Masoud Rokia, Hamed Hosam, Abdelrazek Hassan Magdy, Emara Marwan, Abdelsalam Ramy A
Faculty of Medicine, Mansoura University, Egypt.
Gastrointestinal Surgical Center, Department of General Surgery, Mansoura University, Egypt.
Int J Surg Case Rep. 2025 Aug;133:111527. doi: 10.1016/j.ijscr.2025.111527. Epub 2025 Jun 16.
Primary peritoneal serous borderline tumor (PPSBT) is a rare epithelial tumor that is identical to non-invasive peritoneal implants in patients with ovarian serous borderline tumors.
A 51-year-old woman presented with abdominal swelling. Radiological findings revealed a large, well-defined cystic lesion within the right abdominopelvic cavity, measuring 19 × 14 × 10 cm, without any connection to both ovaries. Given the imaging characteristics, the differential diagnosis primarily included benign cystic neoplasms, mesenteric or peritoneal cysts, and other cystic lesions of gastrointestinal or embryological origin. Laparoscopic excision of the cyst was done. The gross examination showed the smooth outer surface with an intact capsule. The inner surface showed firm yellow-white papillary outgrowths. Microscopic examination revealed numerous irregular papillae with fibro-myxoid cores and a hierarchical branching pattern. The component cells have large hyperchromatic nuclei and a moderate degree of cellular atypia. By immunohistochemical staining, the tumor cells showed a positive reaction for PAX8 and WT1, while calretinin was negative. The diagnosis was reported as a primary peritoneal serous borderline tumor.
The clinical presentation of PPSBT is often misleading. Thorough radiological and laparoscopic examinations are very important to exclude any secondary involvement from ovarian tumors. Microscopic examination and immunohistochemical staining are crucial for establishing the diagnosis of PPSBT and exclusion of other differential diagnoses. Complete surgical excision of the cyst is the standard treatment with follow-up of the patient.
PPSBT is a rare and challenging diagnosis. It requires accurate clinical, radiological, histopathological, and immunohistochemical examination.
原发性腹膜浆液性交界性肿瘤（PPSBT）是一种罕见的上皮性肿瘤，与卵巢浆液性交界性肿瘤患者的非侵袭性腹膜种植瘤相同。
一名51岁女性因腹部肿胀就诊。影像学检查发现右下腹盆腔内有一个大的、边界清晰的囊性病变，大小为19×14×10cm，与双侧卵巢均无连接。鉴于影像学特征，鉴别诊断主要包括良性囊性肿瘤、肠系膜或腹膜囊肿以及其他胃肠道或胚胎源性囊性病变。对该囊肿进行了腹腔镜切除。大体检查显示外表面光滑，包膜完整。内表面可见坚实的黄白色乳头状突起。显微镜检查发现大量不规则乳头，有纤维黏液样核心和分级分支模式。组成细胞有大的深染核和中度细胞异型性。免疫组化染色显示肿瘤细胞PAX8和WT1呈阳性反应，而钙视网膜蛋白呈阴性。诊断为原发性腹膜浆液性交界性肿瘤。
PPSBT的临床表现常常具有误导性。全面的影像学和腹腔镜检查对于排除卵巢肿瘤的任何继发性累及非常重要。显微镜检查和免疫组化染色对于确立PPSBT的诊断以及排除其他鉴别诊断至关重要。囊肿的完整手术切除是标准治疗方法，并对患者进行随访。
PPSBT是一种罕见且具有挑战性的诊断。它需要准确的临床、影像学、组织病理学和免疫组化检查。
