Gynecology: Polyembryoma ovarian — surgery treatment. Treatment
Ovarian polyembryoma is a malignant tumor derived from primordial germ cells. It is diagnosed extremely rarely, mainly in girls and young women. It is distinguished from the other formations by the presence of microscopic embryo-like cells similar to normal embryos in the early development stages. Polyembryoma treatment includes the use of surgical and chemotherapeutic methods.
Surgical intervention is indicated to all patients, regardless of the tumor size. In the early stages of the disease, the organ-preserving surgery is acceptable, which will keep the patient's reproductive function. Laparotomy allows to remove the affected ovary and the adjacent fallopian tube. To determine the stage of the malignant process accurately, the surgeon carefully examines the abdominal organs, performs a biopsy of the peritoneum, diaphragm, lymph nodes and any suspicious areas.
Upon invasion of the ovary capsule or bilateral nature of the disease, the radical intervention is indicated, i.e. removal of the uterus with appendages and greater omentum. If the individual components are identified on the peritoneum, they also excised too. The retroperitoneal or iliac lymphadenectomy (resection of the affected lymph nodes) is performed, subject to indications.
For Advanced (metastatic) polyembryomas, the purpose of the surgery is to remove as much tumor mass as possible. The physician excises the primary formations and all visible metastases. In patients with multiple tumor lesions, surgical treatment may be carried out after 2 to 3 cycles of chemotherapy.
After surgery, all patients receive chemotherapy. The cytostatics dosage regimen is selected in view of the process stage. Patients with the 1st stage are usually recommended 3 courses of therapy under BEP program, are the rest, 4 courses under PEI or BEP program.
The treatment outcome is assessed by laboratory tests, abdominal ultrasound and chest X-ray. The survey is repeated twice, before the 3rd course and after therapy completion. In the absence of effect, the anticancer drugs of the second line are prescribed. The patients with positive dynamics may undergo the second surgery.
After treatment completion, all patients need follow-up by the oncologist.Hide