December 2015 with ovarian remnant syndrome using a diagnosis code search at one institution. All patients underwent surgical excision. Pathology confirmed ovarian tissue. Three recurrences were treated non-surgically. All patients had a history of endometriosis and previous surgeries. The average number of laparotomies, laparoscopies, and cesarean sections was 1.29 (range, 0–3), 2.47 (range, 0–6), and 0.59 (range, 0–3), respectively. Ten patients (58.8 %) had a prior bilateral salpingoophorectomy. Seven patients (41.2 %) had a prior unilateral salpingoophorectomy. Five patients (29.4 %) had one prior excision; two patients (11.8 %) had two prior excisions of their ovarian remnant. Fifteen excisions were performed laparoscopically and two with planned laparotomy. There were no intraoperative complications. All cases had pathologically confirmed ovarian tissue. Three patients had recurrent disease. Treatments included medical suppression, ovarian artery embolization, and radiation. Surgical expertise, often utilizing minimally invasive techniques, allows for the dissection needed to remove ovarian remnants. Recurrence is possible. Medical or other procedural treatments may be appropriate alternatives or adjuncts to treatment.