Abstract
Background : Seromucinous borderline tumor (SMBT) is a rare tumor that accounts for 5-7％ of all borderline epithelial malignancies. Although there have been numerous reports on the clinical and histological characteristics of SMBTs, there are very few reports on the cytological features of these tumors. Herein, we report a case of SMBT that was suspected from the results of intraoperative ascitic fluid and tumor imprint cytology.
Case : A 59-year-old woman with a left ovarian tumor and massive ascites underwent laparotomy. Intraoperative ascitic fluid cytology showed many scattered atypical squamous cells and few cells containing vacuoles in the cytoplasm. Additional intraoperative tumor imprint cytology revealed squamous cells and clusters of mildly atypical mucinous cells in a background of abundant mucus. None of the cells showed a sufficient degree of atypia to allow a definitive diagnosis of carcinoma. Based on these cytological findings, we suspected SMBT. Intraoperative histopathological examination of frozen sections showed squamous epithelial tissue, papillary proliferation of mucinous gland epithelium, and neutrophilic infiltration of the stroma. We performed total hysterectomy, bilateral adnexectomy, omentectomy as radical surgery, with peritoneal biopsy. Permanent specimens showed endometriotic tissue within the cyst of the tumor and a variety of Mullerian epithelial tissues, similar to the intraoperative frozen sections. Based on these findings, we made a final diagnosis of SMBT, FIGO stage ⅠC3. The patient is currently under follow-up with no evidence of recurrence at two years after the surgery.
Conclusion : The combination of ascitic fluid cytology and imprint cytology is useful for intraoperative diagnosis of SMBTs.
