Giant mucinous ovarian borderline tumor. A good lesson from an asymptomatic case

Cases of giant mucinous ovarian tumors are rarely described in literature, with different clinical manifestations. Compressive symptoms or visible abdominal mass are the most frequent observations, with higher surgical risks and life-threatening complications.

We report a case of a 69-year-old female with a giant borderline ovarian mucinous tumor, with peculiarity of absence of clinical manifestation, in front of a mass of over 6500 g. The patient underwent exploratory laparotomy where a giant cystic mass with solid lesions measuring more than 50 cm was found. It originated from the left ovary and extended up to mesocolon. Excision of the tumor intact wall, without fluid aspiration, abdominal hysterectomy with bilateral ooforectomy was performed. No hemodynamic and cardiac intraoperative modifications were observed. There were no significant early or late postoperative complications. Patient was well 12 months after surgery. The pathological examination showed a giant cystic neoplasm measuring 60 × 50 × 40 cm, weighing 6500 g. This histological study showed a mucinous neoplasm of borderline malignancy, with epithelial cells mainly of endocervical type with focal development of intestinal epithelium with goblet cells.

Giant ovarian lesions are often related with compressive symptoms and need resection with high-risk of mortality. Although optimal imaging evolution, rarely rapid growth and abnormal mucina production can determine giant evolution.

Our case report is paradigmatic for absence of symptoms at diagnosis, although dimension of lesion, for borderline mucinous histotype, that determined a good prognosis in this patient, and for safe operative treatment.