Advanced-stage psammocarcinoma: two cases and a comprehensive

Abstract Psammocarcinoma is a rare variant of serous carcinoma of ovarian or primary peritoneal origin, typically characterized by low-grade nuclear atypia, abundant psammoma body formation, and extensive calcification on computed tomography (CT) imaging. Herein, we report two cases of advanced-stage ovarian psammocarcinoma in a 70-year-old woman (FIGO stage ⅣB) and a 58-year-old woman (FIGO stage ⅢC). Both patients underwent diagnostic laparoscopy with biopsy, and primary debulking surgery was not performed. Despite divergent management strategies, ranging from surveillance to platinum-taxane chemotherapy, both patients remained radiologically stable during follow-up. Furthermore, a comprehensive literature review of 93 previously reported cases (37 primary peritoneal and 56 primary ovarian) was conducted. Our review highlights that serum cancer antigen 125 (CA-125) may be a useful biomarker for disease assessment and follow-up, although it is not uniformly elevated at diagnosis. While optimal surgical cytoreduction remains the cornerstone of management, advanced cases require individualized multidisciplinary strategies, potentially including chemotherapy and, in selected receptor-positive patients, endocrine therapy. Prognosis appears more favorable than that of conventional high-grade serous carcinoma, but careful preoperative evaluation and vigilant post-treatment surveillance remain essential.