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Malign mural nodules associated with serous ovarian tumor of borderline malignancy: a case report and literature review

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Cystic tumors of ovary, whether benign, borderline, or malignant may be associated with mural nodule of various types, including sarcomas, sarcoma-like mural nodules (SLMN), and foci of anaplastic carcinoma. Cases of serous borderline ovarian tumor with mural nodules of mixed type are very rare.

Case

A 54-year-old woman referred with abdominal swelling. Imaging studies revealed a huge mass localized in pelvis and lower abdomen and grade 1–2 left renal hydronephrosis. Preoperative Ca-125 was 798 U/ml. In exploratory laparotomy there was a 16 cm mass adherent to lateral abdominal wall and intestines. Adhesiolysis and de-bulking surgery were performed including bilateral pelvic, para-aortic lymphadenectomy, appendectomy and omentectomy. Left ureter was found to be dilated because of the infiltration of distal part by the tumor, so distal ureteral resection and neoureterocystostomy were performed. Final pathology revealed borderline serous ovarian tumor with mural nodules which were consisted of SLMNs, multiple and sharply demarcated from the adjacent tumor, and sarcomatous nodules showing infiltrative appearance in metastatic regions. Mural nodules showed a positive reaction for vimentin and SMA but were negative for cytokeratin and also necrosis, hemorrhage, and 10–15 mitoses in 10 high power fields were noted. She had postoperative chemotherapy and follow-up is going on without metastases in her first year.

Conclusion

The existence of sarcomatous nodules combined with the SLMN necessitates a careful histologic analysis for treatment and the determination of prognosis. However, too few cases of mixed type mural nodules have been published to warrant a conclusion regarding their prognosis.

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Authors and Affiliations

  1. Gynecologic Oncology Department, Zekai Tahir Burak Women’s Health Care Education and Research Hospital, Ankara, Turkey

    Tayfun Gungor, S. Ozlem Altınkaya, Umıt Bılge & Leyla Mollamahmutoglu

  2. Pathology Department, Zekai Tahir Burak Women’s Health Care Education and Research Hospital, Ankara, Turkey

    Serap Akbay

  3. Oguzlar Mah. 39 Sok, Cagdas Apt. 3/6, 06520, Balgat, Ankara, Turkey

    S. Ozlem Altınkaya

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  1. Tayfun Gungor
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Correspondence to S. Ozlem Altınkaya.

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Gungor, T., Altınkaya, S.O., Akbay, S. et al. Malign mural nodules associated with serous ovarian tumor of borderline malignancy: a case report and literature review. Arch Gynecol Obstet 281, 485–490 (2010). https://doi.org/10.1007/s00404-009-1180-3

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