ISSN 2398-2985      

Ovarian remnant syndrome

Jreptile
Contributor(s):

Sarah Brown

Jemma Hildrew


Introduction

  • Cause: incomplete removal of ovarian tissue at the time of ovariectomy/ovariosalpingectomy, ectopic ovarian tissue or auto-transplantation of ovarian tissue at the time of spay. Generally seen in lizards and chelonians as ovariectomy/ovariosalpingectomy is rarely performed in snakes.
  • Signs: return to breeding behavior or clinical signs associated with ovarian activity.
  • Diagnosis: imaging often non-conclusive, although ultrasonography may show retained ovarian tissue. Ultimately exploratory laparotomy and histopathology of found tissue usually indicated for definitive diagnosis.
  • Treatment: exploratory laparotomy to find and remove the retained ovarian tissue.
  • Prognosis: poor if not treated; risk of reproductive disease sequelae, eg yolk coelomitis and potentially development of ovarian neoplasia or cystic change. Good if all retained tissue is removed.

Pathogenesis

Etiology

  • Incomplete removal of ovarian tissue at the time of ovariectomy/ovariosalpingectomy Salpingotomy / salpingectomy, ectopic ovarian tissue or auto-transplantation of ovarian tissue at the time of surgery.

Predisposing factors

General

  • Surgeon inexperience/poor technique.
  • Reptile ovarian tissue is diffuse and in lizards is often intimately associated with the adrenal gland and vena cava, making removal technologically demanding.
  • Small remnants may regrow and regenerate leading to folliculogenesis:
    • This can be compounded if the oviducts have been removed, making normal oviposition impossible.
    • Thus, many authors recommend ovariectomy rather than ovariosalpingectomy in reptiles if the salpinges are not diseased.

Specific

  • Presence of ectopic ovarian tissue.

Pathophysiology

  • Ovarian regrowth and regeneration lead to folliculogenesis and return to breeding behavior. This may lead to a wide range of pathological consequences, eg yolk coelomitis and potentially development of neoplasia or ovarian cysts, dependent on the individual’s condition and concurrent health issues.

Timecourse

  • Very variable depending on the species and level of ovarian regrowth.

Epidemiology

  • Generally, an individual problem.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Di Girolamo N & Mans C (2016) Reptile soft tissue surgery. Vet Clin North Am Exotic Anim Pract 19 (1), 97–131 PubMed.
  • Cruz Cardona J A, Conlet K J, Wellehan J F X et al (2011) Incomplete ovariosalpingectomy and subsequent malignant granulosa cell tumor in a female green iguana (Iguana iguana). JAVMA 239 (2), 237-242 PubMed.
  • Funk R S (2002) Lizard reproductive medicine and surgery. Vet Clin North Am Exot Anim Pract (3), 579–613 PubMed.

Other sources of information

  • Stahl S J (2019) Reproductive Tract. In: Mader’s Reptile and Amphibian Medicine and Surgery. Eds: Divers S J & Stahl S. Elsevier, NL. pp 1077-1089.

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