Management of a borderline ovarian tumor in a pregnant woman in a rural hospital: a case report

Abstract

Borderline ovarian tumors (BOTs) are neoplasms with benign and malignant characteristics, affecting young women in childbearing age. Finding incidental adnexal mass in pregnancy is more common with the use of ultrasound, incidence is about 2% to 10% of pregnancies. A great majority of adnexal masses excised during pregnancy are in fact BOTs. Treatment varies depending of gestational age: before 24 gestational week is usually conservative and surgical staging. Radical management is reserved to patients with suspected malignancy and satisfied parity. A 38-years-old woman presented to external consultation in a rural hospital with 36 gestational weeks of her fourth pregnancy, without antenatal control and asymptomatic. Obstetric ultrasound reported: right ovarian tumor with cystic and solid areas. Laboratory data were normal. She underwent elective cesarean and exploratory laparotomy, surgical findings were: a term female baby with no obstetric complications and a right ovarian tumor with trans-operatory report of mucinous epithelial cells with atypia, suggestive of ovarian borderline tumor. Based on this, a hysterectomy with bilateral oophorectomy was performed. No complications were reported. Post-operatory evolution was normal. Definitive histopathological study reported a borderline ovarian tumor.