Background: borderline ovarian tumors are rare epithelial tumors, more common before the age of 40, with challenging
preoperative diagnosis. Our aim is to describe the management of a case in a resource-limited context in Burkina Faso. Case
report: a 26-year-old primigravida with a 4-year-old child presented with an abdominal mass evolving over one year in the
context of secondary amenorrhea. Clinical examination revealed weight loss, cutaneous-mucosal pallor, increased abdominal
volume with tender deep palpation, and an irregular, mildly firm mass around the umbilicus extending to the iliac fossae, with a
depressed area along the midline. Speculum examination was normal. On vaginal examination, the cervix was unremarkable, the
uterus was of normal size, but the lateral fornices and Douglas pouch were filled. Further investigations revealed microcytic
hypochromic anemia and a borderline normal CA 125 level. The rest of the laboratory tests were normal. Abdominal and pelvic
ultrasound and CT revealed a strong suspicion of a bilateral ovarian tumour, with no signs of secondary localisation. MRI was
not available. The diagnosis of probably malignant bilateral ovarian tumour was retained, and laparotomy was indicated. When
the parietal peritoneum was opened, two ovarian tumours with a budding appearance occupied the entire lower half of the
abdomen. A part of the omentum was in contact with both masses. Bilateral adnexectomy, total hysterectomy and partial
omentectomy were performed in the absence of an extemporaneous histological study. Histological study of the surgical
specimens concluded that the tumour was borderline ovarian. Follow-up at 3 years showed no signs of recurrence or tumour
extension. Conclusion: borderline ovarian tumours are managed surgically, and the choice of conservative or radical surgery is
not easy when there is a desire to have children, and when the ovaries are bilaterally involved. Fortunately, the vital prognosis is
favourable.

Ovary, Borderline Tumour, Abdominal Mass, Amenorrhoea