Ovarian transposition for the preservation of ovarian function in young patients with cervical carcinoma.

Radiotherapy with or without surgery for the treatment of pelvic malignancies irreversibly destroys the hormonal activity and reproductive capacity of ovaries in young women. On the other hand, menopausal symptoms associated with estrogen deficiency is an important contributor to the poor quality of life scores in gynecologic cancer survivors. Transposing of the ovaries into the paracolic gutters (ovarian transposition) was described in 1958 with the aim of protecting gonadal functions in reproductive-aged women treated by pelvic radiotherapy and/or surgery. Although the laparatomic approach has been used as a parallel to development in endoscopic surgery, today it is generally performed laparoscopically. However, there is ongoing debate about the effectiveness of ovarian tranposition with respect to protecting gonadal functions. Moreover, metastasis to the transposed ovaries and port sites is another concern about this procedure. In this short review, indications, techniques and functional outcomes of ovarian transposition have been summarized.

Bilateral breast metastasis of ovarian carcinoma.

Primary breast carcinoma is the most common malignancy in women, however, metastatic breast carcinoma is rarely seen in clinical practice. It has been reported that lymphoma-leukemia, melanoma and sarcomas, the most common primary malignancies, can metastasize to the breast. On the other hand, ovarian carcinoma and other gynecologic cancers rarely develop into breast metastasis. However, the incidence of breast metastasis arising from ovarian carcinoma might be increasing as a result of prolongation in survival and improvement in treatment modalities. Bilateral breast metastasis originating from an ovarian carcinoma is an extremely rare clinico-pathological situation. In our literature review we found just nine cases of bilateral breast metastasis from primary ovarian carcinoma. In this study, the mean age was 46 years (range 16-68). Mean interval from initial diagnosis of ovarian carcinoma to bilateral breast metastases was 22 months (range 11-24) and mean survival was 12 (range 5-27) months after the diagnosis of breast metastasis. Serous papillary adenocarcinoma was the predominant histological subtype. Interestingly, five of the nine (56%) cases reported were from Turkey. This interesting observation can be explained by a genetic predisposition, but it requires further research. In conclusion, although it is a rare entity, breast metastasis should not be ruled out in patients with a history of ovarian carcinoma, if patients present with any symptoms of breast diseases.