Coexistence of three benign and a borderline tumor in the ovaries of a 52-year-old woman

Purpose of investigation: In this paper, the authors describe a rare case of four simultaneous ovarian tumors. Materials and Methods: A 52-year-old postmenopausal woman underwent total hysterectomy and bilateral salpingo-ophorectomy. Multiple slides from the ovaries were examined. Results: Histological examination revealed the presence of three ovarian tumors on the right ovary, of the following types: cystadenoma, mucinous borderline ovarian tumor and mature teratoma, and also a benign Brenner tumor on the left ovary. Conclusion: Pathologists must examine multiple sections of both ovaries, regardless of the macroscopic or clinical specimen's appearance, in order to exclude the presence of malignancy, which could alter the surgical approach. Particular attention should also be paid to the frozen section of the contralateral ovary, as depending on the result, it could change the surgical approach. From the surgeon's perspective, bilateral salpingo-ophorectomy with total hysterectomy should be the treatment of choice in postmenopausal women with multiple ovarian tumors. The diagnosis of a malignant or borderline tumor on a normal-appearing ovary changes the radicality of the surgical approach. In such a case, staging surgery, including omentectomy, multiple peritoneal biopsies, and washes are required.