Our Summary

This research paper is about a case study of a woman in her 60s, who had never been pregnant and was past menopause. She came to the hospital because she had a large growth in her abdomen that had been getting bigger for two months. The doctors found that she also had excess fluid in her abdomen. They used an ultrasound to get a look at the growth, and it seemed like it could be cancer, based on two specific criteria.

Because they thought it could be cancer, the doctors performed surgery to remove her uterus and ovaries. They examined the growth during and after the surgery, and found that it was actually an endometrioma, which is a cyst caused by a condition called endometriosis.

Endometriosis is a condition where tissue similar to the lining of the uterus starts to grow outside the uterus. It is quite rare in women who are past menopause. However, doctors should keep an eye out for it, as it can sometimes turn into cancer and can come back after being treated. The study suggests that women who have had this kind of surgery should be followed up closely afterwards.

FAQs

  1. What is a salpingo-oophorectomy and why was it performed in this case?
  2. How is a mass classified as malignant based on the IOTA Simple Rules?
  3. What is the significance of postmenopausal endometriosis and what are the risks associated with it?

Doctor’s Tip

A helpful tip a doctor might tell a patient about salpingo-oophorectomy is to follow up regularly with your healthcare provider after the surgery. This is important for monitoring any potential complications, ensuring proper healing, and discussing any necessary hormone replacement therapy or other treatment options. It is also important to communicate any new or concerning symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended salpingo-oophorectomy include those with suspected or confirmed gynecological cancer, such as ovarian, fallopian tube, or primary peritoneal cancer. Additionally, patients with a high risk of developing gynecological cancer, such as those with a family history of ovarian or breast cancer, may also be recommended for prophylactic salpingo-oophorectomy. Other indications for salpingo-oophorectomy may include the presence of ovarian cysts, endometriosis, or other benign gynecological conditions that require surgical intervention.

Timeline

  • Patient presents with abdominal mass and ascites
  • Physical examination reveals mobile cystic mass
  • Transvaginal ultrasonography confirms presence of mass with features suggesting malignancy
  • Total hysterectomy and bilateral salpingo-oophorectomy with frozen section performed
  • Frozen section and histopathological examination reveal right endometrioma
  • Postoperative follow-up recommended for monitoring recurrence and malignant transformation risk

What to Ask Your Doctor

  1. What is a salpingo-oophorectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with this procedure?
  3. Will this surgery affect my hormone levels and menopausal symptoms?
  4. How will this surgery impact my future fertility and sexual function?
  5. What is the recovery process like after a salpingo-oophorectomy?
  6. Are there any alternative treatment options for my condition?
  7. How often will I need follow-up appointments and monitoring after the surgery?
  8. What are the chances of the mass being malignant, and what will happen if it is?
  9. How will this surgery impact my overall health and quality of life in the long term?
  10. Are there any lifestyle changes or precautions I should take after the surgery?

Reference

Authors: Mantilidewi KI, Ridwan S, Kurniadi A, Harsono AB. Journal: BMJ Case Rep. 2025 Mar 14;18(3):e260892. doi: 10.1136/bcr-2024-260892. PMID: 40086852