Borderline Ovarian Tumors (BOT) and Uterine STUMP (smooth tumors of uncertain malignant potential) are tumors with a low or an uncertain potential of malignancy and a high risk of recurrence or metastasis. They are challenging in terms of management and follow-up.
We present a rare association of BOT and uterine STUMP in a 50-year-old woman with abdominal distension. The patient had a history of left oophorectomy and myomectomy. Examination revealed a distended abdomen with a pelvic mass corresponding to uterine enlargement and a right latero uterine mass.
Pelvic ultrasound showed a unilocular anechoic cyst and an enlarged uterus with multiple myometrial masses. On Pelvic MRI the ovarian mass showed papillary projections with marked enhancement and a high-intensity signal on DWI. The uterus was enlarged with multiples masses. One of the masses showed an intermediate signal on DWI.
The patient underwent exploratory laparotomy, there was a bulky right adnexal mass with an enlarged and bosselated uterus. A radical hysterectomy and a right oophorectomy were performed.
The pathological examination of the ovarian mass showed cell proliferation, with slight nuclear atypia and micropapillary patterns, without stromal invasion corresponding to a serous borderline tumor.
The examination of the Uterus showed ten stromal tumors: One tumor presented diffuse moderate to severe cellular atypia without coagulative cell necrosis evoking STUMP.
The patient is on close follow-up for 2 years postoperatively with no signs of recurrence or metastasis.
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