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Table of Contents
CLINICAL IMAGE
Year : 2020  |  Volume : 9  |  Issue : 2  |  Page : 106-107

Inevitable removal of left accessory ovary


1 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhonnayok; Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, TaoYuan, Taiwan
2 Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital; Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, TaoYuan, Taiwan
3 Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, TaoYuan, Taiwan

Date of Submission29-May-2018
Date of Decision20-Sep-2019
Date of Acceptance04-Mar-2020
Date of Web Publication28-Apr-2020

Correspondence Address:
Dr. Hsin- Hong Kuo
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Kweishan, Taoyuan, 333
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_44_18

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How to cite this article:
Tantitamit T, Lee CL, Kuo HH. Inevitable removal of left accessory ovary. Gynecol Minim Invasive Ther 2020;9:106-7

How to cite this URL:
Tantitamit T, Lee CL, Kuo HH. Inevitable removal of left accessory ovary. Gynecol Minim Invasive Ther [serial online] 2020 [cited 2020 May 25];9:106-7. Available from: http://www.e-gmit.com/text.asp?2020/9/2/106/283338



A 45-year-old woman presented with a history of abnormal uterine bleeding. Transvaginal sonography and hysteroscopy demonstrated the enlarged uterus with an anterior submucosal myoma. Laparoscopic hysterectomy was scheduled. During the surgery, an enlarged uterus over pelvic brim with both normal adnexal was identified. There was a 2 cm × 3 cm structure resembling ovarian tissue located on the left side of the posterior wall of the uterus [Figure 1]. It connected to the epiploic appendices of sigmoid by a thin strand of ligamentous adhesion proximally and acquired blood supply through a ligament-like conjunction to the uterus. Although an accessory ovary was impressed, resection of which was inevitable to avoid ischemia and performed along with the uterine specimen. Final histology revealed corpus luteal cyst, confirming the diagnosis of an accessory ovary.
Figure 1: Laparoscopic view of the left accessory ovary with adhesion to sigmoid. A: Accessory ovary, LO: Left ovary, S: Sigmoid

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Accessory ovary is an extremely rare gynecologic condition, with a reported incidence of 1/93,000, and usually detected incidentally.[1] Differentiation needs to be made from supernumerary ovary, which is entirely separated from the normal ovary and is located at a different position. However, the accessory ovary is defined as excess ovarian tissue that is situated near the normal ovary, which may or may not connect to it.[2],[3] It seems to have developed from the tissue that was split from the embryonic ovary during its development. Most case reports describe the sizes of accessory ovaries are less than 1 cm.[1],[4] Our case is unique in approximate equal size and shape of a normal ovary. Congenital gynecological and renal anomalies are associated with accessory ovary in one-third of patients.[2],[5] Extragonadal ovarian tumor has been reported. Most of the cases originated from autoamputated mature cystic teratoma. Yazawa et al. reported a case of ovarian fibroma adherent to the sigmoid colon originated from an autoamputated ovary.[6]

The accessory ovary has potential to be preserved under well recognition of this anomaly and an instant frozen biopsy.

Ethical approval

This study was approved by Institutional Review Board of Chang Gung Medical Foundation (IRB number: 202000220B0). Waiver of informed consent was approved by the IRB.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Vendeland LL, Shehadeh L. Incidental finding of an accessory ovary in a 16-year-old at laparoscopy. A case report. J Reprod Med 2000;45:435-8.  Back to cited text no. 1
    
2.
Wharton LR. Two cases of supernumerary ovary and one of accessory ovary, with an analysis of previously reported cases. Am J Obstet Gynecol 1959;78:1101-19.  Back to cited text no. 2
    
3.
Nishio E, Hirota Y, Yasue A, Nishizawa H, Tsukada K, Udagawa Y. Two cases of ectopic ovary and one case of potential ectopic ovary. Reprod Med Biol 2011;10:51-4.  Back to cited text no. 3
    
4.
Nichols JL, Zhang XM, Bieber EJ. Case of accessory ovary in the round ligament with associated endometriosis. J Minim Invasive Gynecol 2009;16:216-8.  Back to cited text no. 4
    
5.
Benbara A, Tigaizin A, Carbillon L. Accessory ovary in the utero-ovarian ligament: An incidental finding. Arch Gynecol Obstet 2011;283 Suppl 1:123-5.  Back to cited text no. 5
    
6.
Yazawa H, Takiguchi K, Kato A, Imaizumi K. An unusual presentation of ovarian fibroma originating from an autoamputated ovary. Gynecol Minim Invasive Ther 2019;8:40-3.  Back to cited text no. 6
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