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How would you counsel a patient regarding possibility of ovarian preservation at time of surgery for malignant mesothelioma initially discovered in a myomectomy specimen and involving peritoneal surfaces?
Patient is 34yo and G0 referred from surgical oncology. Laparoscopic specimens of myoma and what appeared to be adhesions were significant for malignant mesothelioma, epithelioid type.
Plan is for hysterectomy, likely BSO, and peritoneal stripping with possible HIPEC. Given age and fertility status, can one or both ovaries be spared if grossly free of disease?
Answer from: Medical Oncologist at Community Practice
If the mesothelioma is on the lower grade of the spectrum and the margins negative, I would offer fertility preservation if feasible at surgery. If high grade, I would have a discussion about prognosis with the patient. If all the tumor can be resected with an R0 resection, it should be offered - th...
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