Borderline ovarian tumor in pregnancy: can surgery wait? A case series
Borderline ovarian tumor in pregnancy: can surgery wait? A case series
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DOI：
10.1007/s00404-021-06080-0
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发表时间：
2021-05-05
影响因子：
2.6
通讯作者：
Franchi, Dorella
中科院分区：
文献类型：
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作者：
Vidal Urbinati, Ailyn M.;Iacobone, Anna D.;Franchi, Dorella
目的 研究妊娠期间诊断的交界性肿瘤（BOT）的特征，无论是首次诊断还是复发，以评估期待治疗的安全性。方法纳入15例妊娠期BOT女性，评价其临床和组织病理学特征。通过回顾性分析获得患者年龄、产次、孕周、随访时间、肿瘤大小、手术入路、手术类型和时机、FIGO分期、组织学类型。结果除1例外，其余患者均诊断为浆液性BOT（BOTs）。中位随访时间为 147 +/- 57 个月。 8 名女性首次诊断为 BOT，7 名女性在怀孕期间诊断为 BOT 复发，其中 3 名女性第二次复发，4 名女性第三次复发。第一组中的大多数患者 (75%) 和第二组中的 14.3% 分别在FIGO I期被诊断为 BOT。首次诊断 BOT 的患者中有 71.4% 存在微乳头状模式，但在复发的情况下只有 14.2% 存在微乳头状模式。所有复发均为 BOT。没有 BOT 合并妊娠的患者随后出现侵袭性复发。总体而言，10 名患者 (66.7%) 发生 24 次复发。随访期间共妊娠24例，活产率较高（91.6%），仅自然流产2例。结论 根据我们的经验，对于妊娠期间 BOT 复发和高胎龄孕妇首次怀疑 BOT 的情况，“预期管理”可能是一个安全的选择。
Purpose To study the characteristics of borderline tumors (BOT) diagnosed during pregnancy, as either first diagnosis or relapse, to evaluate safety of expectant management. Methods 15 women affected by BOT during pregnancy were included, to evaluate clinical and histo-pathological characteristics. Age of patient, parity, gestational age, follow-up time, size of tumor, surgical approach, type and timing of surgery, FIGO stage, and histologic type were obtained through retrospective review. Results All patients except one were diagnosed with serous BOT (BOTs). Median follow-up time was 147 +/- 57 months. Eight women received first diagnosis of BOT and seven had diagnosis of BOT recurrence during pregnancy, including three with a second relapse and four with a third relapse. BOT were diagnosed at FIGO stage I in most patients (75%) of the first group and in 14.3% of the second group, respectively. Micropapillary pattern was present in 71.4% of patients with first diagnosis of BOT, but only in 14.2% in case of relapse. All relapses were BOTs. No patient with BOT and concomitant pregnancy developed an invasive recurrence later. Overall, 24 relapses occurred in 10 patients (66.7%). Altogether 24 pregnancies occurred during follow-up, with a high livebirth rate (91.6%) and only 2 spontaneous miscarriages. Conclusion According to our experience, an "expectation management" could be a safe option in case of both relapse of BOTs during pregnancy and first suspicion of BOT in pregnant women at advanced gestational age.