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Cobellis L., Ambrosio D., Pecori E., De Lucia E., Stradella L., Cobellis G.
Facoltà di Medicina e Chirurgia, Dipartimento di Ostetricia e Ginecologia, Seconda Università degli Studi di Napoli, Napoli
In this study a probable paracrine activity of the cerebrospinal fluid on ovaries is hypothesized in determining an evident ascites. A severe case of ascites appeared in a patient after 3 years of positioning a cranio-peritoneal shunt for triventricular hydrocephaly and arachnoid retrocerebellar cyst; the tumor markers (Alfer Fetoprotein, CEA, CA 125, CA 19-9) were very high. The patient underwent a laparotomy for suspected ovaric neoplasia not confirmed by a histopathologic intraoperative impromptu examination. Even if the clinical, histopathologic and partially the hormonal pictures were very similar to those of ovaric hyperstimulation syndrome (OHSS), a hysterectomy was carried out with bilateral annexectomy due to the uterus condition and because the syndrome was connected to serious irreversible functional disorders of the ovaries. The ascitic syndrome regressed after excision of the ovaries and tumor markers returned to normal values. It is hypothesized that the ascites could be connected with the hyperproduction of FSH and probably to a paracrine activity the cerebrospinal fluid on ovaries which could ave involved the system of the ovaric homeostasis regulation.