Gülsüm Ekin SARI, Görker SEL, Harun Reşit TÜRKMENOĞLU, Yegana SADIGOVA, Erinç TEKİN, Metecan ATEŞ, Mehmet GÖKSU, Hülya Ayık TOSUN, Tayfun TOPTAŞ
Türk Jinekolojik Onkoloji Dergisi - 2026;26(2):38-47
Objective: To compare the clinicopathologic features and surgical management of benign, borderline, and malignant mucinous tumors involving the ovary and to characterize primary ovarian and extraovarian origins among malignant cases. Methods: We retrospectively reviewed 67 patients who underwent surgery between May 2015 and February 2021 and classified their tumors as benign, borderline, or malignant. Clinicopathologic, surgical, treatment, and follow-up data were recorded. Continuous variables are presented as medians (minimum-maximum) and categorical variables as numbers and percentages. Groups were compared using the Kruskal-Wallis, chi-square, or Fisher's exact test, as appropriate. Results: Of the 67 patients, 33 had benign tumors, 19 had borderline tumors, and 15 had malignant tumors; the malignant group included 10 primary mucinous ovarian carcinomas and five metastases from extraovarian primary tumors. The median age was 43 years (range, 16-86), and the median tumor diameter was 13 cm (range, 5-50); six tumors (9.0%) were bilateral. Median age was higher in the malignant group than in the benign and borderline groups [56 (31-71), 38 (21-86), and 42 (16-69) years, respectively; p=0.004]. Tumor diameter also differed among the groups [10 (5-25), 16 (5-50), and 13 (5-40) cm, respectively; p=0.043]. All benign and borderline tumors were unilateral, whereas 40.0% of malignant tumors were bilateral (p<0.001). Appendectomy rates were 53.3% in the malignant group, 47.4% in the borderline group, and 6.1% in the benign group (p<0.001). Among 19 appendectomy specimens, two showed metastatic involvement by primary mucinous ovarian carcinoma, one represented a primary appendiceal carcinoma with ovarian metastasis, and one contained a serrated adenoma. Five malignant tumors (33.3%) arose from extraovarian primary sites: three colorectal, one gastric, and one appendiceal; all colorectal metastases were bilateral. Six of 10 primary ovarian carcinomas were stage I. Conclusion: Older age and bilateral involvement were associated with malignant mucinous tumors, whereas tumor diameter did not increase linearly across the benign-borderline-malignant spectrum. Because one-third of malignant tumors originated from extraovarian sites, integrated clinicopathologic assessment is essential. Surgical extent and appendectomy should be individualized according to macroscopic findings, fertility goals, and the distinction between primary and metastatic disease.
