242 A Rare Case of Ovarian Serous Borderline Tumor With Brain Metastasis

Abstract

Serous borderline tumor (SBT) represents a group of noninvasive tumor of ovary bridging between benign adenoma and invasive carcinoma. They are commonly seen in younger women and have excellent outcome, except occasional local recurrence. Metastasis to the lymph nodes has rarely occurred. So far, the only distant metastases reported were to the supraclavicular and internal mammary lymph node. Here, we present a 33-year-old nulliparous woman diagnosed with Stage IV-B serous borderline tumor to the brain. Her serous borderline tumor with 1 mm focus of microstromal invasion of left ovary eight years ago, with a recurrent tumor of the right ovary occurred 4 years ago, for which she underwent two unilateral salpingo-oophorectomies with omentectomy on separate occasions with extensive abdominal, peritoneal, and pelvic lymph node biopsies. No evidence of extraovarian spread on both times was identified. However, 4 years after her last surgery, the patient presented to our institution with a migraine. MRI revealed four supratentorial lesions with two dominant proteinaceous mass lesions (6.0 x 4.5 x 3.5 cm and 4.5 x 3.5 x 2.8 cm) having irregular lobulations in the bilateral temporal lobes consistent with metastatic disease. Biopsy of the dominant lesion shows clusters of broad papillae with hierarchical branching lined by polygonal to columnar serous epithelium with mild to moderate atypia. Findings are consistent with metastatic serous borderline tumor. To our best knowledge, this is the first case reported of a serous borderline tumor with metastasis to the brain. No current review or literature supports this distant metastasis.