Tamoxifen for nodal recurrence of serous borderline ovarian tumour - a case report.

Background: Serous borderline ovarian tumours (SBTs) are rare epithelial neoplasms typically associated with excellent long-term survival. Most recurrences occur within the first decade and are limited to the peritoneum. Nodal recurrence after several decades is exceedingly rare. Hormonal therapy is well-established in low-grade serous carcinoma (LGSC), but its role in borderline tumours remains undefined. Case presentation: We describe the case of a 68-year-old woman with a history of advanced stage serous borderline ovarian tumour, previously treated surgically in the 1980s. After 37 years of disease-free survival, she presented with abdominopelvic pain and was found to have biopsy-confirmed recurrence in multiple nodal regions, including bilateral external iliac and mesenteric lymph nodes. Surgical debulking was performed, confirming SBT. The surgery was complicated by a left external iliac vein injury. Postoperatively, the course was complicated by extensive bilateral deep vein thromboses requiring long-term anticoagulation, as well as a left inguinal lymphocele. She subsequently developed progression in the right external iliac nodes eight months later. Due to surgical complexity, further resection was not pursued, and the patient was initiated on hormonal therapy with Tamoxifen. Follow-up imaging demonstrated partial response. Conclusion: This case highlights the rare phenomenon of late nodal recurrence in borderline ovarian tumours and illustrates the potential role of hormonal therapy in selected cases where surgery is no longer feasible.