RAPID GROWTH OF AN OVARIAN CLEAR-CELL CARCINOMA EXPRESSING LH HCG RECEPTOR ARISING FROM ENDOMETRIOSIS DURING EARLY-PREGNANCY/

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.