子宮頸癌卵巣吊り上げ術後に悪性腸腰筋症候群と同様の症状を発症し腹腔鏡下手術で治癒した1例

抄録

  Adjuvant pelvic irradiation will be often applied after cervical cancer operation, despite inducing permanent ovarian damage. For the preservation of ovarian function, ovarian transposition is usually operated in premenopausal women with early-stage cervical cancer. The development of ovarian cysts is the most frequent complication after ovarian transposition. However, the pressure symptom exerted by ovarian cysts is not a usual symptom of ovarian cysts which occur in transposed ovary. Here we report a rare case of ovarian cysts of transposed ovary, presenting symptoms identical to rare malignant psoas syndrome, which refers to pain induced by ipsilateral psoas major muscle involvement of malignant disease. And the symptom was probed to be induced by the lutein cyst after ovarian transposition and radical hysterectomy. The patient was a 43-year-old woman, gravida 1, para 1, who underwent radical hysterectomy and ovarian transposition for early cervical cancer in another hospital. Two years after the operation, bilateral ovarian cysts of transposed ovaries were pointed out. They were not considered as a recurrence as specific tumor markers were within the normal range and the up-take was not recognized in PET-CT. She stated to experience hip and pubic pain when the ovarian cysts were 5 cm. Due to difficulties controlling her pain, we performed a laparoscopic operation for the diagnosis. A swollen left ovary was observed on the iliopsoas in the retroperitoneal space. It was not twisted or ruptured. We performed left adnexectomy and adhesiolysis and her pain resolved after the operation. The pathologic diagnosis was a lutein cyst.