A 56-year-old postmenopausal woman presented with abdominal fullness and a rapid weight gain of 5 kg in a week. She had an approximately 10 cm pelvic mass upon physical examination, and a left adnexal mass was palpable with tenderness upon pelvic examination. Magnetic resonance imaging (MRI) demonstrated a 12 × 10 cm multilocular cystic mass containing several solid portions with multiple disseminations and ascites in her pelvis. Computed tomography (CT) did not detect any sign of distant metastasis or lymphadenopathy.
Preoperative CA125 was 88.6 U/ml (normal b35 U/ml), and alpha-fetoprotein (AFP) was not evaluated at this point. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic lymphadenectomy, partial omentectomy, appendectomy, and partial peritonectomy. The ascetic fluid (3030 ml) was hemorrhagic and positive by cytologic examination. The right…
