Rare Entity of Sarcomatous Nodule Co-Existing With Benign Ovarian Tumour − A Case Report and Review of Literature

Abstract

Coexistence of mural nodule with ovarian tumour is an extremely rare entity. We highlight the case of a 60 year old postmenopausal lady with a sarcomatous nodule co-existing with ovarian mucinous cystadenoma. She had presented with an abdominal mass increasing over 2 years associated with pain. Image and lab analysis showed a multiloculated cystic mass 40FNx0130FNx0112 cm with features suggestive of mucinous cystadenoma with borderline elevation of CA 125 - - 118. 4 IU/ml.. She underwent total abdominal hysterectomy with right sided ovariotomy with left salpigooopherectomy and infracolic omentectomy with bilateral pelvic lymph node sampling. Frozen section report showed cystic ovary with mucinous fluid with a 2.5 cm reddish mural nodule in its wall. Microscopic section showed mucin secreting columnar epithelium lining. Subepithelially, the nodule showed highly pleomorphic cells with large nucleus having corse chromatin 4–10 mitoses/hpf. Final histopathology report was suggestive of mucinous cystadenoma with malignant sarcomatous nodule. Following surgery she recieved 3 cycles of carboplatin, paclitaxel regimen chemotherapy and sustained well. On thorough review of literature, only 42 such cases of coexistence of malignant mural nodules with benign tumors have been found. Considering the malignant potential of such nodules they must not be overlooked and treated accordingly.

Keywords

• autoimmune diseases
• mural nodule
• ovarian tumor
• preeclampsia
• rheumatoid arthritis
• tuberculosis