Advanced sex cord tumor and pregnancy with poor outcome

Background: Sex cord stromal tumors are a rare ovarian tumor account 5-8% of all ovarian malignancies. They occur most frequently in young women and median time to relapse is about 4-6 years after initial diagnosis. They have good prognosis on early stage however late recurrence are not uncommon. Here we report an early recurrence after poorly differentiated sex cord tumor (stage IA) and catastrophic progress. Case: 29 years old null gravida who had unilateral salpingo_oophorectomy due to pelvic mass , pathologic study was poorly differentiated sex cord tumor. She received 4 courses chemotherapy (etoposide and cisplatin). 6 months after last course of chemotherapy she became pregnant, at 28 weeks of gestation developed with huge pelvic mass, sever ascites and dyspnea so exploratory laparotomy was done. Uterus and ovary was normal and 30 cm retroperitoneal abdominopelvic mass resected, she tolerated operation well.This case presented in multidisciplinary oncology conference and termination at 34weeks for start chemotherapy was recommended. 5 weeks post operation 5*6 cm abdominal mass and ascites was detected, at 33 weeks of gestation she had Cesarean section due to breech and labor and resection of abdominal mass was done. 3 weeks after first course of chemotherapy referred with decreased level of consciousness and bone marrow suppression. Brain CT scan had hypo dense area suspicious of malignancy. Unfortunately, she was expired 2 weeks later.Conclusion: Five years survival rate of this tumors is 70_90percentage, most of them are at early stage with low late recurrence and low potential malignancy. Poorly differentiated type is common cause of mortality.

کلیدواژه ها:

cord tumor ، pregnancy ، outcome