|Discussion in 'All Categories' started by dr.sawsan khalil - Nov 28th, 2011 9:27 pm.|
My name is sawsan I have a history of 9ys infertility,I do 4 time ivf but it fail , last ivf I do it in 6-2011 ,recently I discover I have a large lf overian cyst I do laprotomy for removal of ovary &cyst . the histopathology = serous cyst adenocarcinoma .
Can I do ivf after laproscopical removal RT ovary.
what your opinion
re: overian cyst adenocarcinoma by Dr M.K. Gupta - Nov 30th, 2011 12:00 pm
Dr M.K. Gupta
|Dear Dr Sawsan Khalil
We are sorry that you have ovarian cyst adenocarcinoma. Most commonly the primary site of serous cystadenocarcinoma is the ovary. A malignant cystic or semicystic neoplasm. It often occurs in the ovary and usually bilaterally. The external surface is usually covered with papillary excrescences. Microscopically, the papillary patterns are predominantly epithelial overgrowths with differentiated and undifferentiated papillary serous cystadenocarcinoma cells. Psammoma bodies may be present. The tumor generally adheres to surrounding structures and produces ascites.
An ovarian cyst is a sac filled with liquid or semi-liquid material arising in an ovary. The number of diagnoses of ovarian cysts has increased with the widespread implementation of regular physical examinations and ultrasound technology. The finding of an ovarian cyst causes considerable anxiety for women because of the fear of malignancy and unfortunately you have got this disease but never mind because if surgery is performed without delay prognosis is good.
You should discuss with your gynecologists and bilateral oophorectomy could have been performed during formal staging. This would have obviated the need for a second surgery for removal of the contralateral ovary, and arguably could have hastened the patients enlistment into a donor oocyte programme for your definitive fertility treatment. The possibility of bilateral oophorectomy was presented before the first laparotomy, and you need thorough counselling about potential malignant spread if this was not done.
You should also discuss the potential for malignant spread secondary to intraperitoneal spillage during cyst puncture. Even though a frozen embryo transfer remained a possibility, sometime patient did not wish to have both ovaries immediately removed. The tailored, multi-stage surgical approach is only possible with co-management by gynaecologic oncology.
In our opinion your good gynecologists should plan entire treatment not only keeping in mind fertility but also your overall well being.
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