Ovarian cyst management is very individual and endometriosis is a strange disease. Some cysts require surgery and most do not. In this case, this case malignant transformation of an endometriotic cyst (endometrioma) was suspected and surgery on something like this is usually recommended. This was not exactly the case because borderline tumors are not life-threatening. But it illustrates the fact that endo can degenerate into different types of “tumors” and, especially in those women who are approaching menopause or past menopause, a gynecologic oncologist should be part of the surgical team.
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BMJ Case Rep. 2020 Dec 22;13(12):e234692. doi: 10.1136/bcr-2020-234692.
A 65-year-old woman with a previous history of bilateral salpingo-oophorectomy had peritoneal cysts, increasing in size over 15 years and an increasing cancer antigen 19-9 (CA 19-9) level. The size of the cysts eventually reached 86 mm and 70 mm. As malignant transformation of endometriosis was suspected, we performed peritoneal cystectomy and hysterectomy. Histopathology revealed seromucinous borderline tumours (SMBTs) derived from endometriosis. One month after surgery, her CA 19-9 level had decreased. It is rare for SMBT to occur after bilateral salpingo-oophorectomy; surgical management is the best treatment at present.
PMID:33370959 | DOI:10.1136/bcr-2020-234692
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