[A case of young woman with giant ovarian tumor as the manifestation of leukemic recurrence].

Following rapid development of chemotherapy to leukemia, reports about tumor-forming-leukemia are on the increase. But ovarian tumor-forming-leukemia is relatively rare, hence not enough is known about it. Recently, the authors experienced a case of young woman with recurrent leukemia which manifested as a giant ovarian tumor. She suffered from acute lymphocytic leukemia (ALL) in February, 1986, and received chemotherapy (predonisolone and cytocine arabinoside) until complete remission in peripheral blood. But she developed a giant abdominal tumor in May, 1988, and admitted to our hospital for close examination and treatment. Preoperative blood examination was within normal range, and peripheral blood smear revealed no leukemic blasts. She had a giant abdominal tumor occupying whole abdominal cavity, and the tumor showed solid pattern in ultra-sonography, CT and NMR-CT. Malignant lower abdominal tumor was suspected, and simple abdominal hysterectomy, bilateral salphingo-oophorectomy and omentumectomy was performed on 27th. May, 1988. A giant abdominal tumor developed from left ovary, infiltrating to the uterus through left Fallopian tube, and metastatic lesion at omentum were present. Postoperative pathological findings in immunochemistry showed that the tumor was recurrence of ALL as tumor-forming-leukemia. After operation, she was treated in the department of internal medicine for postoperative chemotherapy (TCMP-therapy 1 kur) and discharged in December, 1988. She is alive and healthy 10 months after operation, and reveals no signs of recurrence. It was important to recognize lower abdominal tumor in leukemic patients as gynecologic problem, and significance of surgical approach to ovarian tumor-forming-leukemia was indicated.