Laboratory investigations: CA 125=144 (≤35U/ml), CA 19.9=6 (≤37U/ml), CA 15-3=5.8 (≤31.3U/ml), CEA=2.1 (≤5ng/ml).

Following imaging and laboratory workup, the patient underwent surgery (total abdominal hysterectomy with bilateral salpingo-oophorectomy, peritoneal, omental and small intestine resection). 

Histopathology

Diagnosis: Primary tumor site: left ovary, ovarian surface involvement. Histologic type:  low-grade serous cystadenocarcinoma (psammocarcinoma). Extent of involvement of other tissues/organs: tumor involves both ovaries, both fallopian tubes, bilateral parametrial tissue, omentum, peritoneum and serosa of the small intestine. Pathologic staging (pTNM): pT3b, pNx, FIGO STAGE IIIB.

Additional pathologic findings: Mucinous cystadenofibroma of the right ovary (11 cm in greatest dimension). Atrophic endometrium.

Specimen integrity: intact right ovarian capsule and fragmented left ovary.