F. Kobayashi et al., RAPID GROWTH OF AN OVARIAN CLEAR-CELL CARCINOMA EXPRESSING LH HCG RECEPTOR ARISING FROM ENDOMETRIOSIS DURING EARLY-PREGNANCY/, Gynecologic oncology, 62(2), 1996, pp. 309-313
The complete clinical course of a case of ovarian clear cell carcinoma
expressing luteinizing hormone (LH)/human chorionic gonadotropin (hCG
) receptor arising from endometriosis in a pregnant woman is presented
. A 31-year-old woman visited a private clinic in May 1993 for screeni
ng tests for infertility. Transvaginal ultrasonography revealed no abn
ormal findings in the uterus or ovaries, Her menstrual cycle was regul
ar; however, a slight luteal insufficiency was noted, She had been tre
ated with clomiphene, and soon became pregnant. She was diagnosed to b
e at 5 weeks gestation in June, and at the same time, an ovarian tumor
with the diameter of 5 cm was identified, Since the tumor had grown r
apidly and was 9 cm in diameter 1 week later, she was referred to our
hospital. When she was admitted to our hospital at 9 weeks gestation,
the tumor diameter was 14 cm and we found the solid portion within the
ovarian tumor. The levels of the tumor markers CA125 and CA19-9 were
106 and 51 U/ml, respectively. The crown-ramp length of the fetus (24
mm) was compatible with the gestational age, and fetal heartbeat was c
onfirmed. Under the diagnosis of ovarian carcinoma, right salpingo-oop
horectomy was performed at 10 weeks of gestation. Postoperative histol
ogical examination revealed a clear cell carcinoma and endometriosis o
f the right ovary, Immunohistochemically, the clear cell carcinoma sta
ined positively for LH/hCG receptors and estrogen receptors, but not p
rogesterone receptor. No malignant cells were detected by ascitic cyto
logy, Exploratory specimens obtained at the time of operation from the
left ovary and pelvic lymph nodes exhibited no malignant cells. Based
on these findings, the pregnancy was allowed to proceed, and she deli
vered a 3010-g male baby at 39 weeks of gestation. She had no signs of
recurrence for 2 years after the operation. (C) 1996 Academic Press,
Inc.