Borderline mucinous cystic ovarian tumor with mural nodules (carcinosarcoma)

Carcinosarcoma mural nodules arising form a mucinous ovarian neoplasm is very rare and only two published cases have been reported. We report a case of a 29-year-old female patient who suffered from severe lower abdominal pain unrelated to menstruation for 1 year. She came to our (Shin-Kong Hospital) gynecology outpatient department in February 2010. The CT scan revealed a large cystic tumor, measuring approximately 36 cm in greatest dimension and at least 2 solid foci were noted. The patient underwent left salpingo-oophorectomy. A carcinosarcoma mural nodule arising within a mucinous ovarian neoplasm was diagnosed. The patient was treated by further chemotherapy and was free of the disease at time of publication. We reviewed the published studies, and in particular looked at the histology and immunohistochemistry of tumors, in which sarcomatoid carcinoma and carcinosarcoma like nodules were diagnosed. We also discussed the differential diagnosis of the mural nodule in a mucinous cystic neoplasm.