ArticleFrontiers in oncology2026
Spontaneous rupture of a mucinous borderline ovarian tumour in late pregnancy: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Mucinous borderline ovarian tumours (mBOTs) during pregnancy are rare, and spontaneous rupture in the third trimester is a life-threatening emergency. Most adnexal masses with stable imaging are managed conservatively, which risks delayed intervention. The optimal surveillance and surgical strategies for mBOTs in late pregnancy remain unclear. Case description: A 26-year-old primigravida with a 10-year history of an adnexal cyst presented at 29 + 1 weeks with acute abdominal pain. Serial ultrasounds documented tumour growth from 4.0 cm pre-pregnancy to 17.46 cm (Figure 1), with morphological deterioration. Emergency laboratory tests revealed elevated AFP, CA19-9, and HE4 levels, which, combined with imaging findings, raised suspicion of a neoplastic process. Emergency laparotomy at 29 + 1 weeks revealed a ruptured right ovarian tumour with 1000 mL of mucinous ascites. Frozen section suggested a borderline tumour. Fertility-sparing staging surgery (adnexectomy, peritoneal biopsies, omentectomy) was performed. Postoperative pathology, confirmed by expert consultation, diagnosed a mBOT (atypical proliferative mucinous tumour) with 85% borderline components, Ki-67 ~30%, and no intraepithelial carcinoma, no microinvasion, and no invasive carcinoma The patient recovered uneventfully and she had a spontaneous vaginal delivery at 39 + 2 weeks of gestation, delivering a healthy full-term male infant (2, 840 g, Apgar 10/10). Postpartum imaging and tumour markers showed no evidence of residual disease. Conclusion: This case suggests that conventional expectant management may be inadequate for pre-pregnancy cystic adnexal masses with growth trajectory, highlights the importance of multidisciplinary evaluation and stratified monitoring, and illustrates that emergency fertility-sparing staging surgery in the third trimester is feasible and achieved favourable maternal and neonatal outcomes in a patient with a ruptured mucinous borderline tumour, while preserving fertility.
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