Introduction/Background Mucinous cystic tumor with mural nodules: anaplastic carcinoma and sarcoma like-nodules are very rare. Mural nodules are single or multiple nodules arising within the wall of mucinous tumours whether they are benign, borderline or malignant. The prognosis of SLMNs is excellent, their presence does not affect the prognosis of cystic ovarian tumor. In contrast, the foci of anaplastic carcinoma are aggressive components of cystic ovarian tumors. They carry an unfavorable prognosis, and most patients with mural nodules of anaplastic carcinoma have a malignant, frequently rapid course.

Methodology A woman aged 41 presented abdominal pain. CT scan revealed a cystic mass 110×90×85 mm located in retroperitoneal space.

Results Exploratory laparotomy was performed, and tumor was excised. Grossly the cystic tumor measured 10 cm and was partially lined with mucus epithelium exhibiting features of moderate atypia.

There was a pleomorphic infiltrate formed in the cyst wall formed of oval spindle cells and giant multinucleated cells. Approximately 50% of the infiltration was necrosis.

The tumor developed within the mucinous cystic tumor of Mullerian epithelium in the form of a mixed wall tumor. She was diagnosed with Mucinous cystic tumor with mural nodules: anaplastic carcinoma and sarcoma like-nodules. Afterwards bilateral salpingo-oophorectomy, appendectomy, pelvic lymphadenectomy and omentectomy were performed. Microscopic examination showed no pathological findings. CT scan performed after laparotomy revealed several suspicious small nodules within both lungs. Subsequentally the patient received chemotherapy consisting of Cisplatin, Adriamycin and Cyclophosphamide. PET-CT performed after completion of chemotherapy showed no evidence of metastatic or recurrent disease. Six months following the completion of therapy the patient is in good condition with no signs of disease.

Conclusion Careful histologic and immunohistochemical analysis of mural nodules is essential for the determination of treatment and prognosis.

Disclosure Nothing to disclose.