Ovarian Cancer in a Woman Who Had Undergone Multiple Ovarian Stimulation Cycles and Its Subsequent Spread after Laparoscopic Surgery

使用多次排卵藥物刺激後合併卵巢癌、並在腹腔鏡手術後引發轉移

蔡永杰(Yung-Chieh Tsai) ； 林彥昇(Mike Yan-Sheng Lin) ； 林鈺山(Yue-Shan Lin) ； 康介乙(Chieh-Yi Kang) ； 黃國峰(Kuo-Feng Huang)

《Taiwanese Journal of Obstetrics & Gynecology》 42卷3期 (2003/09) Pp. 199-204

https://doi.org/10.29787/TJOG.200309.0008

摘要

目的：目前排卵藥物的使用十分普遍、腹腔鏡手術更是婦科手術常用的第一選擇。我們報告一例使用排卵藥物時合併發現卵巢癌、並在腹腔鏡手術後引發轉移的案例、來提醒大家使用此兩者時須更謹慎小心。病例報告：一個29歲的女性因罹患次發性不孕而接受連續六個月的排卵刺激。由於在接受排卵刺激後，右側卵巢持續存在一腫瘤，因此接受腹腔鏡手術的檢查，並將腫瘤摘除。術後，此腫瘤被發現是一惡性腫瘤，雖然病人後來有再來接受開腹手術，不過此腫瘤已轉移出去。
結論：使用排卵藥物需十分的小心，任何在誘導排卵中持續存在的卵巢腫瘤，均需仔細加以評估。一旦發現是惡性腫瘤，最好馬上改為開腹手術，並轉由婦癌專科醫師將病人做一詳細的檢查，以徹底摘除腫瘤。

關鍵字

排卵藥物 ； 不孕 ； 腹腔鏡手術 ； 卵巢腫瘤

並列摘要

Objective: To report on a woman with a history of multiple ovarian stimulation cycles using clomiphene citrate who developed ovarian cancer and its subsequent spread after laparoscopic surgery.
Case Report(s): A 29-year-old woman suffered from secondary infertility. She failed to conceive after 6 consecutive cycles of clomiphene citrate. A laparoscopic operation was arranged due to a persistent echolucent cystic mass found during ovulation induction. This mass turned out to be a well-differentiated endometrioid adenocarcinoma. Subsequent exploratory laparotomy found cancer progression with implants at the trocar site and on the ovarian and peritoneum surface.
Conclusion(s): Although a possible link between ovulation induction drugs and the risk of ovarian carcinoma is inconclusive, one should be very cautious when prescribing ovulation induction agents. Any persistent adnexal mass should be carefully evaluated. Immediate conversion to surgical staging is necessary once a malignancy is found during a laparoscopic examination.

並列關鍵字

clomiphene citrate ； infertility ； laparoscopic surgery ； ovarian neoplasm