Journal of Gynaecology-Lupine Publishers



A 36-year old woman without comorbidities who underwent unilateral adnexectomy and appendectomy in 2011 with diagnosis of low grade ovarian intestinal type borderline mucinous tumor. CA19.9 tumor marker testing was slightly elevated, 78 U/ml; the others tumor markers were normal. Surgical exploration by median laparotomy showed widespread gelatinous mucinous ascites and a huge ruptured right ovarian tumor of 30 cm in diameter. All visible mucinous deposits were resected. The Immunohistochemistry study was: Ck7: +, Ck20: +++, CDX2: +, R.E: (-), R.P: (-), CEA: +, Muc2: +, Ki-67: + 5%. No adjuvant therapy was given. In 2013 she had a pregnancy by in vitro fertilization with cesarean delivery and no evidence of tumor recurrence at that time. In 2017 the patient wanted a new pregnancy. Due to the diagnosis of early ovarian failure, she was remitted to the Reproduction Unit again. During the ovarian stimulation, a large column of fluid was observed through sonographic exploration in the douglas space. The Ca19.9 tumor marker testing was elevated again, 80 U/ml. In the CT- scan there were signs of peritoneal carcinomatosis, so a diagnostic laparoscopy was performed showing a gelatinous-mucinous ascites and disseminated peritoneal carcinomatosis with implants widespread on the peritoneum, small intestine, colon, diaphragm and liver.



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