Cargando…
Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report
RATIONALE: Adnexal torsion is 1 of the most common emergency gynecological disease. It is more often diagnosed in reproductive age, but rarely in postmenopausal women. The clinical symptoms of adnexal torsion are nonspecific in postmenopausal women. Epithelial ovarian tumors are common in adults, an...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738009/ https://www.ncbi.nlm.nih.gov/pubmed/28984773 http://dx.doi.org/10.1097/MD.0000000000008207 |
_version_ | 1783287611781021696 |
---|---|
author | Jeon, Hyeji Ryu, Aeli Seo, Hui-Gyeong Jang, Si-Hyong |
author_facet | Jeon, Hyeji Ryu, Aeli Seo, Hui-Gyeong Jang, Si-Hyong |
author_sort | Jeon, Hyeji |
collection | PubMed |
description | RATIONALE: Adnexal torsion is 1 of the most common emergency gynecological disease. It is more often diagnosed in reproductive age, but rarely in postmenopausal women. The clinical symptoms of adnexal torsion are nonspecific in postmenopausal women. Epithelial ovarian tumors are common in adults, and the risk of malignancy increases with age, especially after menopause. So, it is difficult to diagnose adnexal torsion precisely compared with reproductive women, and most cases of adnexal torsion with postmenopausal women are diagnosed as a malignancy preoperatively. We report a case of ovarian torsion with mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman. PATIENT CONCERNS: A 65-year-old woman presented lower left abdominal pain, and there was slight abdominal distension, but no tenderness or rebound tenderness on abdominal palpation. DIAGNOSES: Radiologic assessments showed a huge multiseptated cystic mass with solid portion in the left ovary, and malignancy was suspected. The test for serum tumor markers revealed normal levels of cancer antigen 125 (CA-125). INTERVENTIONS: The patient underwent a laparotomy and there was torsion of the left ovary. We conducted frozen biopsy of left ovary for confirming malignancy before performing staging surgery. OUTCOMES: The result of a frozen section biopsy confirmed a borderline Brenner tumor associated with a benign mucinous tumor. Subsequently, total hysterectomy and right salpingo-oophorectomy were performed. The operation was completed without addition procedures LESSONS: Ovarian torsion is benign in most cases and malignancy is rare. Although very rare, ovarian torsion can occur in postmenopausal women, and it should be taken into consideration that the possibility of malignancy is low in postmenopausal women with normal CA-125 levels. Instead of performing staging surgery, it appears to be appropriate to carry out surgery based on the result of intraoperative frozen section biopsy so that we were able to avoid unnecessary surgical procedures. |
format | Online Article Text |
id | pubmed-5738009 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-57380092018-01-02 Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report Jeon, Hyeji Ryu, Aeli Seo, Hui-Gyeong Jang, Si-Hyong Medicine (Baltimore) 5600 RATIONALE: Adnexal torsion is 1 of the most common emergency gynecological disease. It is more often diagnosed in reproductive age, but rarely in postmenopausal women. The clinical symptoms of adnexal torsion are nonspecific in postmenopausal women. Epithelial ovarian tumors are common in adults, and the risk of malignancy increases with age, especially after menopause. So, it is difficult to diagnose adnexal torsion precisely compared with reproductive women, and most cases of adnexal torsion with postmenopausal women are diagnosed as a malignancy preoperatively. We report a case of ovarian torsion with mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman. PATIENT CONCERNS: A 65-year-old woman presented lower left abdominal pain, and there was slight abdominal distension, but no tenderness or rebound tenderness on abdominal palpation. DIAGNOSES: Radiologic assessments showed a huge multiseptated cystic mass with solid portion in the left ovary, and malignancy was suspected. The test for serum tumor markers revealed normal levels of cancer antigen 125 (CA-125). INTERVENTIONS: The patient underwent a laparotomy and there was torsion of the left ovary. We conducted frozen biopsy of left ovary for confirming malignancy before performing staging surgery. OUTCOMES: The result of a frozen section biopsy confirmed a borderline Brenner tumor associated with a benign mucinous tumor. Subsequently, total hysterectomy and right salpingo-oophorectomy were performed. The operation was completed without addition procedures LESSONS: Ovarian torsion is benign in most cases and malignancy is rare. Although very rare, ovarian torsion can occur in postmenopausal women, and it should be taken into consideration that the possibility of malignancy is low in postmenopausal women with normal CA-125 levels. Instead of performing staging surgery, it appears to be appropriate to carry out surgery based on the result of intraoperative frozen section biopsy so that we were able to avoid unnecessary surgical procedures. Wolters Kluwer Health 2017-10-27 /pmc/articles/PMC5738009/ /pubmed/28984773 http://dx.doi.org/10.1097/MD.0000000000008207 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 5600 Jeon, Hyeji Ryu, Aeli Seo, Hui-Gyeong Jang, Si-Hyong Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report |
title | Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report |
title_full | Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report |
title_fullStr | Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report |
title_full_unstemmed | Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report |
title_short | Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report |
title_sort | ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: a case report |
topic | 5600 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738009/ https://www.ncbi.nlm.nih.gov/pubmed/28984773 http://dx.doi.org/10.1097/MD.0000000000008207 |
work_keys_str_mv | AT jeonhyeji ovariantorsionofmixedepithelialtumormisdiagnosedasamalignancyinpostmenopausalwomanacasereport AT ryuaeli ovariantorsionofmixedepithelialtumormisdiagnosedasamalignancyinpostmenopausalwomanacasereport AT seohuigyeong ovariantorsionofmixedepithelialtumormisdiagnosedasamalignancyinpostmenopausalwomanacasereport AT jangsihyong ovariantorsionofmixedepithelialtumormisdiagnosedasamalignancyinpostmenopausalwomanacasereport |