Deceptive clinical course of mucinous ovarian carcinoma mimicking pelvic abscess in a postmenopausal woman: An exceptional case report

TL;DR

A rare case of mucinous ovarian cancer in a postmenopausal woman was initially mistaken for a pelvic abscess, highlighting diagnostic challenges.

Contribution

This case report highlights the deceptive clinical presentation of mucinous ovarian carcinoma in postmenopausal women.

Findings

Mucinous ovarian carcinoma can mimic a pelvic abscess, leading to delayed diagnosis.

Persistent symptoms and elevated tumor markers prompted further investigation and correct diagnosis.

Multidisciplinary evaluation is crucial for accurate diagnosis and timely treatment.

Abstract

Background: Mucinous ovarian carcinoma (MOC) is a rare subtype of epithelial ovarian cancer (3–5%), typically affecting women between 20 and 40 years old. It often presents diagnostic and management challenges.

Case Report: We present an exceptional case of a postmenopausal woman with abdominal pain disguised as a pelvic abscess. A 73-year-old postmenopausal woman presented with abdominal pain for 6 months and postmenopausal spotting for 1 month. Initial imaging (CT scan) suggested a pelvic abscess, which was managed conservatively. However, persistent symptoms and a complex adnexal mass prompted further evaluation. MRI revealed a multiloculated right adnexal mass, and tumour markers (CA-125, CEA, HE4) were elevated. Surgical staging included total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Histopathology confirmed stage IC2 mucinous adenocarcinoma. Postoperative recovery was uneventful, and the patient received six cycles of carboplatin and paclitaxel as adjuvant chemotherapy.

Conclusions: This case emphasizes the diagnostic challenge of MOC in postmenopausal women.

Misinterpretation as benign pelvic pathology can delay appropriate treatment. Precise imaging, tumour markers, and a multidisciplinary approach are critical for early diagnosis and improved outcomes.

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