Atypical glandular cells in pap smear as a primarily presentation of ovarian serous borderline tumor

The Pap test is designed as a screening test to detect primarily carcinoma of the cervix and its precursors, most often of squamous type. Rarely atypical or malignant cells found in cervical smear can be indication for the existence of an extrauterine disease. We present a case of a 26 year old woman with very small asymptomatic ovarian bilateral borderline tumors whose diagnosis was triggered by finding of atypical glandular cells with psammoma bodies on Pap smear. She had a history of abnormal Pap smears and was admitted to our Hospital for colposcopy. Pap smear was taken and reported as atypical glandular cells (AGC) with psammoma bodies. Colposcopically directed biopsy along with an endocervical curettage showed no abnormalities as well as transvaginal ultrasound examination. Three months later control Pap smear confirmed AGC with psammoma bodies (suggestive of endometrial or serous origin), ultrasound showed the presence of indistinctive, hyperechoic mass 2 cm in diameter in the left ovary along with slightly elevated CA-125 and diagnostic hysteroscopy and laparoscopy was performed. At laparascopy, both ovaries had surface cauliflower like papillary projections measuring up to 3 cm. A histological examination revealed bilateral serous borderline tumor.