Laparoscopical management ovarian early sex cord-stromal tumors in postmenopausal women: a proposal method.

BACKGROUND

Ovarian sex-cord stromal tumor (SCST) comprises 5% of the ovarian neoplasm; it occurs as an ovarian mass or hemoperitoneum, and the surgical management of SCST is not well defined at early stage and in adult patients.

PURPOSE OF THE STUDY: The authors tested to test the total not radical laparoscopic management of SCST in postmenopausal women at early stage.

METHODS

Three postmenopausal women were admitted in University-affiliated hospitals for pelvic pain, ovarian complex mass and genital bleeding. Preoperative clinical and instrumental examination suspected an ovarian tumor; therefore, a total laparoscopic approach was attempted. All patients underwent laparoscopic oophorectomy with the frozen section, who suggested for ovarian SCST; one woman received a total laparoscopic hysterectomy plus other oophorectomy, two received only the complementary oophorectomy, all without intensive surgical staging by with pelvic and para-aortic lymphadenectomy, appendectomy, peritoneal biopsies, and omentectomy.

RESULTS

All patients completed surgery without intrasurgical and postsurgical complications, with a fast dismissal. They are, currently, in long-term follow-up, with a 100% of survival after 3 years and with none morbility and morbidity.

CONCLUSIONS

In order to fast restore and preserve women's integrity, total laparoscopic approach of early SCST in adult age, without intensive radical staging, could be an appropriate clinical choice, since these tumors at slow growth, recurring locally and only a long time after initial treatment. This minimally invasive management could be suggested in association with a long-term follow-up, as possible "wait and see" postoperative option.