Mucinous ovarian cancer is a rare subtype of epithelial ovarian carcinoma, comprising <5% of all cases. Twenty three years old lady with increasing abdominal fullness and discomfort. Contrast enhanced computed tomography revealed a multiloculated ovoid cystic mass (17.5*21.6*9.1)cm in right adnexa. She underwent staging laparotomy with right salphingo-oophorectomy, peritoneal fluid cytology, bilateral pelvic lymph node dissection, infracolic omentectomy and appendectomy. Histopathology confirmed stage IA, grade 1, (well differentiated) mucinous adenocarcinoma of the ovary. After counseling, patient opted for completion surgery and underwent total abdominal hysterectomy with left salphingo-oophorectomy, repeat peritoneal fluid cytology and supracolic omentectomy. Due to malignant cell in the peritoneal fluid, she received adjuvant chemotherapy. She remains disease-free one year postoperatively. Fertility sparing surgery is oncologically permissible for stage 1A MOC but contraindicated in 1C3 disease. In Nepal, scaling diagnostic capacity, centralizing services, and integrating culturally sensitive councelling are critical to balance fertility preservation with survival.
Kunwar et al. (Thu,) studied this question.