Abstract
Ovarian borderline serous tumors present with peritoneal involvement in 20% of cases, either as non-invasive or invasive implants, the latter also known as extraovarian low-grade serous carcinoma. The coexistence of high-grade serous carcinoma is rare, suggesting a synchronous neoplasia with a distinct and independent tumor biology and behavior. We aim to describe a case of a synchronous ovary-peritoneum neoplasia: serous borderline tumor and primary peritoneal high-grade serous carcinoma. A discussion and literature review concerning the optimal diagnostic and therapeutic approach is provided.
Highlights
Ovarian borderline serous tumors present with peritoneal involvement in 20% of cases, either as non-invasive or invasive implants, the latter known as extraovarian low-grade serous carcinoma
Any further responses from the reviewers can be found at the end of the article Introduction Serous borderline tumors/atypical proliferative serous tumors (SBT/APST) are defined as non-invasive tumors displaying greater epithelial proliferation and cytological atypia than their benign counterparts
Peritoneal lesions associated with SBT/APST may occur in 20% of cases and were classically defined as non-invasive or invasive implants based on the capacity to infiltrate the underlying tissue
Summary
Any reports and responses or comments on the article can be found at the end of the article. Regarding the diagnosis of the SBT in the right ovary,multiple tissue blocks from the ovarian tumor were examined in the microscopy exam and none identified invasive component. Both adnexa were totally included and analyzed according to the Sectioning and Extensively Examining the Fimbriated End Protocol (SEE-FIM) and no precursor lesions in the fallopian tube epithelia were found. The final histology with hematoxylin and eosin staining revealed two synchronous tumors: SBT of the right ovary and HGSC of probably primary peritoneal origin, FIGO stage IIIC (Figure 1A–B and Figure 3A–B). The post-operative CT scan performed four weeks later revealed rapid peritoneal disease progression, with highvolume ascites and hydronephrosis, resulting in an important decline on clinical status and death before initiating palliative chemotherapy
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