Laparoscopic treatment of ovarian granulosa cells tumor developed in the pelvic anterior preperitoneal space 20 years after laparotomic salpingo-oophorectomy: case report and review of literature

Abstract

Granulosa cells (GC) tumors are rare tumors which account for approximately 2–3% of all ovarian malignancies with a favorable prognosis. We report a case of a 54-year-old postmenopausal woman who developed an ovarian GC tumor in the pelvic anterior preperitoneal space 20 years after laparotomic salpingo-oophorectomy due to small part of the cyst could drop or remain entrapped into the abdominal wound during the closure of laparotomy 20 years before. Then, the patient underwent a second laparoscopic procedure with peritoneal washing, a type A radical hysterectomy, omentectomy, appendectomy, and pelvic and para-aortic lymphadenectomy. This rare case of ovarian GC tumor developing in the site of previous laparotomy demonstrates the importance of a correct and clean surgical procedure to avoid the risk of leaving even small portions of the cyst exposing the patients to either the risk of malignancy or additional surgical procedures.

Precis: This rare case of ovarian granulosa cells tumor developed from residual ovarian tissue intrapped into the abdominal wound 20 years after laparotomic ovariectomy.

Chinese abstract

颗粒细胞瘤(GC)是一种罕见的肿瘤, 约占所有卵巢恶性肿瘤的2-3%, 预后良好。我们报告一例54岁的绝经后妇女, 在开腹输卵管卵巢切除术后20年, 由于在20年前的开腹手术中, 一小部分囊肿可能脱落并卡在腹部伤口内, 导致盆腔前腹膜前间隙发生卵巢颗粒细胞瘤。然后, 患者接受了第二次腹腔镜手术加腹膜冲洗, A型根治性子宫切除术, 网膜切除术, 阑尾切除术, 盆腔和主动脉旁淋巴结切除术。这例罕见的卵巢颗粒肿瘤发生在以前的开腹手术部位, 证明了正确和干净的外科手术的重要性, 以避免留下即使是一小部分囊肿的风险, 使患者暴露于恶性肿瘤的风险或额外的外科手术。

总结：这例罕见的卵巢颗粒细胞瘤是在开腹卵巢切除术后20年由残留的卵巢组织注入腹部伤口形成的。

Keywords:

• Cancer
• granulosa cell
• laparoscopy
• lymphadenectomy
• peritoneum
• recurrence
• tumor

Acknowledgements

The authors thank the Department of Pathology at “A. Perrino” Hospital for assistance with pathological diagnosis.

Ethics approval

Approval was obtained from the Institutional Review Board (IRB) for publishing this case report.

Consent for publication

Informed written consent was provided by the patient.

Author contributions

All authors analyzed and interpreted the patient data according to the histological examination and the literature review. GT and RT were the major contributor in writing the manuscript. MS and EC were in charge of the final approval of the version to be published. RT performed the surgery. All authors read and approved the final manuscript.

Disclosure statement

The authors declare that there are no conflicts of interest.