Ovarían Fibroma in the Era of Laparoscopic Surgery: A General Surgeon’s Experience

Târcoveanu, E; Dimofte, Gabriel; Niculescu, D; Vasilescu, A; Moldovanu, R; Ferariu, Dan; Marcovici, Iacob

doi:10.1080/00015458.2007.11680143

Cited by 18 publications

(18 citation statements)

References 22 publications

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“…In conclusion, laparoscopic surgery for potentially malignant tumors may be feasible and safe [35] but requires an experienced gynecological oncology team and is beyond the expertise of the general surgeon [36]. Then, diagnostic laparoscopy is useful in patients with potentially malignant tumors and laparoscopic tumor resection can be performed also if there are signs of malignancy and removal can be achieved without peritoneal contamination.…”

Section: Discussionmentioning

confidence: 99%

Large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe anemia treated by laparoscopic surgery

et al. 2014

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BackgroundThe Meigs' syndrome is a rare but well-known syndrome defined as the triad of benign solid ovarian tumor, ascites, and pleural effusion. Meigs' syndrome always requires surgical treatment. However, the optimal approach for its management has not been sufficiently investigated.Case presentationWe report a patient with a large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe hemolytic anemia that was treated by laparoscopic surgery. This case highlights the difficulties that may be encountered in the management of patients with Meigs’ syndrome, including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the medical and surgical approach and the adverse impact that Meigs’ syndrome can have on the patient’s condition, especially if it is associated with acute pain and severe anemia. Considering the patient’s serious clinical condition and assuming that she had Meigs' syndrome with a twisted large ovarian mass and possible hemolytic anemia, we first concentrated on effective medical management of our patient and chose the most appropriate surgical treatment after laparoscopic examination. The main aim of our initial approach was preoperative management of the anemia. Blood transfusions and glucocorticoid therapy resulted in stabilization of the hemoglobin level and normalization of the bilirubin levels, which confirmed the appropriateness of this approach. Laparoscopic surgery 4 days after admission enabled definitive diagnosis of the tumor, confirmed torsion and removed the bulky ovarian fibroma, resulting in timely resolution of symptoms, short hospitalization, relatively low morbidity and a rapid return to her social and professional life.ConclusionsThis case highlights the difficulties that may be encountered in the management of patients with Meigs' syndrome, including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the medical and surgical approach, and the adverse impact that Meigs' syndrome can have on the patient's condition, especially if it is associated with acute pain and severe anemia. The present case suggests that laparoscopic surgery for potentially large malignant tumors is feasible and safe, but requires an appropriate medical and gynecological oncology expertise.

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Section: Discussionmentioning

confidence: 99%

Large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe anemia treated by laparoscopic surgery

et al. 2014

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“…Recently, the laparoscopic approach has been considered for the management of ovarian fibromas, and thus far, a few of case series have been reported [10,11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Surgical Management Options for Ovarian Fibroma/Fibrothecoma: A Study of 97 Cases

Cho

Lee

Kim

et al. 2013

Gynecol Obstet Invest

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Aims: The aims of this study were to analyze the clinical characteristics, diagnostic features, and operative outcomes of patients with ovarian fibroma/fibrothecoma and to discuss appropriate management options. Methods: We performed a retrospective comparative analysis of 97 patients with ovarian fibroma/fibrothecoma who underwent laparoscopic and laparotomic procedures, including tumorectomy between January 2008 and December 2011. Results: The mean patient age was 42.5 ± 11.4 years. Seventy-three patients (75.3%) were premenopausal women. A preoperative diagnosis of benign ovarian tumor or fibroma was made in only 49 cases (50.5%). We found that 42.2% of cases were misdiagnosed as uterine myomas (n = 41) and 6.2% were misdiagnosed as malignant ovarian tumors (n = 6). The presence of ascites was associated with larger tumor size (p < 0.05) but not higher CA125 levels (p = 0.159). Twenty-nine patients (29.9%) underwent laparotomy, and 68 (70.1%), laparoscopic surgery. Laparoscopic surgery facilitated shorter operation times than laparotomy (p < 0.05). Tumorectomy was performed in 40 patients (43.5%), 36 (90%) of whom underwent laparoscopy with operative outcomes comparable to those of patients who underwent laparotomy. Conclusions: Ovarian fibromas/fibrothecomas are often misdiagnosed as uterine myomas and malignant ovarian tumors. Laparoscopic surgery including tumorectomy may be an effective surgical approach in patients with ovarian fibromas/fibrothecomas.

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“…The mode of surgery (laparotomy or laparoscopy) depends on the surgeon's experience and the suspicion of the malignancy. Although it is hard to remove large and solid masses through endoscopic route, it is possible to remove these tumours by the help of morcellator or using a posterior colpotomy in laparoscopic approach . Although malignant potential of the tumour is low, surgery is the mainstay of treatment to relieve possible symptoms and due to probability of malignancy.…”

Section: Discussionmentioning

confidence: 99%

Ovarian fibroma/fibrothecoma: Retrospective cohort study shows limited value of risk of malignancy index score

Numanoğlu

Kuru

Sakıncı

et al. 2013

Aust NZ J Obst Gynaeco

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Ovarían Fibroma in the Era of Laparoscopic Surgery: A General Surgeon’s Experience

Cited by 18 publications

References 22 publications

Large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe anemia treated by laparoscopic surgery

Large twisted ovarian fibroma associated with Meigs’ syndrome, abdominal pain and severe anemia treated by laparoscopic surgery

Clinical Characteristics and Surgical Management Options for Ovarian Fibroma/Fibrothecoma: A Study of 97 Cases

Ovarian fibroma/fibrothecoma: Retrospective cohort study shows limited value of risk of malignancy index score

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