Ovarian surface papillomatosis of borderline malignancy.

Bilateral ovarian surface papillomatosis of borderline malignancy is a rare condition. In our case it was associated with benign serous cystadenofibroma. The histologic diagnosis and the clinical aspects are discussed.A rare case of bilateral ovarian surface papillomatosis of borderline malignancy is reported. A 50-year-old gravida 1, para 0 woman was referred in July 1976 for evaluation of a pelvic mass manifested by vaginal bleeding of short duration 2 months before. Pelvic examination revealed a solid uterus, the size of a 10-week pregnancy, with irregular contour. At laparatomy, the uterus appeared 12 cm long and exhibited several intramural leiomyomata. A bilateral hydrosalpinx was also found. A 20 by 15 cm left ovarian cyst filled the pelvis and was adherent to the uterus. The right ovary was 3 by 2 cm long. On both surfaces of the ovaries multiple small grey solid papillomas were observed. Histologic examination of hysterectomized tissue revealed benign serious cystadenofibroma of the left ovary without inner papillary formations. On the outer surface of both ovaries there were serous papillomatosis; in most of them the epithelium showed proliferation, atypism, and clusters of free atypical cells. In the uterus there were benign leiomyoma and normal proliferative endometrium. The omentum was normal. In addition to surgical treatment, the patient received postoperative radiation to the pelvis and lower abdomen because of bilateral, low-potential malignant tumor on the outer surface of both ovaries. The need for postoperative radiation in cases of ovarian surface papillomatosis is emphasized.