A case of malignant tumor in the ovary diagnosed by histopathological examination despite normal laparoscopic findings.

Abstract

Case: A 63-year-old woman (gravida/para = 0/0) with an unremarkable past medical history was referred to our hospital for an ovarian tumor detected by routine examination. A unilocular mass was evident on magnetic resonance imaging but the findings did not clearly suggest malignancy. Tumor marker levels were elevated (CA125, 53.6 U/ml; CEA, 13.0 ng/ml), but whole-body inspection failed to locate apparent malignancies. At the patient's request, we performed laparoscopic bilateral salpingo-oophorectomy. An approximately 12-cm tumor was found in the left ovary. The right ovary was normal size, with mild conglutination around the ovary being the only abnormality detected. Diagnostic histopathological examination of the resected ovaries revealed the presence of a serous cystadenoma in the left ovary and an endometrioid adenocarcinoma (Grade 1; 7 mm × 5 mm) in the right ovary. Tumor capsule rupture was absent and no tumor was found on the external surface of the right ovary. The patient was diagnosed as having pT1aN0N0 (Stage Ia) ovarian cancer, confirmed by staging laparotomy, and is currently under observation.