Introduction Ovarian Remnant Syndrome (ORS) is a rare complication that arises as a consequence of residual ovarian tissue afer an oophorecto- my. It is characterized by pelvic pain, which can be chronic or cyclic. Surgery is considered the primary treatment but can present with certain difculties [1]. We report an unusual case of ORS successfully treated with Gonadotropin-releasing Hormone agonist (GnRHa) in association with gabapentin. Case Report A 44-year-old Caucasian woman who underwent hysterectomy and bilateral adnexectomy 3 years earlier presented with pelvic pain. Clinical examination revealed no particular signs. A Follicle-stim- ulating Hormone (FSH) blood level of 11 IU/dL and transvaginal ultrasound revealed a lef lateral mass of 46 × 38 mm. ORS was suspected and MRI confrmed a lef cystic mass. Continuous oral contraceptives were prescribed, with no pain relief. She was then prescribed 10.8 mg goserelin acetate, a Gonadotropin-releasing *Corresponding author: Leila Cristina Soares, Department of Gynecology, Rio de Janeiro State University, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil, Tel: +55 88564796; E-mail: lcs1507@yahoo.com.br Citation: Soares LC, de Souza RJ, Brollo JLA (2016) Ovarian Remnant Syndrome: A Case Report. J Reprod Med Gynecol Obstet 1: 002. Received: November 22, 2015; Accepted: January 22, 2016; Published: February 08, 2016 Hormone agonist (GnRHa). Because the treatment was multidisci- plinary, she started taking gabapentin when she was already using a GnRHa. One month later, she reported clinical improvement. She stopped taking the GnRHa afer 6 months and underwent magnetic resonance imaging that showed a suspected adnexal malignancy. She underwent laparotomy, and the remnant ovary was removed (Figure 1). Histopathological analysis revealed corpus albicans. Discussion Ovarian remnant syndrome results from an unintentionally incomplete oophorectomy. In most patients, it seems that ORS results from an incidental implantation of ovarian tissue rather than an incomplete excision of a lesion [2]. Symptoms most ofen occur within the frst 5 years of a previous surgery, although reports have shown patients whose initial surgeries were more than 20 years ago [1]. Dense periovarian adhesions and ovarian enlargement can make the identifcation of ovarian tissue difcult, and they are considered the predisposing factors of this disease. Both of those factors are present in severe endometriosis, the most typical preexisting disease [1]. Te risk factors include pelvic infammatory disease and adhesion [2]. Te recurrence of pelvic symptoms is associated with the devel- opment of a hormonally functional follicular or corpus luteum cyst within the ovarian fragment, or with reactivation of endometriosis [3]. When the remaining ovary continues to produce sex steroids, the FSH levels remain low. Although the absence of this fnding does not rule out the diagnosis, FSH levels <40 IU/dL indicate the presence of an ovarian remnant. A defnitive diagnosis involves histologic confrmation of ovarian tissue obtained from the subsequent surgery [1]. Te main treatment is surgery. Moreover, excision of remnant tissue requires retroperitoneal dissection [1]. Ovarian fragments may be difcult to localize, and reappearance of new fragments is Soares LC, et al., J Reprod Med Gynecol Obstet 2016, 1: 002 HSOA Journal of Reproductive Medicine, Gynaecology & Obstetrics Case Report Leila Cristina Soares 1 *, Ricardo José de Souza 1 and Jorge Luiz Alves Brollo 2 1 Department of Gynecology, Rio de Janeiro State University, Rio de Janeiro, Brazil 2 Department of Gynecology, Grande Rio University, Rio de Janeiro, Brazil Ovarian Remnant Syndrome: A Case Report Abstract Ovarian Remnant Syndrome (ORS) results from the presence of residual ovarian tissue after oophorectomy. The gold standard treatment for ORS is surgery. We report the case of a 44-year-old woman who presented with pelvic pain and was diagnosed as having ORS. She obtained relief after treatment with a gonadotro- pin-releasing hormone agonist and gabapentin. Avoiding surgery with its greater risks is desirable in ORS; however, more studies should be performed to assess the long-term effects of gabapentin. Keywords: Gabapentin; GnRHagonist; Pelvic pain; Remnant ovarian syndrome Figure 1: Remnant ovarian tissue removed by laparotomy.