Mucinous Ovarian Cancer in a Young Woman: A Case Report

TL;DR

A young woman with mucinous ovarian cancer underwent fertility-sparing surgery and remains disease-free, highlighting treatment options and challenges in Nepal.

Contribution

The case emphasizes fertility-sparing surgery for early-stage mucinous ovarian cancer in a resource-limited setting.

Findings

The patient had stage IA, grade 1 mucinous adenocarcinoma and opted for fertility-sparing surgery.

Adjuvant chemotherapy was administered due to malignant cells in peritoneal fluid.

Fertility preservation is oncologically safe for stage IA but not for 1C3 disease.

Abstract

Mucinous ovarian cancer is a rare subtype of epithelial ovarian carcinoma, comprising <5% of all cases. Twenty three years old lady with increasing abdominal fullness and discomfort. Contrast enhanced computed tomography revealed a multiloculated ovoid cystic mass (17.5*21.6*9.1)cm in right adnexa. She underwent staging laparotomy with right salphingo-oophorectomy, peritoneal fluid cytology, bilateral pelvic lymph node dissection, infracolic omentectomy and appendectomy. Histopathology confirmed stage IA, grade 1, (well differentiated) mucinous adenocarcinoma of the ovary. After counseling, patient opted for completion surgery and underwent total abdominal hysterectomy with left salphingo-oophorectomy, repeat peritoneal fluid cytology and supracolic omentectomy. Due to malignant cell in the peritoneal fluid, she received adjuvant chemotherapy. She remains disease-free one year postoperatively. Fertility sparing surgery is oncologically permissible for stage IA MOC but contraindicated in 1C3 disease. In Nepal, scaling diagnostic capacity, centralizing services, and integrating culturally sensitive councelling are critical to balance fertility preservation with survival.

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