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Transposição dos ovários em mulheres com cancro do colo do útero: o que o radiologista precisa de saber
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Abstract(s)
A transposição dos ovários consiste num procedimento cirúrgico cujo objectivo é preservar a função hormonal em mulheres pré-
menopáusicas com neoplasias pélvicas submetidas a radioterapia. Uma vez que os ovários transpostos podem ter qualquer localização
nas goteiras parieto-cólicas, é fundamental reconhecê-los nos estudos de follow-up e evitar confundi-los com implantes peritoneais.
É também importante conhecer a predisposição desta população para a formação de quistos ováricos e sempre que possível
diferenciar lesões benignas de lesões potencialmente suspeitas.
Foram revistos retrospectivamente os achados radiológicos de mulheres com cancro do colo do útero submetidas a histerectomia
com transposição dos ovários entre Janeiro de 2007 e Agosto de 2009 no IPOLFG. Os ovários foram identificados nas goteiras
parieto-cólicas em 75% dos casos. Documentaram-se lesões quísticas em 25% das doentes, tendo sido observado um caso de
metastização ovárica.
O radiologista deve estar familiarizado com os aspectos radiológicos normais dos ovários transpostos e saber reconhecer as
principais anomalias associadas a este procedimento.
Cervical cancer is estimated to occur in women younger than 40 years in nearly 50% of the cases. Since radiation therapy plays an important role in the management of this condition, lateral ovarian transposition can be performed in selected cases to preserve hormonal function. The transposed ovaries can be localized anywhere in the paracolic gutters, so it is important to recognize them in the follow-up studies and to distinguish normal ovaries from peritoneal implants. Several studies report an increased incidence of cyst formation in this population therefore it is also crucial to differentiate benign from malignant lesions. We retrospectively reviewed imaging findings of cervical cancer patients submitted to ovarian transposition at our institution between January 2007 and August 2009. Transposed ovaries were recognized in 75% of the cases. Cyst formation was reported in 25% of the cases, which is concordant with the literature. Metastatic cancer to the ovaries occurred in one case. The radiologist should be able to recognize normal transposed ovaries, to describe their location and to diagnose the most frequent anomalies associated with this procedure.
Cervical cancer is estimated to occur in women younger than 40 years in nearly 50% of the cases. Since radiation therapy plays an important role in the management of this condition, lateral ovarian transposition can be performed in selected cases to preserve hormonal function. The transposed ovaries can be localized anywhere in the paracolic gutters, so it is important to recognize them in the follow-up studies and to distinguish normal ovaries from peritoneal implants. Several studies report an increased incidence of cyst formation in this population therefore it is also crucial to differentiate benign from malignant lesions. We retrospectively reviewed imaging findings of cervical cancer patients submitted to ovarian transposition at our institution between January 2007 and August 2009. Transposed ovaries were recognized in 75% of the cases. Cyst formation was reported in 25% of the cases, which is concordant with the literature. Metastatic cancer to the ovaries occurred in one case. The radiologist should be able to recognize normal transposed ovaries, to describe their location and to diagnose the most frequent anomalies associated with this procedure.
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Keywords
Transposição dos ovários Neoplasia colo do útero Histerectomia radical Ovarian transposition Cervical cancer Radical hysterectomy
Citation
Sara Belião; Teresa Margarida Cunha. Ovarian Transposition in Patients with Cervical Carcinoma: Imaging Pearls and Pitfalls, Acta Radiológica Portuguesa, 24, 93, 25-30, 2012.