Borderline mucinous tumor (ovary)

Case contributed by Dr Alexandra Stanislavsky

Presentation

Pelvic pain and fullness. Ca125 44

Patient Data

Age: 20 years
Gender: Female
Ultrasound

Large multilocular cystic pelvic mass measuring 23.7 x 10.7 x 19.6 cm. Some vascularity is seen in the septa, however no significant solid component is identified.
The left ovary is not identified.


A normal right ovary is seen separate to the mass.

Normal anteverted uterus. Endometrial thickness of 2 mm.
No ascites.

CT confirms the presence of a large multilocular mass occupying the pelvis and mid abdomen. There is no ascites and no evidence of visceral, peritoneal or nodal metastases.

Case Discussion

Discussion:

Large mass with numerous loculations but no solid component or papillary projections.  This appearance is typical for a mucinous borderline tumor - although not pathognomonic and has overlap with both mucinous cystadenomas, as well as malignant lesions e.g. low grade mucinous adenocarcinoma.

Risk stratification:

According to IOTA simple rules, it is an inconclusive lesion, with neither "B" or "M" features present.

ADNEX score: 89% benign

O-RADS Category 4: 10-50% risk of malignancy, recommend management by a gynecologic oncologist.

Histology:

Borderline mucinous tumor

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Case information

rID: 78228
Published: 5th Jun 2020
Last edited: 6th Jun 2020
System: Gynaecology
Inclusion in quiz mode: Included

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