A case report on spindle cell neoplasm of ovary

Abstract

Ovarian spindle cell neoplasms are rare stromal tumors that pose significant diagnostic and management challenges due to their potential for aggressive behavior and their ability to mimic other malignancies. These tumors can be classified as benign, borderline, or malignant, each with distinct clinical features and treatment approaches. Despite their rarity, spindle cell tumors can exhibit malignant potential, necessitating early detection and intervention. This report presents the case of a 35-year-old woman who presented with lower abdominal pain and distension for four months. Imaging revealed a large solid-cystic mass suggestive of a neoplastic etiology, classified as ORADS 5, though tumor markers remained within normal limits. Laparotomy uncovered a 10 kg left ovarian mass, primarily cystic with mucinous degenerative changes, and histopathology confirmed a spindle cell neoplasm with focal atypia but no malignant transformation. Although imaging indicated a high suspicion for malignancy, the histological findings negated malignancy. Surgical management through total abdominal hysterectomy with bilateral oophorectomy provided significant symptom relief. Given the rare and potentially aggressive nature of these tumors, ongoing follow-up and consideration of oncological therapies are essential. This case emphasizes the importance of a comprehensive diagnostic approach including imaging, tumor markers, surgical staging, and histopathology, particularly as such tumors can occur in younger women. Age alone should not exclude the possibility of an ovarian spindle cell neoplasm, and further research is needed to refine diagnosis and treatment strategies for improved clinical outcomes.