Synchronous bilateral primary ovarian carcinoma - case presentation

Bilateral synchronous primary ovarian carcinoma, histopathologically identical or different is a rare entity encountered in clinical practice. We present the case of a 38-year-old patient who is admitted with the presence of a massive pelvic abdominal tumor formation of 45÷35÷25 cm occupying the lower pelvic and upper abdominal floor, reaching halfway distance between the umbilicus and sternum and lateral bilaterally in the two abdominal flanks until iliac wing. The mixed transabdominal÷transvaginal ultrasound and computed tomography (CT), establish the diagnosis of bilateral ovarian tumor. The CA-125 level is 1822 IU÷mL. The exploratory laparotomy identifies two distinct bilateral ovarian tumors, ascites liquid and pelvic and lumbo-aortic lymphadenopathy, thus the surgery involves hysterectomy with bilateral ovariectomy, pelvic and paraaortic lymphadenectomy and omentectomy. Histopathological and immunohistochemistry (IHC) diagnosis highlights a well-differentiated serous carcinoma on the left ovary and right ovary. The six-month check after surgery as well as the one-year check showed the efficiency of postsurgery chemotherapy and did not signal the presence of relapses. The particularity of this case lies in the presence of bilateral synchronous primary ovarian carcinoma, histopathologically and IHC indicated serous carcinoma present with a difficult differential diagnosis including clear cell carcinoma at a young patient.