Laparoscopic uncontained power morcellation-induced dissemination of ovarian endodermal sinus tumors: A case report

BACKGROUND Endodermal sinus tumors (ESTs), which arise primarily in children and adolescents, account for 20% of malignant ovarian germ cell tumors, but constitute only 1% of all ovarian malignancies. Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy. CASE SUMMARY A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital. Exploratory laparotomy; total abdominal hysterectomy, right salpingo-oophorectomy, and lymphadenectomy were performed with optimal debulking, and surgical stage 3C was assigned to the patient. CONCLUSION In 2014, the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue. Furthermore, the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor. This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.

Automated summary

Endodermal sinus tumors (ESTs) are rare malignant ovarian germ cell tumors primarily occurring in children and adolescents, comprising 20% of all malignant ovarian germ cell tumors. Surgical staging, fertility-sparing surgery, and chemotherapy are the main treatments. This case report highlights the risks associated with using uncontained power morcellation to treat solid adnexal masses.