卵巣子宮内膜症性嚢胞を合併した不妊症患者に対して腹腔鏡下卵巣嚢腫摘出術を施行し、類内膜境界悪性腫瘍の診断に至った一例

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Objective: Endometrioid borderline ovarian tumor accounts for 0.2％ of all ovarian epithelial tumors, and 63％ of them are associated with endometriosis. In this report, we present a case of an infertile woman with ovarian endometrioma, which was diagnosed as an endometrioid borderline tumor postoperatively.

Case: The patient was a 37-year-old infertile woman with an ovarian cyst. Pelvic magnetic resonance imaging showed a 65-mm ovarian cyst with high signal on T1-weighted imaging and low signal on T2-weighted imaging. Serum CA125 and CA19-9 levels were 17.3 U/mL and 778 U/mL, respectively. We performed laparoscopic cystectomy with a diagnosis of ovarian endometrioma. A 6-cm-sized left ovarian endometrioma was removed, and superficial endometriotic lesions on the pelvic peritoneum and right adnexa were ablated. The score on the revised American Society for Reproductive Medicine classification was 33 points. The histopathological examination revealed that the ovarian cyst was an endometrioid borderline tumor. We discussed the treatment plan with the patient and decided to try to achieve pregnancy as soon as possible instead of performing additional surgery. The patient is currently undergoing assisted reproduction.

Conclusion: We encountered a case of an infertile woman with an endometrioid borderline ovarian tumor who wished to bear a child. Endometrioid borderline tumors are rare, and few reports have described assisted reproduction for patients with this tumor; these patients have lower pregnancy rates than those with other histologic types of ovarian borderline tumor. More studies are required to determine the safety and efficacy of assisted reproductive technology in infertile patients with endometrioid borderline ovarian tumors.