A 45-year-old woman has a unilateral 8 cm complex ovarian cyst with papillary projections, thick septations, and CA-125 of 420 U/mL. Intraoperative frozen section shows borderline serous tumour. The MOST appropriate surgical management is:

• A Total abdominal hysterectomy with bilateral salpingo-oophorectomy only
• B Cystectomy alone to preserve the ovary
• C Bilateral oophorectomy without uterine removal
• D Unilateral salpingo-oophorectomy with peritoneal washings and omentectomy ✓

Explanation

For borderline serous ovarian tumours in a postmenopausal or peri-menopausal woman, the standard surgical staging includes unilateral salpingo-oophorectomy (or BSO in post-menopause), peritoneal washings, omentectomy, and multiple peritoneal biopsies. Total hysterectomy is not mandatory for borderline tumours unless staging requires it. Cystectomy alone has a higher recurrence rate compared to oophorectomy for borderline tumours.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.