Intestinal obstruction associated with ovarian remnant in postmenopausal female

Abstract

Ovarian remnant syndrome (ORS) is a rare condition, in which the ovarian tissue is inadvertently left behind after difficult oophorectomy. The most common preexisting conditions associated for this complication include endometriosis, pelvic inflammatory disease, and prior abdominal surgery as in these conditions, removal of ovarian tissue becomes difficult. This is likely due to the presence of the dense fibrotic adhesions between an ovary and the surrounding structures. This residual ovarian tissue can become functional and cystic. A 56-year-old multigravida postmenopausal female was diagnosed with intestinal obstruction. She had multiple abdominal surgeries in the past, including cholecystectomy, appendectomy, hysterectomy, and bilateral salpingo-oophorectomy. Patient underwent exploratory laparotomy. Intraoperatively, extensive adhesions and scarring of bowel wall were present and approximately 15 cm proximal to the terminal ileum, a small bowel mesenteric nodule was present. Histopathology of the mesenteric nodule was consistent with the diagnosis of overian remnant. ORS can be prevented with careful resection of the entire ovarian tissue during the difficulty oophorectomy so that no ovarian tissue is left behind.

Clear cell carcinoma arising in an ovarian remnant 19 years after oophoerctomy: case report

“…Studies [ 3 ]have shown that replantation of ovarian specimens in the abdominal cavity can be viable even without blood supply in a cat model. Ectopic implantation of ovarian tissue has also been reported in cases of ORS after laparoscopic ovarian cyst excision, resulting in abdominal incision and intestinal obstruction [ 4 – 6 ]. Although rare, malignant tumors can develop from ovarian remnants, including mucinous cystadenocarcinoma, endometrioid adenocarcinoma, and borderline serous neoplasia [ 7 – 11 ], suggesting the possibility of malignant transformation of remnant ovarian tissue.…”