Case Report:
A 40-year-old female, P1, L1 without comorbidity, was presented with
fullness of the abdomen for three months and nonspecific pain abdomen on
and off for one month. Computed tomography scan showed a large cystic
lesion 9 cm x 8.3 cm with peripheral enhancing nodule soft tissue
component in the left adnexa. The serum cancer antigen-125 (CA-125) was
389.8 ยต/ml with a suspicious diagnosis of ovarian malignancy. The
patient underwent laparotomy with left ovariotomy and was sent for
frozen biopsy, which revealed borderline ovarian malignancy, and thus
surgery was extended to total abdominal hysterectomy with bilateral
salphingo-opophorectomy with bilateral pelvic and paraaortic lymph node
dissection with total omentectomy and multiple peritoneal sampling. The
diagnosis of a borderline serous tumor of the left ovary was established
after the evaluation of the surgical specimen in the Pathology
department. On gross examination, a small gray yellow soft mass on the
right ovary was seen. The lesion was well-circumscribed and measured 1
cm x 0.7 cm x 0.6 cm. The outer surface was smooth, intact and the cut
surface was solid, yellow, and homogeneous. [Figure-1] Areas of
hemorrhage, necrosis were not appreciated. The microscopic picture
showed the presence of a well-circumscribed lesion consisting of matured
adipocytes along with a few interlacing fibrous bands in between and
thin-walled capillary-sized blood vessels. The final diagnosis of
ovarian lipoma of the right ovary was made. Features of malignancy,
borderline tumor or teratoma in the right ovary were not seen.
[Figure-2A and 2B]