A RARE CASE OF BORDERLINE MUCINOUS TUMOR OF RIGHT OVARY IN YOUNG FEMALE CHILD. A CASE REPORT
Date Issued
2024-04
Author(s)
Darko Angjushev
Marija Kotevska-Angjushev
Abstract
Abstract
Introduction: Borderline ovarian tumors (BOTs) are extremely rare premalignant tumors in children, with an incidence
of 1% of all childhood malignancies. (1) Clinical presentation is diverse, from asymptomatic to clinically significant
compression of abdominal organs, great blood vessels and urinary tract. There are few reported cases in literature.
(2,3) We present a rare case of BOT in young female child, successfully treated with uneventful course. Case-Report: A 12-year-old premenarchal female was admitted on Pediatric surgery department with a history of progressive abdominal distension in the last 7 months, followed by mild dysphagia and abdominal pain. Laboratory
exams and serum tumor markers were unremarkable. Magnetic resonance imaging of the abdomen revealed an
encapsulated, cystic right ovarian mass with huge dimensions, (37x28x18cm) suggestive for a possible ovarian tumor. Right urethra was compressed with consecutive right kidney hydronephrosis and compression of inferior vena
cava. The cyst was surgically removed in total, along with 12L of clear fluid and right ovariectomy under general a
nesthesia. Invasive hemodynamic monitoring was provided as perioperative course was uneventful. Postoperative
analgesia was provided with Paracetamol, Metamizole and Morphine. Enteral feeding was resumed on the 2nd postoperative day. Patient was safely discharged on the 6th postoperative day. Abdominal ultrasound showed complete
resolution of the kidney hydronephrosis. Pathohistological examination showed it to be a borderline mucinous tumor
of the right ovary. The patient didn’t require any chemotherapy. On the 6 mouths follow up patient was free from any
recurrence.
Discussion: Borderline ovarian tumor is extremely rare in children. High index of suspicion is important, since clinical
presentation can be unspecific. (2,4) Every female child with long lasting abdominal distension should be early examined with imaging methods such as abdominal ultrasound or MRI. Early recognition and timely surgical excision
are important to avoid significant morbidity and malignant alteration. (3)
Keywords: Borderline ovarian tumor, young girl, early diagnosis, premalignancy
References: 1. Xu M., Wang B, Shi Y. Borderline ovarian tumor in the pediatric and adolescent population: a clinic-pathologic analysis of fourteen cases Int J Clin Exp Pathol
2020;13(5):1053-1059. 2. Ojha P, Singh Nigam J, Deshpande A, Bal Gargade C. Epithelial ovarian tumors in a premenarchal girl: a rare case report Obstet Gynecol Sci 2017;60(5):469-472.
3. Canfarotta M, Gillan E, Balarezo F, Campbell B, Tsai A, Finck C. Diagnosis, surgical treatment and management of borderline ovarian surface epithelial neoplasms: Report of 2 cases
and review of literature, Journal of Pediatric Surgery Case Reports (2014), doi: 10.1016/ epsc.2014.09.009. 4. Persano G, Severi E, Cantone N, Incerti F, Ciardini E, Noccioli B. Surgical
approach to giant ovarian masses in adolescents: technical considerations Pediatric Reports 2018; 10:7752 doi: 10.4081/pr.2018.7752
Introduction: Borderline ovarian tumors (BOTs) are extremely rare premalignant tumors in children, with an incidence
of 1% of all childhood malignancies. (1) Clinical presentation is diverse, from asymptomatic to clinically significant
compression of abdominal organs, great blood vessels and urinary tract. There are few reported cases in literature.
(2,3) We present a rare case of BOT in young female child, successfully treated with uneventful course. Case-Report: A 12-year-old premenarchal female was admitted on Pediatric surgery department with a history of progressive abdominal distension in the last 7 months, followed by mild dysphagia and abdominal pain. Laboratory
exams and serum tumor markers were unremarkable. Magnetic resonance imaging of the abdomen revealed an
encapsulated, cystic right ovarian mass with huge dimensions, (37x28x18cm) suggestive for a possible ovarian tumor. Right urethra was compressed with consecutive right kidney hydronephrosis and compression of inferior vena
cava. The cyst was surgically removed in total, along with 12L of clear fluid and right ovariectomy under general a
nesthesia. Invasive hemodynamic monitoring was provided as perioperative course was uneventful. Postoperative
analgesia was provided with Paracetamol, Metamizole and Morphine. Enteral feeding was resumed on the 2nd postoperative day. Patient was safely discharged on the 6th postoperative day. Abdominal ultrasound showed complete
resolution of the kidney hydronephrosis. Pathohistological examination showed it to be a borderline mucinous tumor
of the right ovary. The patient didn’t require any chemotherapy. On the 6 mouths follow up patient was free from any
recurrence.
Discussion: Borderline ovarian tumor is extremely rare in children. High index of suspicion is important, since clinical
presentation can be unspecific. (2,4) Every female child with long lasting abdominal distension should be early examined with imaging methods such as abdominal ultrasound or MRI. Early recognition and timely surgical excision
are important to avoid significant morbidity and malignant alteration. (3)
Keywords: Borderline ovarian tumor, young girl, early diagnosis, premalignancy
References: 1. Xu M., Wang B, Shi Y. Borderline ovarian tumor in the pediatric and adolescent population: a clinic-pathologic analysis of fourteen cases Int J Clin Exp Pathol
2020;13(5):1053-1059. 2. Ojha P, Singh Nigam J, Deshpande A, Bal Gargade C. Epithelial ovarian tumors in a premenarchal girl: a rare case report Obstet Gynecol Sci 2017;60(5):469-472.
3. Canfarotta M, Gillan E, Balarezo F, Campbell B, Tsai A, Finck C. Diagnosis, surgical treatment and management of borderline ovarian surface epithelial neoplasms: Report of 2 cases
and review of literature, Journal of Pediatric Surgery Case Reports (2014), doi: 10.1016/ epsc.2014.09.009. 4. Persano G, Severi E, Cantone N, Incerti F, Ciardini E, Noccioli B. Surgical
approach to giant ovarian masses in adolescents: technical considerations Pediatric Reports 2018; 10:7752 doi: 10.4081/pr.2018.7752
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