Accidental ovarian autograft after a laparoscopic surgery: case report

OBJECTIVE: To report an autograft of ovarian tissue in the incision of the surgical trocar during laparoscopic surgery and to assess the potentiality of grafting of ovarian parenchyma in nonpelvic tissue in humans. DESIGN: A case report. SETTING: Instituto de Fertilidad y Ginecología de Buenos Aires (IFER), Buenos Aires, Argentina. PATIENT(S): Infertile patient undergoing surgery due to an endometriotic cyst of the left ovary. INTERVENTION(S): Laparoscopic cystectomy. Accidental retention of a portion of the capsule and adjacent ovarian tissue of the endometrioma in SC cellular tissue. Months after surgery, a SC tumor was formed under the surgical incision. It was subsequently excised. MAIN OUTCOME MEASURE(S): Observation of tumor growth during menstrual cycles and ovulation induction; anatomopathologic study of the tissue after its extirpation. RESULT(S): The tumor grew spontaneously in the periovulatory period and during treatments of ovulation induction. The anatomopathologic report of the tumor, removed 15 months after the first surgery, revealed functioning ovarian tissue with vessels of neoformation. CONCLUSION(S): This is the first description of autografted ovarian tissue in humans. We describe that the ovary can maintain its ovulatory function even in the absence of its pedicel. Also, we suggest that extirpation of surgical material through the incision of the trocar is not recommended, as the possibility of "sowing" or of autografts may occur.