Abstract
Background
The borderline ovarian mucinous cystic tumor may appear with mural nodules. However, its entity may remain rare. Malignant mural nodules mainly occur in old patients and have poor clinical outcomes. Accurate diagnosis of mural nodules is vital to choose the proper treatment, although it is complicated to manage.
Case Presentation
A 24-years-old nulliparous woman was examined due to abdominal pain and enlargement. She had been performed salpingo-oophorectomy due to ovarian tumor suspicion in the previous hospital. We did the surgical staging and found severe adhesion, but no cancer cell was found. During the follow-up, the symptoms got worsened. The CT-Scan results said massive ascites, CA 125 levels raise to 174 U/mL, and CA 19-9 920 U/mL. Exploratory laparotomy was performed, histology examination concluded malignant mural nodules mixed type on an ovarian borderline mucinous tumor. Carboplatin 750mg, paclitaxel 300mg, and bevacizumab 800mg was prescribed. In the beginning, the response was great, CA 125 and CA 19-9 levels decreased. But after four cycles, the CA 19-9 levels raise significantly. On the other hand, the CA 125 remains normal. We concluded that it was a chemotherapy resistance – malignant mural nodules and new chemotherapy regiment was prescribed but also resistance. Currently, the patient refused to continue the treatment.
Conclusion
Although it is rare, malignant mural nodules should be considered when we find a mucinous borderline ovarian tumor at a younger age. The angiosarcoma-type mural nodule is very difficult to manage due to the high probability of chemotherapy resistance.
The borderline ovarian mucinous cystic tumor may appear with mural nodules. However, its entity may remain rare. Malignant mural nodules mainly occur in old patients and have poor clinical outcomes. Accurate diagnosis of mural nodules is vital to choose the proper treatment, although it is complicated to manage.
Case Presentation
A 24-years-old nulliparous woman was examined due to abdominal pain and enlargement. She had been performed salpingo-oophorectomy due to ovarian tumor suspicion in the previous hospital. We did the surgical staging and found severe adhesion, but no cancer cell was found. During the follow-up, the symptoms got worsened. The CT-Scan results said massive ascites, CA 125 levels raise to 174 U/mL, and CA 19-9 920 U/mL. Exploratory laparotomy was performed, histology examination concluded malignant mural nodules mixed type on an ovarian borderline mucinous tumor. Carboplatin 750mg, paclitaxel 300mg, and bevacizumab 800mg was prescribed. In the beginning, the response was great, CA 125 and CA 19-9 levels decreased. But after four cycles, the CA 19-9 levels raise significantly. On the other hand, the CA 125 remains normal. We concluded that it was a chemotherapy resistance – malignant mural nodules and new chemotherapy regiment was prescribed but also resistance. Currently, the patient refused to continue the treatment.
Conclusion
Although it is rare, malignant mural nodules should be considered when we find a mucinous borderline ovarian tumor at a younger age. The angiosarcoma-type mural nodule is very difficult to manage due to the high probability of chemotherapy resistance.
| Original language | English |
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| DOIs | |
| Publication status | Published - 22 Feb 2022 |
Keywords
- Mural nodule
- Ovarian Cancer
- Malignant
- Chemotherapy Resistance
