EP29.23: Ultrasound findings of a rare ovarian mixed Müllerian tumour: a case report and literature review

Ovarian mixed Müllerian tumour or ovarian carcinosarcoma, is a rare tumour which accounts for <1% of all ovarian malignancies. It has an aggressive behaviour with a poor prognosis. Debulking surgery followed by chemotherapy is the standard treatment using platinum containing regimens. We report a case of a 41-year-old, gravida 1, para 1, presenting with hypogastric pain associated with enlarging hypogastric mass. Physical findings showed a 20 × 16 × 11 cm firm, slightly movable non-tender abdominopelvic mass. Ultrasound revealed a heterogeneous solid mass with smooth and regular border, measuring 12.9 × 9.3 × 11.4 cm (volume: 715.0 cc) at the left adnexal area, with anechoic cystic spaces and areas with posterior acoustic shadows, which showed moderate peripheral vascularity on power Doppler. Impression was a left adnexal mass, consider ovarian new growth, probably malignant by subjective assessment (cannot totally rule out fibroma versus thecoma), malignant by IOTA ADNEX (with Ca-125: 219.2 u/ml), with 67.7% risk of malignancy and a relative risk of 3.1 probably metastatic to the adnexa, with moderate ascites. The patient underwent debulking surgery, and histopathology revealed a carcinosarcoma of the left ovary associated with endometriosis and was staged IC2. Chemotherapy using Carboplatin-Paclitaxel were administered postoperatively. Elderly women who present with large solid heterogeneous adnexal masses with irregular borders and cystic areas need to be evaluated further, and an ovarian carcinosarcoma should be considered. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.