Presentation
Pelvic pain and fullness. Ca125 44
Patient Data
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