Management of a perforated extensive ovarian tumor with radical resection and long-term tumor-free outcome: a case report

Résumé fourni par la source

Serous borderline tumors (SBTs) of the ovary typically follow an indolent clinical course. However, cases presenting with invasive peritoneal implants may exhibit aggressive clinical progression. We report a diagnostically and surgically challenging case of a 37-year-old Iranian woman with a perforated, extensively disseminated SBT (International Federation of Gynecology and Obstetrics (FIGO) Stage IIIC) who achieved long-term disease-free survival. The patient initially presented with acute abdominal symptoms and septic shock. Intraoperative exploration revealed tumor involvement across multiple organs, including the uterus, gastrointestinal tract, omentum, and retroperitoneal vasculature. Management required an aggressive multivisceral resection, including an en bloc radical hysterectomy, rectosigmoid resection, small bowel resection, total omentectomy, systemic lymphadenectomy, and iliac vein reconstruction. The patient has remained clinically and radiologically disease-free for 3 years. This status was confirmed by regular follow-up evaluations, including surveillance Positron emission tomography (PET)/Computed tomography (CT) scans performed to rule out suspected residual or recurrent disease. This case demonstrates that maximal cytoreductive surgery can achieve durable remission in select patients with advanced-stage SBTs and invasive implants. While this favorable outcome highlights the feasibility of aggressive surgical management, no definitive conclusions regarding overall prognosis or the standard role of adjuvant therapy can be drawn from a single case. Further studies are required to define optimal management strategies for this high-risk patient population.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.