Laparoscopic Management of Recurrent Mucinous Cystadenoma of the Ovary in the Second Trimester of Two Consecutive Pregnancies

Abstract

Abstract

Background: The recurrence of mucinous ovarian tumors is rare after oophorectomy. Five cases of recurrence after cystectomy have been reported but none has been reported after oohporectomy. Laparoscopic surgery during pregnancy has been reported to be safe. Case: This case report describes an unusual case of laparoscopic management of recurrent mucinous cystadenoma from the ovarian stump after oophorectomy in the second trimester of two consecutive pregnancies. A 26-year-old, gravida 2, para 1, presented at 15 weeks' gestation with 15×14–cm benign ovarian cyst visible on ultrasound. Laparoscopic left salpingo-oophorectomy was performed using an Endo GIA™ stapler, after aspirating 2700 mL of mucinous fluid. She subsequently delivered a live male neonate at term. After 18 months, she presented again with a 12×–10 cm ovarian cyst, which was aspirated under ultrasound guidance. One year later, she presented once again at 17 weeks' pregnancy with a 20×14×10–cm cyst on the left side of the uterus. At laparoscopy, there was a large cyst originating from the left adnexa, possibly from the remains of the left ovary. Mucinous fluid (2500 mL) was aspirated and the cyst was excised completely. The right ovary was normal. Results: The patient's subsequent antenatal care was uneventful, and gave birth at term to a live female neonate weighing 3.1 kg. Subsequent histology testing of samples that were taken during both procedures confirmed mucinous cystadenoma of the left ovary on both occasions. Conclusions: This is a first case of recurrent mucinous cystadenoma following oophorectomy in the second trimester of two consecutive pregnancies. (J GYNECOL SURG 27:271)