Gray zone: a case report on borderline mucinous tumor

Authors

  • Srinidhi S. Department of Obstetrics and Gynecology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  • N. Palaniappan Department of Obstetrics and Gynecology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252506

Keywords:

Borderline ovarian tumors, Fertility sparing surgery, Laparotomy, Salpingo-oopherectomy

Abstract

Borderline ovarian tumors (BOTs) represent an intermediate form between benign and malignant epithelial ovarian neoplasms, with mucinous subtype accounting for a significant proportion. These tumors often present in women of reproductive age and are frequently diagnosed at an early stage. We report the case of a 25-year-old unmarried woman with regular menstrual cycles who was incidentally found to have a complex left adnexal mass during routine imaging. Clinical examination revealed a firm, midline abdominopelvic mass corresponding to 20 weeks’ uterine size. Tumor markers, including CA-125, CEA, CA 19-9, AFP, and LDH, were within normal limits. MRI pelvis revealed a 15 cm mixed solid-cystic lesion in the left adnexa. Intraoperatively, a unilateral ovarian mass with no evidence of extraovarian spread was noted. Frozen section was suggestive of a borderline mucinous tumor. The patient underwent a fertility-sparing staging laparotomy including left salpingo-oophorectomy, infracolic omentectomy, appendicectomy, pelvic lymph node dissection, and peritoneal biopsies. Final histopathology confirmed a borderline mucinous tumor, FIGO Stage IA. This case highlights the importance of thorough preoperative evaluation and intraoperative decision-making in young women with adnexal masses. Fertility-sparing surgery with complete staging offers an excellent prognosis in early-stage borderline mucinous ovarian tumors, with the added benefit of preserving reproductive potential.

Metrics

Metrics Loading ...

References

Nayyar N, Lakhwani P, Goel A, Pande PK, Kumar K. Management of Borderline Ovarian Tumors-Still a Gray Zone. Indian J Surg Oncol. 2017;8(4):607-14. DOI: https://doi.org/10.1007/s13193-017-0697-3

Du Bois AD, Ewald-Riegler N, Du Bois O, Harter P. Borderline tumors of the ovary-a systematic review. Geburtshilfe Frauenheilkunde. 2009;69(09):807-33. DOI: https://doi.org/10.1055/s-0029-1186007

Yokoyama Y, Moriya T, Takano T, Shoji T, Takahashi O, Nakahara K, Yamada H, et al. Clinical outcome and risk factors for recurrence in borderline ovarian tumours. Br J Cancer. 2006;94(11):1586-91. DOI: https://doi.org/10.1038/sj.bjc.6603139

Prat J. Pathology of borderline and invasive cancers. Best Pract Res Clin Obstet Gynaecol. 2017;41:15-30. DOI: https://doi.org/10.1016/j.bpobgyn.2016.08.007

Singer G, Oldt R 3rd, Cohen Y, Wang BG, Sidransky D, Kurman RJ, et al. Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma. J Natl Cancer Inst. 2003;95(6):484-6. DOI: https://doi.org/10.1093/jnci/95.6.484

Uzan C, Muller E, Kane A, Rey A, Gouy S, Bendiffallah S, et al. Prognostic factors for recurrence after conservative treatment in a series of 119 patients with stage I serous borderline tumors of the ovary. Ann Oncol. 2014;25(1):166-71. DOI: https://doi.org/10.1093/annonc/mdt430

Valentin L. Use of morphology to characterize and manage common adnexal masses. Best Pract Res Clin Obstet Gynaecol. 2004;18(1):71-89. DOI: https://doi.org/10.1016/j.bpobgyn.2003.10.002

Pai RK, Longacre TA. Appendiceal mucinous tumors and pseudomyxoma peritonei: histologic features, diagnostic problems, and proposed classification. Adv Anat Pathol. 2005;12(6):291-311. DOI: https://doi.org/10.1097/01.pap.0000194625.05137.51

Morice P, Camatte S, El Hassan J, Pautier P, Duvillard P, Castaigne D. Clinical outcomes and fertility after conservative treatment of ovarian borderline tumors. Fertil Steril. 2001;75(1):92-6. DOI: https://doi.org/10.1016/S0015-0282(00)01633-2

Downloads

Published

2025-08-05

How to Cite

S., S., & Palaniappan, N. (2025). Gray zone: a case report on borderline mucinous tumor. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(9), 3127–3129. https://doi.org/10.18203/2320-1770.ijrcog20252506

Issue

Section

Case Reports