A young nulliparous woman with right ovarian serous borderline tumor and left ovarian micropapillary serous carcinoma

Introduction: serous borderline tumor (sbt) of low malignant potential (LMP) is heterogeneous group, neither wholly benign nor frankly malignant. It usually involves premenopausal age patients, has good prognosis and may recur even after 20 years. Decades later, transformation to low grade serous carcinoma can occur in 7%, mandating prolonged follow-up. ten and 20 years survival in stage I is 95% and 80% respectively. Micropapillary type and invasive tumor implants warrant treatment like carcinoma and need adjuvant chemotherapy. case report: We present the case of a 25-year-old nullipara, married for four years who had ovarian cystectomy one year back. she reported to our institute with massive ascites and failure of anti-tubercular treatment of three months. Diagnostic tap revealed cells Vinita Jaggi Kumar1, Dhruv Jain2, Asit Mridha3, Sidharth Nanda3, Jyotica Jain4, Rajesh Kumar Grover5 Affiliations: 1MBBS, MD, MRCOG, Department of Surgical oncology (Gynecological Oncology Division, Delhi State Cancer Institute (Govt. of NCT), Dilshad Garden, Delhi, India; 2MBBS, MD, Assistant Professor, Department of Onco Pathology, Delhi State Cancer Institute (Govt. of NCT), Dilshad Garden, Delhi, India; 3MBBS, MD, Assistant Professor, Clinical Oncology, Delhi State Cancer Institute (Govt. of NCT), Dilshad Garden, Delhi, India; 4MBBS, MD, Associate Professor, Clinical oncology, Delhi State Cancer Institute (Govt. of NCT), Dilshad Garden, Delhi, India; 5MBBS, MD, PGDHHM, Director, Radiation Oncology, Delhi State Cancer Institute (Govt. of NCT), Dilshad Garden, Delhi, India. Corresponding Author: Dr. Vinita Jaggi Kumar, Delhi State Cancer Institute (Govt. of NCT Delhi), Dilshad Garden, Delhi, India; Postal Code-110095; Ph: +91 9560390112; Fax: +9111-22110505; Email: [email protected] Received: 16 November 2012 Accepted: 1 June 2013 Published: 01 September 2013 suggestive of metastatic adenocarcinoma. bilateral complex adnexal masses with ascites were seen on computed tomography (ct) scan. cA125 was 191 U/mL. thorough staging laparotomy i.e., inspection and palpation of abdomen and pelvic organs, ascitic fluid cytology, bilateral salpingo-oophorectomy, and bilateral pelvic and aortocaval lymph nodes sampling up to inferior mesenteric artery level, along with supracolic and infracolic omentectomy, and multiple peritoneal biopsies was carried out. Uterus was preserved. In our patient while right ovarian tumor was the benign type of sbt, the left ovarian tumor was the aggressive micropapillary type of sbt. conclusion: this case emphasizes the need of subclassification of serous borderline tumors showing a broad spectrum of clinical and biological behavior from benign to low grade carcinoma. We suggest that in patients of reproductive age with infertility and adnexal masses, despite malignant cells in ascites, serous borderline tumor should be kept as a differential diagnosis and conservative surgery be offered.