Giant mucinous borderline tumor of the ovary in a postmenopausal woman: A rare case report and review of the literature

Introduction and importance: Mucinous cystadenoma is a benign cystic ovarian tumor arising from the surface epithelium of the ovary that usually presents with vague, unspecified abdominal symptoms. If not detected early, this tumor has the potential to grow to a substantial size and can present with huge abdominal distention leading to various compression symptoms. The reported incidence of giant ovarian cystadenoma in postmenopausal women is relatively unknown due to the widespread use of ultrasound and other radiological imaging modalities. Case presentation: Here, we present a rare case of giant borderline mucinous cystadenoma in a 67-year-old female 10 years postmenopausal from Northern Tanzania with multiple comorbidities including hypertension and type 2 diabetes mellitus. She presented with abdominal distention which was of gradual onset for 1 year. Abdominal CT scan with contrast revealed a huge septated cystic mass occupying the entirety of the abdominal and pelvic cavities causing a mass effect on adjacent intra-abdominal structures. An intact 23-kg left ovarian cyst was removed, and a total abdominal hysterectomy (TAH) along with bilateral salpingo-oophorectomy (BSO) was performed. Post-operative recovery was excellent and the patient was discharged. The final histopathological report showed a borderline ovarian mucinous cystadenoma and the patient was managed conservatively after surgery. Clinical discussion: In this case report, we discuss the condition's rarity especially in postmenopausal women, related reports in the literature, and the numerous difficulties clinicians face when encountering a patient with borderline mucinous cystadenoma. The rarity of borderline mucinous cystadenomas in postmenopausal women makes these cases clinically unusual, challenging diagnostic and therapeutic expectations. Conclusion: This case report highlights the importance of thoroughly evaluating women with vague abdominal symptoms. While this condition is rare in postmenopausal women, its massive form can be dangerous if not diagnosed and managed promptly, with the potential to progress to malignancy. Greater awareness of this condition could lead to earlier detection and reporting of more cases.