Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3212-3218
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3212
Laparoscopic uncontained power morcellation-induced dissemination of ovarian endodermal sinus tumors: A case report
Ha Kyung Oh, Seong Nam Park, Byoung Ryun Kim
Ha Kyung Oh, Seong Nam Park, Byoung Ryun Kim, Department of Obstetrics and Gynecology, Wonkwang University Hospital, Iksan 54645, Jeollabuk-do, South Korea
Author contributions: Oh HK and Park SN obtained the patient consent, collected patient data, and contributed to manuscript drafting; Kim BR was the operating surgeon of this patient and responsible for the revision of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Byoung Ryun Kim, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Wonkwang University Hospital, 895 Muwang-ro, Iksan 54645, Jeollabuk-do, South Korea. brkim74@wku.ac.kr
Received: December 31, 2020
Peer-review started: December 31, 2020
First decision: January 25, 2021
Revised: February 3, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: May 6, 2021
Abstract
BACKGROUND

Endodermal sinus tumors (ESTs), which arise primarily in children and adolescents, account for 20% of malignant ovarian germ cell tumors, but constitute only 1% of all ovarian malignancies. Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.

CASE SUMMARY

A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital. Exploratory laparotomy; total abdominal hysterectomy, right salpingo-oophorectomy, and lymphadenectomy were performed with optimal debulking, and surgical stage 3C was assigned to the patient.

CONCLUSION

In 2014, the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue. Furthermore, the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor. This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.

Keywords: Dissemination, Endodermal sinus tumor, Morcellation, Yolk sac tumor, Case report

Core Tip: Laparoscopic power morcellation is useful technique in that large specimens can be removed through a small incision. However, the use of power morcellation to remove solid adnexal masses is considered a contraindication because solid adnexal masses cannot be completely excluded from the possibility of malignant tumor. Here, we report a case of disseminated ovarian endodermal sinus tumors after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation. This case highlights the possibility of disseminated suspected malignancy after laparoscopic uncontained power morcellation, and gynecologists should be cautious about using uncontained power morcellation for solid adnexal masses.