Military medicine · 2015
Laparoscopic staging of ovarian immature teratomas: a report on three cases.
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Brown Kaessee L, Barnett Jason C, Leath Charles A
Аннотация
BACKGROUND: Ovarian malignant germ cell tumors (MGCT) tend to occur in younger women and are amenable to fertility sparing surgery. Traditionally, most ovarian cancers are staged via laparotomy; however, laparoscopy is a potential alternative to laparotomy for surgical staging in malignant germ cell tumors.
CASE: Three patients with immature teratoma were surgically staged with laparoscopy over a 1-year period at our institution. All patients underwent an initial surgery, unilateral salpingo-oophorectomy, for a complex adnexal mass that demonstrated immature teratoma on final pathology. Laparoscopic surgical staging was performed for all patients, with peritoneal and omental biopsies and pelvic and para-aortic lymph node dissection. Two patients with Stage IA disease secondary to negative biopsies and lymph nodes were observed. One patient was found to have omental disease; she underwent chemotherapy and remains in remission. As of last follow-up, no recurrences have been documented.
CONCLUSION: Laparoscopic surgical staging of immature teratomas discovered occult disease in one case allowing for appropriate treatment decisions based on minimally invasive surgical findings. Laparoscopy represents a viable, and potentially preferable, option for surgical staging in patients with immature teratoma not initially diagnosed on frozen section. Determination of adequacy of laparoscopic staging needs long-term surveillance and outcome results.
CASE: Three patients with immature teratoma were surgically staged with laparoscopy over a 1-year period at our institution. All patients underwent an initial surgery, unilateral salpingo-oophorectomy, for a complex adnexal mass that demonstrated immature teratoma on final pathology. Laparoscopic surgical staging was performed for all patients, with peritoneal and omental biopsies and pelvic and para-aortic lymph node dissection. Two patients with Stage IA disease secondary to negative biopsies and lymph nodes were observed. One patient was found to have omental disease; she underwent chemotherapy and remains in remission. As of last follow-up, no recurrences have been documented.
CONCLUSION: Laparoscopic surgical staging of immature teratomas discovered occult disease in one case allowing for appropriate treatment decisions based on minimally invasive surgical findings. Laparoscopy represents a viable, and potentially preferable, option for surgical staging in patients with immature teratoma not initially diagnosed on frozen section. Determination of adequacy of laparoscopic staging needs long-term surveillance and outcome results.