A case of female adnexal tumor of probable Wolffian origin treated with fertility-sparing surgery thereafter, the patient attained spontaneous pregnancy

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  • FUJII Hajime
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • NAGAI Akira
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • MIYAKE Ryuta
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • YASUKAWA Hisayoshi
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center
  • AKADA Shinobu
    Department of Obstetrics and Gynecology, Osaka Habikino Medical Center

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  • 妊孕性温存手術を行い，その後に自然妊娠に至ったfemale adnexal tumor of probable Wolffian originの1例
  • 症例報告 妊孕性温存手術を行い,その後に自然妊娠に至ったfemale adnexal tumor of probable Wolffian originの1例
  • ショウレイ ホウコク ニンヨウセイ オンゾン シュジュツ オ オコナイ,ソノゴ ニ シゼン ニンシン ニ イタッタ female adnexal tumor of probable Wolffian origin ノ 1レイ

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Abstract

<p>Female adnexal tumor of probable Wolffian origin (FATWO) is a rare tumor that develops preferentially in the broad ligament of the uterus and mesosalpinx. Cases with relapse and metastasis have been reported, and no treatment has been established yet. We report a case of FATWO treated with fertility-sparing surgery thereafter, the patient attained spontaneous pregnancy. A 35-year-old primigravida woman presented with a palpable mass on the Douglas pouch on pelvic examination. Pelvic contrast-enhanced magnetic resonance imaging revealed a 7.5&#x2005;cm mass on the left dorsal side of the uterus. Taking into consideration the possibility of subserous uterine fibroids, a laparoscopic myomectomy was performed. The laparoscopic findings showed a goose egg-sized mass in the left oviduct membrane, which was then resected. Pathological findings showed homogenous, medium-sized, heteromorphic, columnar epithelial cells proliferating with tubular and cord-like shapes. Immunohistochemical examination of the mass revealed calretinin, CAM5.2, androgen receptor, CD10, and AE1/AE3 expressions. Thus, the patient was diagnosed as having FATWO. Fertility-sparing surgery (left laparoscopic salpingo-oophorectomy) was subsequently performed. In FATWO, diagnosis of clinical malignancy is difficult. While fertility sparing surgery should be considered in young patients, careful long-term follow-up is also necessary. [Adv Obstet Gynecol, 71 (3): 259-267, 2019 (R1.8)]</p>

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