European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Clear cell ovarian carcinoma in a pregnant woman with a history of infertility, endometriosis and unsuccessful IVF treatment
Ovarian cancer in pregnancy is a very rare event. We present here the case of a 37-year-old woman in whom a clear cell ovarian carcinoma was diagnosed in the first trimester of pregnancy. This patient had a history of infertility, endometriosis and two previous unsuccessful attempts of in vitro fertilization. Transvaginal sonography at six gestational weeks revealed a 6 × 4 cm ovarian cyst with an internal papillary excrescence. The cyst persisted throughout the first trimester, whereas the initial CA 125 value of 226 U/mL dropped to 61 U/mL at 12 gestational weeks. Exploratory laparotomy and cystectomy was performed at 14 weeks and the disease was classified as Stage le, arising in endometriosis. The couple decided to continue with pregnancy and the woman was followed by serial sonographic, MRI and CA 125 examinations A cesarean section, hysterectomy, bilateral salpingo-oophorectomy and omentectomy was performed at 34 weeks. Histology and cytology were negative for recurrence. Four months later the woman and baby are doing well. We review cases of ovarian clear cell carcinoma diagnosed during pregnancy and discuss the association of endometriosis, infertility, infertility drugs and ovarian cancer.