Epithelial ovarian cancer of low malignant potential in a 15 year old patient: A case report

Ravanos Κ1, Kologiannidis I1, Tsertanidou A1, Flaris N2, Agorastos T1

14th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
2Department of Pathology, Hippokrateio hospital, Thessaloniki, Greece

Correspondence: Ravanos Konstantinos. 29 Parnithos St, GR-54453, Thessaloniki, Greece. E-mail: kdravanos@hotmail.com


Epithelial ovarian cancer is extremely rare in adolescence but must be included in the differential diagnosis of an ovarian mass. Most patients present with early stage tumors of low malignant potential and achieve favorable overall survival. Preservation of fertility is essential, therefore conservative treatment is recommended according to oncological guidelines. For localized tumors, good prognosis is achieved either by unilateral salpingo-oophorectomy or cystectomy of the tumor without adjuvant chemotherapy being required. This is a report of a 15 year old patient who presented with abdominal pain and distension. Physical examination, ultrasonography and abdominal CT-scan revealed an abdominal-pelvic cystic mass of 30cm in largest dimension (probably originating from the left ovary) with internal diaphragms and a solid area (5cm) in one pole of the mass. Cancer biomarkers (Ca125, Ca19-9, CEA, AFP) were normal. The patient underwent a diagnostic laparotomy through a midline incision including peritoneal washings, complete resection of the primary tumor of 30cm including the ipsilateral (left) adnexa. The frozen section sample revealed a mucinous epithelial tumor without evidence of malignancy. Furthermore, an appendectomy and omental biopsy was performed. The final histopathologic examination revealed mucinous epithelial tumor of low malignancy, however the rest of surgical specimens were free of malignancy. The patient did not receive adjuvant treatment and for the last nine months is being followed as an outpatient without evidence of relapsed disease.

Keywords: epithelial ovarian cancer, adolescence, borderline, ovarian tumor

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