Abstract
Two cases with ovarian sex cord stromal tumors and successful pregnancy outcomes after laparoscopic surgery for infertility are described. Case 1 was a 33-year-old primipara with a history of ovulation induction for the first pregnancy. The evaluation for secondary amenorrhea after the birth demonstrated an elevated level of estradiol (161 pg/ml) and a decreased level of FSH and LH. A solid tumor of the left ovary, 2.5 cm in a diameter, was detected by trans-vaginal ultrasonography and MRI. A left salpingo-oophorectomy was performed laparoscopically. The histology of the tumor was a sex cord tumor with annular tubules. The patient conceived 9 months after the surgery and delivered a second baby. There has been no tumor recurrence for 4 years. Case 2 was a 33-year-old nullipara. She had a 4 year history of infertility and 2 years of amenorrhea. The testosterone level was elevated (297 ng/dl), but no adrenal massed were detected on CT scan. A solid tumor of the right ovary, 3 cm in a diameter, was detected by trans-vaginal ultrasonography and MRI, and removed laparoscopically. The histology of the tumor was a stromal Leydig cell tumor. She conceived spontaneously 3 months post-operatively and delivered a baby uneventfully. These tumors were both small; however, the MRI finding ( a solid mass surrounded by small follicles) was very helpful in establishing an accurate diagnosis, and laparoscopic surgery was quite useful for prompt recovery of fertility.
