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Extra Ovarian Serous Cystadenocarcinoma in the Broad Ligament
The embryonic remnants of the gonadal ridge and the genital duct apparatus, the Mullerian apparatus, remain atretic throughout the life of a woman. The definitive organs arising from these, the Ovary, Fallopian tubes, Uterus, Cervix and the Broad ligaments share common coelomic origin. Epithelial metaplasia in any of these organs may differentiate along any of the cell lines in these definitive organs. A. M. was a 52-year old para3+1 woman who presented with eighteen month history of increasing abdominal pain and discomfort, nine months history of progressive abdominal swelling, distension and weight loss. She had ascites that was cytologically positive for malignant cells. Abdominal ultrasonogram and other clinical indices were in keeping with advanced ovarian disease. At surgery findings were 1,450 mls of bloodstained ascitic fluid, uterus of about 16 weeks size, grossly normal ovaries and a huge multi-nodular and friable right broad ligament tumour. She had total abdominal hysterectomy, bilateral salpingo-oophorectomy and infra-colic omentectomy. The broad ligament mass was excised along with the delivery of the uterus, and revealed moderately differentiated serous cyst adenocarcinoma. This presentation demonstrates a rare condition of serous cystadenocarcinoma in the broad ligament found in our practice.