Abstract
Introduction: In deciding whether laparoscopic surgery is necessary for suspected ovarian tumors, an accurate preoperative evaluation should be performed. We report a young patient with familial breast and ovarian cancers diagnosed as primary ovarian cancer after laparoscopic cystectomy and treated with radical surgery.
Patient: The patient was a 34-years old woman, 0 gravida 0 para, who had a family history of cancer and was suspected to have hereditary breast and ovarian cancer (HBOC) syndrome. After presentation at a local clinic, she visited our hospital with no complaint of a pelvic cystic mass. Although only the serum CA125 level was high on laboratory examination, magnetic resonance imaging and computed tomography revealed an 8-cm mass without a solid part in the left adnexa and metastasis. Therefore we performed laparoscopic left ovarian tumor cystectomy without intraoperative rupture. The resected tumor was pathologically diagnosed as a serous papillary adenocarcinoma. After the initial surgery, we finally performed a simple total hysterectomy, as well as adnexectomy, omentectomy and pelvic lymph node dissection. The clinical disease stage wad Ic(b). The patient underwent six cycles of TC chemotherapy (paclitaxel. 175mg/m2 and carboplatin. AUC5 q3w). The patient is now disease free.
Conclusion: Laparoscopic surgery plays an important role in gynecological malignant surgery, not only for being minimally invasive but also for its diagnostic value. Informed consent should be obtained from the patient in order to perform the appropriate therapy. More attention should be given to patients' familial and genetic background, especially for young patients with suspected ovarian cancer.
