Detection of a Unilateral Mucinous Borderline Ovarian Tumor With Sonography and Magnetic Resonance Imaging

Abstract

Mucinous borderline ovarian tumors (MBOTs) are a form of ovarian neoplasm that consists of both benign characteristics of a cystadenoma and malignant components of a cystadenocarcinoma. Currently, there are three accepted, synonymous terms that describe MBOTs: borderline, low malignant potential, and atypical proliferation. 1 Therefore, this type of tumor is classified as an intermediate phase between benign and malignant. Mucinous borderline ovarian tumors account for approximately 30% to 50% of ovarian epithelial borderline tumors and are estimated to make up 10% of mucinous ovarian tumors. 2,3 Mucinous borderline tumors are typically unilateral, but in about 5% of reported cases, they have been bilateral. 4 There are two forms of MBOTs depending on the type of epithelium from which it originated. The most common is the intestinal-type MBOT (I-MBOT) and, less commonly, the endocervical-type MBOT, also known as Mül-lerian type (M-MBOT) or seromucinous type. 2,5 Sonography, magnetic resonance imaging (MRI), and computed tomography (CT) are all modalities used to evaluate MBOTs. For lesions indeterminate on sonography, MRI increases the specificity of imaging evaluation, thus decreasing benign resections, whereas CT is useful in the diagnosis and management planning of more advanced cancers. 6 The case reported below illustrates a patient with a mucinous borderline ovarian tumor and the diagnostic imaging tests used in the detection and diagnosis of the pathology. Sonography and MRI were key in this patient's diagnosis and treatment, in which sonographically the tumor was evaluated locally, and large-scale assessment was done with MRI. Case ReportA woman in her late teens presented to the emergency room with complaints of abdominal and pelvic pain. Upon the initial physical examination, she was found to have a protruding abdomen and appeared as if she could be pregnant, possibly in her late second to third trimester. Initially, a transabdominal pelvic sonogram was ordered. The patient stated she was not, nor had she ever been, sexually active; therefore, a pregnancy test was not done and an endovaginal sonographic examination was not included. Blood testing for markers such as CA125 or CA19-9 also was not done during the initial workup and evaluation. A curvilinear transducer with a center frequency of 4 MHz was used for this study on a GE Logiq E9 machine (GE Healthcare, Piscataway, New Jersey). AbstractVarious modalities of diagnostic imaging have been proven to be adequate in the characterization and diagnosis of ovarian neoplasms. This case study investigates a unique form of mucinous borderline ovarian tumor consisting of both intestinal and Müllerian types. Borderline tumors are considered an intermediate form of neoplasm between the benign and malignant form. Shortly after sonographic and magnetic resonance imaging, the large tumor was removed and the patient was determined to have an excellent prognosis. The utilization of sonography in diagnosing this tumor is discussed, demonstrating the significance of ...