Abstract

BACKGROUND
Giant ovarian tumors (GOTs) are rarely observed in current gynecological practice. They are mostly described as benign, with a mucinous subtype, whereas the borderline type constitutes only 10% of all GOTs. Due to the lack of data regarding this histological GOT subtype, the main goal of this paper is to highlight some critical aspects of the management of borderline GOTs, which are associated with life-threatening complications. Moreover, we review other cases of borderline GOTs published in the literature, to improve the knowledge of this rare condition.
CASE REPORT
We present the multidisciplinary management of a 52-year-old symptomatic woman with a giant serous borderline ovarian tumor. Preoperative assessment showed a multiloculated pelvic-abdominal cyst responsible for compression of the bowel and retroperitoneal organs, and dyspnea. All tumor markers were negative. Together with anesthesiologists and interventional cardiologists, we decided to perform a controlled drainage of the cyst of the tumor, to prevent hemodynamic instability. Subsequent total extrafascial hysterectomy, contralateral salpingo-oophorectomy, and abdominal wall reconstruction, followed by admission to the intensive care unit, were also conducted by the multidisciplinary team. During the postoperative period, the patient experienced a cardiopulmonary arrest and acute renal failure, which were managed by dialysis. After discharge, the patient underwent oncologic followup, and after 2 years, she was found to be completely recovered and disease free.
CONCLUSIONS
Intraoperative controlled drainage of GOT fluid, planned by a multidisciplinary management team, constitutes a valid and safe alternative to the popular choice of “en bloc” tumor resection. This approach avoids rapid changes in body circulation, which are responsible for intraoperative and postoperative severe complications.

Keywords: Case Reports; Ovarian Cysts; Ovarian Neoplasms; Patient Care Team