Pseudomyxoma peritonei (PMP) is characterized by mucinous ascites in the peritoneal cavity and might involve the omentum and peritoneum. The PMPs originating from the ovary are mostly caused by ruptured ovarian mature teratomas and mucinous ovarian carcinomas. The present case is a rare advanced mucinous borderline ovarian tumor and late recurrence in PMP in a 52-year-old menopaused woman. She presented with gradual abdominal enlargement and cystic abdominopelvic lesion with internal septa and ascites. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, lymphadenectomy, and appendectomy. Histopathologic examination revealed mucinous borderline tumors. About 5.5 years after the first surgery, she presented with abdominal bloating and a sonography report of peritoneal seeding in the abdomen and pelvis. Abdominal exploration showed gelatinous-mucinous ascites and disseminated peritoneal carcinomatosis. The final histopathologic evaluation indicated PMP. Although the recurrence of mucinous borderline tumors is in an average of two years, the present case had relapsed after 5.5 years as pseudomyxoma with borderline pathology.
Paratubal cysts account for 5-20% of all adnexal lesions. Malignant modifications seldom arise in the paratubal cysts that are usually known as primary carcinomas of fallopian tube. Paratubal borderline tumors are very infrequent conditions and until now only sixteen cases of primary paratubal borderline tumors have been previously reported in the literature. Herein, we describe a rare paratubal serous borderline tumor occurring in a woman of reproductive age and provide insights into its management. A 32-year-old woman referred to Imam Hussein Hospital, Tehran with chief complaint of amenorrhea for the last year and transvaginal sonography (TVS) report indicating a 68×74 mm persistent right adnexal cyst from 10 months ago. The patient was candidate for laparotomy and due to the report of paratubal serous borderline tumor in frozen section she underwent right total salpingectomy and infracolic omentectomy. No evidence of recurrence or metastasis was observed after 3 years of follow up. Persistent adnexal cysts need to be evaluated precisely even in young women in order to rule out the malignancy of fallopian tubes.
Endometrial stromal sarcoma is a rare condition, constituting nearly 0.2% of all reproductive tract malignancies. The condition mainly affects the peri-menopausal population; however, it can occasionally be found in younger women and adolescents.Here, this is a case of a 20-year-old primiparous female who was referred to us with the main complaint of vaginal bleeding (menometrorrhagia), ongoing for 6 months after delivery. Her sonography report indicated a 5 cm intra-cavitary mass suspicious for myoma or placental polyp. Given the pathology report of low-grade endometrial stromal sarcoma (LGESS) on samples obtained through hysteroscopy and D&C, she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO). Endometrial stromal sarcoma is a rare uterine malignancy of mesenchymal origin that should be considered, even in very young patients.
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