A Retrospective Analysis Of 8 Cases Unexpected Ovarian Malignancy Found Operative Laparoscopy

Object: To assess the incidence ,management, and implication for prognosis of the unexpected ovarian malignancy found during operative laparoscopy.Method: A total of 4125 patients with benign ovarian mass were treated by laparoscopy at The Affiliated Obstetrics and Gynecology Hospital of Zhejiang University from January 2001 to December 2005. Their clinical data were reviewed retrospectively. All the ovarian masses suspicious of malignancy at the time of laparoscopy were sent for frozen section evaluation intraoperatively. The cases of unexpected ovarian malignancy found operative laparoscopy were investigated. A retrospective analysis was made refering to printed literature.Result: 8 ovarian tumors (0.19%) were subsequently found to be malignant out of the 4125 patients, among which 6 were diagnosedintraoperatively and 2 postoperatively. The final pathological diagnosis were epithelial ovarian cancer in 5 (62.5%), germinal cell tumor in 1 (12.5%), and low malignant potential tumor in 2(25%). In 6 of the 8 malignant cases, staging laparotomy was performed immediately, whereas in 2 cases, frozen sections were negative,and the patients were treated initially by laparoscopic adnexectomy. A subsequent staging laparotomy was performed after the final pathology report, with delay of 11 day and 14 day respectively.Conclusion: Appropriate management may help to loosen the linkage between operative laparoscopy and worse prognosis in cases of unexpected ovarian malignancy .A key factor in order to reduce the possibility of encountering an unexpected malignancy when approaching an ovarian cyst by laparoscopy is the appropriate preoperative selection of patient candidates for the laparoscopic approach.