Abstract:

Radical surgery for cervical cancer combined with ovarian transposition is increasingly performed in young patients with cervical cancer. However, the occurrence of tumors in transposed ovaries is relatively rare. Tumors arising in transposed ovaries after cervical cancer surgery have an insidious onset and lack typical symptoms, posing certain challenges in clinical diagnosis and management. This report presents two cases admitted to the Affiliated Hospital of Guizhou Medical University in 2023. Both patients had previously undergone abdominal radical hysterectomy, bilateral salpingectomy, pelvic lymphadenectomy, and bilateral ovarian transposition for cervical cancer. During surgery, both ovaries were preserved and transposed to the ipsilateral paracolic gutters, located in the iliac fossae. During postoperative follow-up, neither patient reported discomfort such as abdominal pain or bloating. They were admitted to the hospital due to the discovery of pelvic masses on imaging studies, which were initially suspected to be metastasis to the transposed ovaries from cervical cancer. Postoperative pathological examination confirmed that one case was a primary benign cyst in the transposed ovary after cervical cancer surgery, and no abnormalities have been detected during follow-up to date. The other case was a primary malignant tumor of the transposed ovary after cervical cancer surgery. This patient received four cycles of supplemental chemotherapy with paclitaxel combined with carboplatin postoperatively. During follow-up, metastasis to the descending colon accompanied by mechanical intestinal obstruction was discovered. The patient did not attend scheduled follow-up visits after discharge. These cases suggest that when a tumor is detected in a transposed ovary after cervical cancer surgery, clinicians should not limit their differential diagnosis to metastasis from cervical cancer. They should also be vigilant about the possibility of primary tumors developing in the preserved ovaries to reduce misdiagnosis and mismanagement.

Key words: Uterine cervical neoplasms, Carcinoma, Ovarian neoplasms, Diagnosis, Therapy, Prognosis, Transposed ovary