임신중 발생한 난소종양의 임상적 고찰

서정욱(Jeong Wook Seo),노정훈(Jeong Hoon Rho),오관영(Kwan Young Oh),박미혜(Mi Hye Park),김은경(Eun Kyung Kim),양윤석(Yun Seok Yang),황인택(In Taek Hwang),정지학(Ji Hak Jung),박준숙(Joon Sook Park) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.9

Objective : Our purpose was to evaluate the clinical appearance and outcome of pregnancy associated with ovarian tumors. Methods : A review was performed of patients who were seen with an ovarian tumor in pregnancy from January 1995 to December 1999. We excluded ovarian tumors that resolved spontaneously and were found simultaneously with ectopic pregnancy. Results : 1. The incidence of ovarian tumors in pregnancy was 69 in 10,550 deliveries.(1:153) One case of mucinous borderline malignancy was found. 2. The ovarian tumors occuring in pregnancy were the most common at 25 to 29 years old-pregnant women(42.0%) and more common in nulliparous pregnant women(59.4%) than in multiparous women.(40.6%) 3. The most common complication of ovarian tumors in pregnancy was torsion which is 10 cases(14.6%) 4. Pre-operative diagnosis of ovarian tumors was made in the first trimester(53.6%), second trimester(14.5%), and third trimester(31.9%) 5. Excluding the 20 cases of cesarean section, operation was performed at first trimester in 25cases(67.6%), at second trimester in 9 cases (24.3%), at third trimester in 3 cases (8.1%). 6. The surgical management was performed from 18 women and the conservative therapy was done at 6 cases. 7. According to the outcome of pregnancy, among 18 cases in which the ovarian tumor was removed, vaginal delivery occurred at term in 12 cases (66.7%), cesarean section in 5 cases(27.8%) and premature delivery in 1 case. Among the other cases in which conservative management was performed, term vaginal deliveries were done in 1 case(16.7%), cesarean section in 4 cases(67.0%) and premature delivery in 1 case(16.7%). 8. The histologic features of the exised ovarian tumors were benign cystic teratoma 25 cases (35.7%), mucinous cystadenoma 16 cases(22.9%), serous cystadenoma 10 cases(14.3%) and simple cyst 10 case(14.3%) 9. The cesarean section was performed in 32 cases including emergency operation. In 25 cases, common cause was due to obstetrical problem( elective repeat cesarean section, fetal malpresentation, labor disorder) and in the rest 7 cases was due to adnexal masses. Conclusion : Although the incidence of ovarian cancer in pregnancy is low, the incidental finding of an adnexal mass in pregnancy is more common. Because complications of surgery are increased in pregnancy, operative management needs to be considered. Our data was consistent with what has been reported clinical study to determine optimal management of an ovarian tumor in pregnancy.

흰쥐의 번식과정에 있어서 Progesterone-tube 이식이 난소와 태반중량 및 임신기간에 미치는 영향

민관식,오석두,윤창현 한국동물번식학회 1990 Reproductive & developmental biology Vol.14 No.4

This study was conducted to find out the changes of ovarian, placental and fetal weights and periods of pregnancy in rats implanted with progesterone-tube during the reproductive stages. One hundred and thirty-four mature rats, 10~13 weeks old, were offered for this experiment. The animals, which were implanted with silicon tubes filled with progesterone on day 15 of pregnancy, were sacrified at 18, 20, 21 and 22 days of pregnancy. The changes of ovarian, placental and fetal weights and the number of fetuses during late pregnancy were recorded. The results obtained were summarized as follows : 1. After progesterone-tube implantation, ovarian weight reached to a peak value of 92.0$\pm$0.9mg at 20 days of pregnancy, there after decreased significantly to 79.5$\pm$7.6 and 68.26$\pm$4.2mg at 20 and 22 days of pregnancy(P<0.01). 2. The placental weight increased rapidly during 15~18 days of pregnancy in control and progesterone treated rats. A peak value of 447.78$\pm$20.9mg was shown at 20 days of pregnancy after progesterone-tube implantation, and in control rats the value decreased significantly to 419.42$\pm$11.6 and 404.1$\pm$29.3mg at 20 and 21 days of pregnancy(P<0.01). 3. The fetal weights was not shown any significant differences between control and progesterone-tube implanted rats. 4. The number of fetuses in control rats were 14.75$\pm$0.4 at 8~10 days of pregnancy and 13.5$\pm$0.3 and 13.25$\pm$0.4 at 12 and 20 days of pregnancy. 5. The significant difference in periods of pregnancy was appeared between progesterone-tube implanted(27.3$\pm$0.3 days) and control(22.1$\pm$0.3 days)rats(P<0.01).

Don’t Hesitate on Performing Laparoscopic Surgery for Ovarian Masses during Pregnancy: A Multidisciplinary Approach to Ovarian Masses Complicating Pregnancy

( Sujung Oh ),( Ji Hye Jo ),( Subeen Hong ),( Hyun Sun Ko ),( In Yang Park ),( Hyesung Hwang ) 대한주산의학회 2022 Perinatology Vol.33 No.2

Objective: This study demonstrates sonographic features of such ovarian masses and share treatment process for those that require surgery during pregnancy. Methods: This retrospective study includes females diagnosed with ovarian masses during pregnancy at The Catholic University of Korea, Seoul St. Mary’s Hospital from 2009 to 2020. The study population was categorized into 2 groups depending on the need for surgery based on gestational age at the time of detection of ovarian masses, sonographic findings, and delivery outcomes. From the group that had surgery, outcomes were analysed according to the gestational age at surgery and the surgical indications. Results: Of the 114 females with ovarian masses found during pregnancy, 49 (43.0%) underwent surgery during pregnancy, and 65 (57.0%) did not require surgery. Ovarian masses were found in the first trimester in 82 cases (71.9%). The risk factors for surgery were maternal age (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.72-0.98), gestational age at the time of detection (OR, 0.85; 95% CI, 0.76-0.94), the size of the mass (OR, 1.06; 95% CI, 1.03-1.09), and ascites (OR, 18.09; 95% CI, 1.83-178.78). In females undergoing surgery during pregnancy, 45 (91.8%) had laparoscopic surgery, and 20 (40.8%) were treated surgically after 1st trimester. The most common cause of surgery was mass torsion (n=22, 44.9%). Conclusion: The risk of ovarian surgery is higher during pregnancy when the mass is identified at an earlier gestational age, the masses are larger, or ascites is detected. Laparoscopic surgery is recommended even after the first trimester.

난소 임신 10예의 분석

김용진,이충일,이해혁,남계현,이임순,이권해 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

Ovarian pregnancy is an uncommon form of the ectopic pregnancies. The ovarian vascularity results in maternal hemorrhage early in the first trimester, which disrupts the pregnancy and usually ruptures the ovary with sufficient hemoperitoneum to require emergency operation. This report presents 10 cases of ovarian pregnancy by retrospective review between January 1986 and December 1995 at the Department of Obstetrics and Gynecology, Soonchunhyang University Hospital. There was 19,849 deliveries and 637 ectopic pregnancies during same period. It showed that the incidence of ovarian pregnancy was 3.21 % of all ectopic pregnancies. The clinical features of ovarian pregnancy revealed that abdominal pain was the major symptom, and history of amenorrhea was obscure. Because of life-threatening course, the early diagnosis and treatment of ovarian pregnancy is important. The clinical diagnosis of ovarian pregnancy was more difficult than that of tubal pregnancy.

원조: 임상 : 임신 중 진단의 난소암: 17년간의 경험

위지선 ( Ji Sun We ),최세경 ( Sae Kyung Choi ),최정수 ( Jeong Soo Choi ),안현영 ( Hyun Young Ahn ),이영 ( Young Lee ),김사진 ( Sa Jin Kim ),신종철 ( Jong Chul Shin ) 대한주산의학회 2008 Perinatology Vol.19 No.2

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 ultra-sonography. Pathologic evaluation showed 2 clear cell tumors in stage IIlb and Ia, I germ cell tumor in Ic, I 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 I stage IIlb 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 IIlb 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.

Teenage pregnancy complicated by primary invasive ovarian cancer: association for oncologic outcome

Erin A. Blake,Madushka Y. De Zoysa,Elise B. Morocco,Samantha B. Kaiser,Michiko Kodama,Brendan H. Grubbs,Koji Matsuo 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5

Objective: To examine survival of teenage women with pregnancies complicated by primary ovarian cancer. Methods: This is a secondary analysis of a previously organized systematic literature review of primary ovarian cancer diagnosed during pregnancy. Cases eligible for analysis were patients whose age at cancer diagnosis and survival outcome were known (n=201). Pregnancy and oncologic outcome were then examined based on patient age. Results: These were comprised of 95 (47.3%) epithelial ovarian cancers (EOCs), 82 (40.8%) malignant germ cell tumors (MGCTs), and 24 (11.9%) sex-cord stromal tumors (SCSTs). Teenage pregnancy was seen in 21 (10%) cases, and was highest among the SCST group compared to the other cancer types (EOC, 1.1%; MGCT, 14.6%; and SCST, 29.2%, p<0.001). Live birth rates, neonatal weight, full term delivery rates, and Cesarean section rates were similar between the teenage group and the non-teenage group (all, p>0.05); however, teenage pregnancy was significantly associated with an increased risk of serious maternal/neonatal adverse events (50% vs. 22.7%, p=0.013). On univariable analysis, teenage pregnancy was significantly associated with decreased ovarian cancer-specific survival (5-year rate: age ≥30, 79.6%; age 20–29, 87.2%; and age <20, 41.6%; p<0.001). On multivariable analysis controlling for calendar year, cancer type, cancer stage, and gestational age at ovarian cancer diagnosis, teenage pregnancy remained an independent prognostic factor for decreased ovarian cancer-specific survival compared to women aged ≥30 (adjusted-hazard ratio=4.71; 95% confidence interval=1.17–18.9; p=0.029). Conclusion: Teenage women with pregnancies complicated by primary ovarian cancer may be at increased risk of poor survival from ovarian cancer.

Ovarian pregnancy rupture in second trimester manifesting mental change in pregnancy: a case report

( Dong Won Hwang,),( Hae Won Choi ),( Yun Yeon Choi ),( Hee Sun Kim ),( Young Ah Kim ),( Kyoung-chul Chun ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

Ovarian pregnancies comprise approximately 3% of ectopic pregnancies. Moreover, ovarian pregnancies in the second trimester are extremely rare. We herein present a case of ruptured ovarian pregnancy in the second trimester. A 26-year-old Asian woman presented to our hospital complaining of an abrupt mental change. She was pregnant; however, she had not been receiving antenatal care. Her initial vital signs were unstable, and pelvic ultrasound revealed pelvic fluid collection. We analyzed the hemoperitoneum and performed exploratory laparotomy. When her abdomen was opened, we observed that her right ovary was ruptured. Placental cord insertion originated from the ovary, and a fetus was found in the pelvic cavity. The ovarian pregnancy was detected in a delayed state. Pregnant women require appropriate antenatal care, and pelvic ultrasound should be performed in the second trimester to ensure that the fetus is in the intrauterine cavity.

난소임신에 관한 증례보고

황효순 ( Hyo Soon Hwang ),조금준 ( Geum Joon Cho ),진찬희 ( Chan Hee Jin ),오민정 ( Min Jeong Oh ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.2

Ovarian pregnancy is a rare form of ectopic pregnancy, and is most difficult to diagnosis before surgery. This study was conducted as a retrospective cohort series of women presenting to Korea University Medical Center between January 2000 and July 2011 in whom a diagnosis of ovarian pregnancy was made. We had total 7 cases of ovarian pregnancies between January 2000 and July 2011 at Korea University Medical Center. The mean age of the 7 ovarian pregnancy cases was 33.0 years (range, 22 to 42 years), mean parity was 1.0 (range, 0 to 3), mean gestational age at diagnosis was 8.0 (range, 5.6 to 12.4 weeks), and mean initial beta human chorionic gonadotropin (HCG) was 1,195.49 mIU/mL (range, 200.5 to 2,098.201 mIU/mL). The beta HCG level was lower remarkably in ovarian pregnancy group than in the tubal pregnancy group, and further study may be needed to find out the correlation between beta HCG level and ovarian pregnancy.

복강경을 이용한 난소임신의 보존적 수술 1 예

김경모(KM Kim),유호근(HG Yoo),김성태(ST Kim),양거승(KS Yang),정호순(HS Chung) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.6

Ovarian pregnancy is a rare form of ectopic pregnancy. Lately, prevalence of ovarian pregnancy is on the increase, the age is tending younger. In the past, oopherectomy was a major part as a surgical management of ovarian pregnancy. But, by young women who want to keep ability for pregnancy are on the increase, conservative surgery like, wedge resection or cystectomy is on the increase. All the more because of the development and merit of laparoscopy, laparoscopy than laparotomy is on the increase in the surgical management of ectopic pregnancy, and ovarian pregnancy is no an exception. One case of ovarian pregnancy that treated by conservative surgery under the surgical laparoscopy are presented with a brief review of the literatures.

Ovarian Cancer during Pregnancy: Clinical and Pregnancy Outcome

권용순,목정은,임경택,이인호,김태진,이기헌,심재욱 대한의학회 2010 Journal of Korean medical science Vol.25 No.2

The aim of this study is to evaluate the clinical feature and pregnancy outcome in patients with ovarian cancer diagnosed during pregnancy. We retrospectively analyzed the medical records of 27 patients diagnosed with ovarian cancer during pregnancy at Cheil General Hospital & Women’s Healthcare Center from January 1996to December 2006. Mean age of the patients was 29.1 yr (range 23-40), and a mean follow-up period was 57 months (range 7-112 months). Of 27 patients, 15 (55.5%)had borderline malignancies, 7 (25.9%) had epithelial malignancies and 5 (18.6%)had germ cell tumors. A total of 26 patients received a conservative surgery preserving pregnancy. The mean time for surgical intervention during pregnancy was 20 weeks of gestational age. Of the 27 patients, 26 had full term delivery of a healthy baby without any congenital malformation. Only one patient with epithelial ovarian cancer had a relapse at 19 months after the first conservative operation with adjuvant chemotherapy. There were few data for managing patients with ovarian cancer diagnosed during pregnancy. This study results could help establish a guideline for management of ovarian malignancy complicating pregnancy.