521 Ovarian carcinoma after long-term ovulation induction-reality or coincidence?

• Published in: European journal of cancer (1990) 1995-11, Vol.31, p.S111-S111
• Main Author: Jevremović, Milan I.
• Format: Article
• Language: English
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/0959-8049(95)95775-2

In September 1994 thirty-nine years old woman was admitted for lower right abdominal pain. During 1993/1994 there were 7 ovulation inductions with hMG/hCG followed by either artificial insemination of IVF-ET procedure, the last one in April. Complaints dated from that time. Lower right abdominal pain persisted and even worsened after treatment with antibiotics and hemotherapeutics. After preoperative evaluation adnexectomy was performed. Multilocular highly differentiated serous papillary cystadenocarcinoma was found, displaying moderate nuclear atypia and small areas of clear-cell differentiation, with foci of necrosis and stromal microinvasion. Elevated serum CA-125 levels at the time of operation slightly decreased four weeks after (from 145 IU/ml to 124 IU/ml). Serum concentrations of CA-125 were within normal range between 6 th to 8 th postoperative week. Nine weeks after operation, at the end of December, severe metrorrhagia occurred and curettage was performed. Histological evaluation of the obtained material showed papillary cystadenocarcinoma endometrioides endometrii G 1NG 1. Serum CA-125 were extremely elevated to the values of 1360 IU/ml. In January 1995 hysterectomy, adnexectomy and omentectomy were performed. There were no apparent metastatic features during the operative procedure. In order to assess current knowledge of the potential excess risk of ovarian carcinomas associated with ovulation induction, a Medline search of the literature was performed. It was confirmed that up to December 1994 there are eleven cases of ovarian malignancies after ovulation induction. Our patient is the twelfth one.