Gynecology & Reproductive Medicine

Abstract

Abscess, Ovarian Cancer and Pregnancy

Jovanovic M. Ana, Branka Nikolic, Vladimir Pazin and Novakovic Sanja

The Objective: To report our experience with complications of the eggs donation pregnancy with endometriosis, abscess and ovarian cancer.

Design: Observational study.

Setting: University Clinic for Gy and OB Narodni front.

Patient: A 33-year old patient was admitted to our clinic when she was 14 weeks pregnant because of grave condition and high fever. The pregnancy was established through IVF procedure using a donor egg. The donor egg IVF procedure was completed regardless the endometriosis cyst of 5cm. Intervention: Adnexectomy during pregnancy, ileus, hysterectomy, omentectomy, resection of the small intestine with T–T anastomosis, resection of the descending colon and sigma according to Hartmann and positioning colostomy bag to the anterior abdominal wall.

Main Outcome Measure: Data from the eggs donation IVF pregnancy, surgery during pregnancy, re surgery treatment, chemo therapy and exitus.

Result: Within 16 hours of admission, according to the patient’s medical condition, rapidly worsening clinical picture, deterioration in lab test results and ultrasound results, a decision was made to perform a surgery due to vital indications. A large left – sided tubo – ovarian abscess was found (around 10 cm); it was crumbling and necrotic, filled with a large amount of purulent collection. When hystopathological test was completed, the result reveled not only inflammatory, but malignant ovarian disease as well. Adenocarcinoma endometroides ovarii, HG3 NG2, Endometriosis ovarii. The patient was urgently hospitalized at week 22 because of serious condition, having abdominal pains and signs of initial stage of ileus. A total classic hysterectomy was performed together with right – sided adnexectomy, omentectomy, resection of the small intestine with T–T anastomosis, resection of the descending colon and sigma according to Hartmann and positioning colostomy bag to the anterior abdominal wall.

The patient did not present to the consulting body for malignant diseases.We learnt from her family that she continued the chemo treatment abroad. The patient lived for 6 months since she had first been admitted to our hospital.

Conclusion: Ovarian cancers are rare during pregnancy but should be suspected in patients presenting with a large inflammatory cyst. Complex adnexal mass should be histopatologicaly evaluated before donor IVF cycles.