A case of ovarian cancer detected by diagnostic laparoscopy for hereditary breast and ovarian cancer

Abstract

  The efficacy of screening and risk-reducing salpigo-oophorectomy (RRSO) for women with BRCA1 or BRCA2 mutations has been widely reported. At our institution, women with these mutations consult with genetic counselors, and gynecologists then provide surveillance or RRSO. RRSO is performed laparoscopically for lower invasiveness and morbidity. We report a case of ovarian cancer detected by surveillance for hereditary breast and ovarian cancer. A 63-year-old woman who had undergone surgery 2 months previously for triple-negative breast cancer visited our department. Although an FDG-PET scan suggested an abnormality in her left ovary, general screening methods (such as transvaginal sonography or magnetic resonance imaging) did not detect it. She underwent a laparoscopic bilateral salpingo-oophorectomy. We found a small nodule on her left ovary, which was pathologically diagnosed as endometrioid carcinoma. Because staging laparotomy found no other lesion, this case was diagnosed as stage IA. This case indicates that conventional screening might miss early ovarian cancers. Diagnostic laparoscopy should be considered for women with BRCA mutations when any small ovarian abnormality is suggested.