CASE REPORT article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1581241
Serous Borderline Ovarian Tumor and Extensive Abdominopelvic Endometriosis Mimicking Advanced Epithelial Ovarian Cancer in a Postmenopausal Patient
Provisionally accepted
- Good Samaritan University Hospital, West Islip, United States
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The lifetime risk of ovarian cancer is 1 in 75, often diagnosed at an advanced stage due to lack of effective screening. EOC is the most common ovarian cancer in older patients, with BOTs accounting for 15% of EOC. BOTs are usually of low malignant potential. Platinum based chemotherapy has not been shown to increase the survival rate, so cytoreductive surgery is recommended. Endometriosis is present in 10.5% of patients with EOC. Endometriosis commonly progresses to clear cell and endometrioid ovarian cancer and is thought to progress to cancer due to repetitive cycles of inflammation, mutations in multiple pathways, and microsatellite instability. Other types of cancers, such as BOTs, are possible but rarer in endometriosis. This case report describes the unusual case of a 62-year-old female who appeared to present with advanced stage epithelial ovarian cancer (EOC) but was unexpectedly diagnosed with a borderline ovarian tumor (BOT) with extensive endometriosis. The patient's history of endometriosis, infertility, and low parity increased her chances of developing a BOT, however the age of presentation was unusual. The key clinical feature of this case that adds to the existing literature is the importance of pathology to dictate chemotherapy decisions, especially in the case of progression of disease despite chemotherapy. It highlights the importance of a thorough history and physical examination, for many factors in her history suggested BOT.The patient initially presented with emesis, abdominal distention, postmenopausal bleeding, and a large, rapidly growing pelvic mass. This lead to the initial suspicion of advanced EOC. She was unable to undergo surgery due to supraventricular tachycardia and venous thromboembolism caused by mass effect from the tumor. Despite being medically unstable, exploratory laparotomy with resection of the mass was performed. Pathology showed stage 1C3 serous BOT within a large endometrioma.Chemotherapy was not required postoperatively and she has continued to follow closely with gynecologic oncology for surveillance, hematology to monitor her VTE, and cardiology to monitor for SVT.
Keywords: case report, Endometriosis, Serous borderline ovarian tumor, Exploratory laparotomy, Postmenopausal
Received: 21 Feb 2025; Accepted: 16 May 2025.
Copyright: © 2025 Livatova, Nguyen, Pizzuti, Yi-Chun and McEachron. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Katherine Livatova, Good Samaritan University Hospital, West Islip, United States
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