Malignant neoplasia arising from ovarian remnants following bilateral salpingo-oophorectomy (Review)

Atsushi Imai, Kazutoshi Matsunami, Hiroshi Takagi, Satoshi Ichigo
Oncology letters · 2014 · vol. 8(1) , pp. 3–6 · doi:10.3892/ol.2014.2089 · PMID:24959210 · W1986727977
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Malignant neoplasia can arise from residual ovarian tissue after bilateral salpingo-oophorectomy, particularly in patients with endometriosis, and surgical removal of ovarian remnants is recommended when endometriosis is present during BSO.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This review examines ovarian remnant syndrome (ORS), focusing on malignant and benign tumors that arise from histologically confirmed residual ovarian cortical tissue after bilateral salpingo-oophorectomy, and summarizes reported clinical features and pathology across previously published cases. It reports that endometriosis is a common preexisting condition and discusses a disproportionately high prevalence of endometriotic histology among ORS cases with malignant transformation, while noting that ORS incidence is unknown and the available evidence is limited by small numbers of cases and incomplete data on timing from ORS to neoplasia (mean time to adenocarcinoma reported as 12.6 years, range 2–54). The review concludes that neoplasia in ovarian remnants is rare but documented, with various tumor types described and imaging/CA125 patterns sometimes indicating malignancy. Relevance to endometriosis: the paper is centrally about ovarian remnant syndrome in which endometriosis is repeatedly identified as a major predisposing factor and is linked to ovarian malignant transformation within remnants, and it includes specific discussion of endometriosis-associated ovarian cancer risk.

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Abstract

Ovarian remnant syndrome (ORS) is a rare, but well-known gynecological complication, most often induced by difficult bilateral salpingo-oophorectomy (BSO) procedures that leave residual ovarian tissue on the pelvic wall. The most common preexisting conditions for this complication include endometriosis, pelvic inflammatory disease and prior abdominal surgery. The residual ovarian tissue may eventually cause malignant development. A total of 12 cases of malignant and benign tumors (clear cell adenocarcinoma in 1 case, mucinous-type tumors in 2, endometrioid-type tumors in 5, adenocarcinoma in 3 and border serous neoplasia in 1) and 21 benign cysts developing from an ovarian remnant have been described in the literature to date. Endometriosis, known to increase the risk of ovarian cancer, predisposes patients to ORS, with an incidence rate of 30 to 50% in ORS patients with ovarian carcinoma. Although the true incidence of ORS remains unknown, when endometriotic adhesions are diagnosed during BSO, the possibility of ORS and subsequent ovarian malignant transformation may mandate complete surgical resection.

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endometriosis

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