Obstet Gynecol Sci.  2018 Nov;61(6):702-706. 10.5468/ogs.2018.61.6.702.

Supernumerary ovary on recto-sigmoid colon with associated endometriosis

• Lim CK
• Kim HJ
• Pack JS
• Ha JG
• Yang YS
• Lee HK
• Kim SH

• KMID: 2426016
• DOI: http://doi.org/10.5468/ogs.2018.61.6.702

Abstract

A supernumerary ovary is a rare gynecological anomaly, and is usually excised due to its malignant transformation potential. We report a case of a supernumerary ovary and endometriosis situated on the anterior rectosigmoid colon. When laparoscopy was conducted, a firm, 5-cm mass was discovered on the anterior rectosigmoid colon along with normal ovaries. In this case, the discovery of a supernumerary ovary implied the presence of endometriosis. It is unusual for endometriosis and a supernumerary ovary to exist simultaneously.

Keyword

Supernumerary ovary; Accessory ovary; Ectopic ovary; Endometriosis; Endometrioma; Ovary

MeSH Terms

Colon*
Endometriosis*
Female
Laparoscopy
Ovary*

Figure

• 

  Fig. 1 (A) Sonographic findings. (B) magnetic resonance imaging findings. Both ovaries were normal and a pelvic mass measuring 5.8×4.8 cm was discovered. (C) Laparoscopic findings. Both ovaries were visible, but a third ovarian cyst was discovered. (D) Gross findings. The ovarian cystic mass measured 5.0×4.0×1.5 cm and weighed 16.9 g. The external surface was grayish-white and smooth. On section, the cyst was unilocular and the inner surface was coated with dark brown hemorrhagic material. The wall thickness measured up to 0.2 cm. (E, F) Histopathologic findings. (E) Hematoxylin and eosin stain. Cystic wall of the supernumerary ovary showing spindle cell layer around endometrial tissue. The spindle cells suggested ovarian stroma (HE, ×100). (F) Benign cystic lesion lined by CD 10-positive cells in endometrial stroma, in association with endometrial glands. Aggregates of hemosiderin-laden macrophages were observed.

Reference

1. Wharton LR. Two cases of supernumerary ovary and one of accessory ovary, with an analysis of previously reported cases. Am J Obstet Gynecol. 1959; 78:1101–1119.

2. Winckel F. Lehrbuch der Frauenkrankheiten. 2nd ed. Leipzig: S. Hirzel;1890.

3. Irving JA, Clement PB. Nonneoplastic lesions of the ovary. In : Kurman RJ, Ellenson LH, Ronnett BM, editors. Blaustein's pathology of the female genital tract. Boston (MA): Springer;2011. p. 579–624.

4. Lachman MF, Berman MM. The ectopic ovary. A case report and review of the literature. Arch Pathol Lab Med. 1991; 115:233–235.

5. Printz JL, Choate JW, Townes PL, Harper RC. The embryology of supernumerary ovaries. Obstet Gynecol. 1973; 41:246–252.

6. Imir G, Arici S, Cetin M, Kivanc F. Supernumerary ovary on sigmoid colon resembling an endometriotic lesion. J Obstet Gynaecol Res. 2006; 32:613–614.

7. Badawy SZ, Kasello DJ, Powers C, Elia G, Wojtowycz AR. Supernumerary ovary with an endometrioma and osseous metaplasia: a case report. Am J Obstet Gynecol. 1995; 173:1623–1624.

8. Ogishima D, Sakaguchi A, Kodama H, Ogura K, Miwa A, Sugimori Y, et al. Cystic endometrioma with coexisting fibroma originating in a supernumerary ovary in the rectovaginal pouch. Case Rep Obstet Gynecol. 2017; 2017:7239018.

9. Lim MC, Park SJ, Kim SW, Lee BY, Lim JW, Lee JH, et al. Two dermoid cysts developing in an accessory ovary and an eutopic ovary. J Korean Med Sci. 2004; 19:474–476.

10. Levy B, DeFranco J, Parra R, Holtz P. Intrarenal supernumerary ovary. J Urol. 1997; 157:2240–2241.

11. Kriss BR. Neoplasm of a supernumerary ovary; report of two cases. J Mt Sinai Hosp N Y. 1947; 14:798–801.

12. Hogan ML, Barber DD, Kaufman RH. Dermoid cyst in supernumerary ovary of the greater omentum. Report of a case. Obstet Gynecol. 1967; 29:405–408.

13. Huhn FO. Dermoid cysts of the greater omentum (author's transl). Arch Gynakol. 1975; 220:99–103.

14. Roth LM, Ehrlich CE. Mucinous cystadenocarcinoma of the retroperitoneum. Obstet Gynecol. 1977; 49:486–488.

15. Cruikshank SH, Van Drie DM. Supernumerary ovaries: update and review. Obstet Gynecol. 1982; 60:126–129.

16. Mercer LJ, Toub DB, Cibils LA. Tumors originating in supernumerary ovaries. A report of two cases. J Reprod Med. 1987; 32:932–934.

17. El-Gohary Y, Pagkratis S, Lee T, Scriven RJ. Supernumerary ovary presenting as a paraduodenal duplication cyst. J Pediatr Surg Case Rep. 2015; 3:316–319.

18. Barik S, Dhaliwal LK, Gopalan S, Rajwanshi A. Adenocarcinoma of the supernumerary ovary. Int J Gynaecol Obstet. 1991; 34:75–77.

19. Besser MJ, Posey DM. Cystic teratoma in a supernumerary ovary of the greater omentum. A case report. J Reprod Med. 1992; 37:189–193.

20. Kamiyama K, Moromizato H, Toma T, Kinjo T, Iwamasa T. Two cases of supernumerary ovary: one with large fibroma with Meig's syndrome and the other with endometriosis and cystic change. Pathol Res Pract. 2001; 197:847–851.