Ovarian malignancy in pregnancy: Experience for 17 years

We, Ji Sun; Choi, Sae Kyung; Choi, Jeong Soo; Ahn, Hyun Young; Lee, Young; Kim, Sa Jin; Shin, Jong Chul

Abstract

OBJECTIVE
The aim of this study was to evaluate the clinical course and pregnancy outcome in patients who had ovarian cancer diagnosed during pregnancy.
METHODS
Review of medical records of 10 cases of patients who have ovarian cancer diagnosed during pregnancy at three affiliated hospitals in the Catholic Medical Center from January 1991 to December 2007 was done.
RESULTS
Among 10 cases diagnosed as ovarian cancer during pregnancy, six cases were in the first trimester, one case in the second trimester, and 3 cases in the third trimester. Six cases did not show any specific symptoms at diagnosis and seven cases showed malignant characteristics on ultrasonography. Pathologic evaluation showed 2 clear cell tumors in stage IIIb and Ia, 1 germ cell tumor in Ic, 1 immature teratoma in Ic, and 2 serous adenocarcinoma in Ic and Ic, 2 borderline serous adenocarcinoma, and 2 borderline mucinous adenocarcinoma. Three cases with epithelial ovarian cancer in stage I did not receive chemotherapy. Two cases in non-epithelial ovarian malignancy and 1 stage IIIb epithelial ovarian cancer received chemotherapy. In one case, chemotherapy was performed during pregnancy and a healthy child was delivered. Five in 10 cases were lost in long term follow-up and 5 cases including stage IIIb case, remain without evidence of recurrent disease.
CONCLUSION
If early diagnosis and treatment are performed, ovarian cancer diagnosed during pregnancy has favorable prognosis. So, delay the treatment of ovarian cancer due to pregnancy should not be permitted and proper chemotherapy during pregnancy should be considered if necessary.