Vascular complication during staging lymphadenectomy in early-stage ovarian cancer

Abstract

Ovarian cancer (OC) is the fifth most frequent cancer in Europe and currently represents the main cause of death in women presenting gynecological cancer. In 70% of cases, the disease may be diagnosed at an advanced stage with nonspecific symptoms. In the early stages OC, surgical staging is needed to assess the extent of the disease. According to the National Comprehensive Cancer Network (NCCN), surgical staging includes total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, peritoneal biopsies, and pelvic and lumboaortic lymphadenectomy. The classic surgical approach provides a median laparotomic longitudinal incision. However, in specialized centers, staging surgery may be performed through laparoscopic surgery for selected patients. Laparoscopic approach showed minor intra and postoperative complications, shorter hospital stay, faster return to work, and better aesthetic satisfaction when compared to laparotomic surgery. Nonetheless, even minimally invasive surgery is not without complications. In case of major complications occurring during laparoscopy rapid and prompt life-saving treatments could be necessary. We present a 63-year-old woman case with a 55 mm, multilocular-solid left adnexal mass, Color Score 2, with abnormal CA 125, requiring comprehensive staging surgery. The study aims to show a possible and dangerous vascular complication that may occur during staging lymphadenectomy in early-stage OC. In this case, a rapid laparotomic conversion was needed to quickly stop bleeding.