Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of recurrent mucinous cystadenoma of the ovary

Purpose: Mucinous cystadenomas (MCA) of the ovary may lead to multiple complications and become recurrent. This study presents the management and long term follow-up of three patients with recurrent ovarian MCA treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Materials and Methods: A retrospective review of a prospective database of 675 patients treated with CRS/HIPEC at a single institution was conducted. Of 132 patients with gynecological tumors, three patients with recurrent ovarian MCA were identified. CRS/HIPEC was performed with 40 mg of mitomycin-C for 90 minutes. Follow-up for disease recurrence was carried out with computed tomography. Results: All patients with recurrent ovarian MCA had a total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO) as the initial intervention. Two patients recurred twice after the initial procedure and one patient had three recurrences. At the time of CRS/HIPEC, all patients had multiple organ involvement and urinary complications, which resolved after CRS/HIPEC. There were no further recurrences after CRS/HIPEC. Follow-up after CRS/HIPEC was 12, 60, and 72 months. Conclusion: The present authors’ experience shows that CRS/HIPEC is a feasible and effective treatment for recurrent MCA of the ovary in selected patients.

Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Mucinous cystadenoma; Ovarian tumor; Recurrence

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