PSAMMOCARCINOMA WITH AN AGGRESSIVE COURSE

Background: Psammocarcinoma is an unusual variant of serous cystadenoc arcinoma characterized by heavy deposits of psammoma bodies. This dise ase has been suggested to be similar to carcinomas of low malignant po tential in its indolent clinical course. We present this case report o f an aggressive course of this disease to alert others that psammocarc inoma may not always follow a benign course. Case: A 66-year-old woman underwent staging laparotomy for bilateral ovarian cystadenofibromata with rare foci of borderline serous tumors and several small bowel pe ritoneal surface nodules showing infiltrating psammocarcinoma. She was not recommended for adjuvant therapy because of the previously report ed indolent course of this disease. Eighteen months later she represen ted with small bowel obstruction and underwent an exploratory laparoto my that demonstrated diffuse recurrence of the psammocarcinoma. Conclu sion: Psammocarcinoma may have a more aggressive course than has been suggested. Patients with this disease should have optimal tumor debulk ing. There may be a role for adjuvant therapy in its treatment. (Obste t Gynecol 1998;92:659-61. (C) 1998 by The American College of Obstetri cians and Gynecologists.)