Use of hormone suppression then oocyte freezing to preserve reproductive capability in an adolescent girl with ovarian luteinized thecoma associated with sclerosing peritonitis.

Abstract

OBJECTIVE:

To describe a case of ovarian luteinized thecoma, a rare ovarian neoplasm, which is only the 26th reported case associated with sclerosing peritonitis.

DESIGN:

Case report.

SETTING:

NYU Fertility Center and Memorial Hospital for Cancer and Allied Diseases, New York.

PATIENT(S):

A 17-year-old woman presenting with a large pelvic mass and abdominal pain.

INTERVENTION(S):

Conservative surgical treatment with laparotomy, unilateral salpingooophorectomy, and biopsy of contralateral ovary. Gonadotropin-releasing hormone agonist suppression. Ovarian hyperstimulation with oocyte retrieval/freezing to preserve biologic fertility.

MAIN OUTCOME MEASURE(S):

Response to conservative therapy and oocyte cryopreservation as a method of fertility preservation.

RESULT(S):

At laparotomy, obvious unilateral ovarian involvement was present, and a left salpingoophorectomy was performed. Biopsy of the contralateral ovary confirmed bilateral disease. The initial pathological review was complicated by extensive ovarian edema. The patient was treated with gonadotropin-releasing hormone agonist suppression plus intermittent estradiol supplementation. When she became intolerant of hormone therapy and when removal of the remaining ovary became a possibility, she underwent ovarian hyperstimulation; oocyte retrieval and freezing were performed to preserve her biologic fertility. Thirty-eight eggs were obtained.

CONCLUSION(S):

Surgically diagnosed luteinized thecoma can be managed medically. Oocyte cryopreservation as a means of fertility preservation should be considered in young women with this diagnosis who are at risk for bilateral gonad removal.

• Authors: Nicole Noyes, Rosanna C Perretta, M Elizabeth Fino, Theodore Matulewicz, Richard Barakat
• Journal: Fertility and sterility (Fertil Steril) Vol. 92 Issue 1 Pg. 393.e11-4 (Jul 2009) ISSN: 1556-5653 [Electronic] United States
• PMID: 19327766 (Publication Type: Case Reports, Journal Article)

Chemical References

• Gonadotropin-Releasing Hormone
• Estradiol

Topics

• Adolescent
• Cryopreservation (methods)
• Estradiol (therapeutic use)
• Female
• Gonadotropin-Releasing Hormone (agonists)
• Humans
• Oocyte Retrieval (methods)
• Oocytes (cytology)
• Organ Preservation (methods)
• Ovarian Neoplasms (complications, drug therapy, pathology)
• Ovulation Induction (methods)
• Peritonitis (complications)
• Thecoma (complications, drug therapy, pathology)