Ovarian Malignancies Incidentally Diagnosed During Cesarean Section: Analysis of 13 Cases

Introduction: To describe and analyze the clinicopathologic characteristics of ovarian malignancies discovered at cesarean section (CS). Methods: A retrospective study based on clinical histories from 13 patients diagnosed concurrently with CS at our hospital from January 1991 to December 2008. Results: The incidence of ovarian malignancies diagnosed during CS was 0.21 in 1000 CS. Histopathologic categories included malignant germ cell tumor (2, 15.38%), invasive epithelial carcinoma (3, 23.08%) and low-malignant potential tumor (8, 61.54%). All patients were clinically asymptomatic and diagnosed in stage I. Ovarian masses were detected by ultrasound in only 5 patients before surgery, but no malignancy was indicated. Tumor sizes ranged from 2.5 to 30 cm. Six malignancies were diagnosed by paraffin section after surgery, and of these, 2 patients received second surgery for tumor staging. Conservative surgical treatment was performed on 12 patients. Three patients received adjuvant chemotherapy. All patients are currently in complete remission. No maternal and fetal complication related to surgery was observed. Conclusions: Ultrasound in the first trimester is recommended to rule out the adnexal mass. Frozen section is indicated for any suspicion. Conservative therapy could be applied to most patients with good prognosis if the patient was chosen carefully.