腹腔鏡下卵巣腫瘍摘出術後14年で再増大し、茎捻転となった両側卵巣線維腫の一例

抄録

  Ovarian fibromas, the most common benign solid ovarian tumors, often occur unilaterally in postmenopausal women treated with laparoscopic salpingo-oophorectomy. Here, we report a rare case of unusual bilateral ovarian fibroma torsion in a young woman. A 38-year-old nulliparous woman presenting with an acute abdomen had a history of laparoscopic right partial ovarian resection for bilateral ovarian fibroma and cystectomy for a left ovarian chocolate cyst at 24 years of age. Magnetic resonance imaging showed bilateral solid adnexal masses with microcysts similar to the tumor seen 14 years prior, with the largest measuring 10 cm. We diagnosed torsion of re-enlarged ovarian tumors and performed emergency laparoscopic bilateral salpingo-oophorectomy rather than conservative surgery because it was difficult to macroscopically identify normal ovaries. For a young woman with bilateral fibroma, partial tumor excision may be selected to preserve ovarian function and fertility. In such cases, careful follow-up with informed consent is critical because the tumor may re-grow and subsequently twist.