Ovarian cancer diagnosed accidentally during treatment for ruptured ectopic pregnancy: is fertility-sparing surgery a viable alternative? Case report and review of the literature

According to cancer incidence statistics, it is estimated that 226,000 women are diagnosed annually with epithelial ovarian cancer (EOC) and 140,000 die of the disease worldwide. Ovarian cancer represents the fourth leading cause of all cancer-related deaths in women, and the first cause of death among all gynecological malignancies. With the constant shift towards later parenthood, the growing incidence of EOC in women of reproductive age is noted. Most young EOC women are concerned with preserving their fertility despite oncological outcomes. Nowadays gynecologic oncologists are being asked to include into their decision-making processes the patients' desire for fertility preserving alternatives. The question remains whether it is possible to use fertility-sparing surgery (FSS) without compromising the survival. In the present report, the authors present a case of a 27-year-old patient with ovarian cancer accidentally diagnosed during surgical treatment of an ectopic pregnancy. In this paper, the proper selection of the patients for the conservative management, oncological safety, indications for subsequent chemotherapy, the risk of relapses, obstetrical outcomes, and further oncological control were analyzed based on the largest and most relevant series outcomes data and recommendations. Numerous recent studies have confirm that FSS in young women with early stage of epithelial ovarian cancer, who wish to preserve their childbearing potential, after appropriate selection, appears a viable and safe option. However, there is still a possibility of relapse and regular oncological control is strongly recommended.

Epithelial ovarian cancer; Fertility-sparing surgery (FSS); Obstetrical outcome; Ectopic pregnancy.

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