A 71-year old patient presented with distended abdomen. Ultrasound and CT demonstrated a huge ovarian mass taking over the entire abdomen. Ascites was not present. There was also no evidence of metastatic disease. CA-125 was normal.
The tumor, arising from the right ovary and consuming the right tube weighted 10.3kg and was removed intact via laparotomy. The left adnexa was also removed. The surgery took less than 120 minutes and the blood loss was less than 50ml. In the early postoperative period the patient developed mild paralytic ileus, from which she quickly recovered through early intervention. After a while the histopathologists confirmed the presence of an intracystic borderline serous ovarian carcinoma. Omentectomy and peritonectomy ensued – there was no metastasis (FIGO IA, GB).
Giant ovarian tumors are thankfully a rare entity. The removal of such a tumor could pose a few unusual hazards for the patient, like hypotension, cardiac failure, pulmonary edema and ileus. Thus careful, preoperative consideration of such complications and treatment through a multi-disciplinary team are imperative.
Bibliography
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- Cai, S., Dai, R., Mi, J., Wang, S., & Jiang, Y. (2020). Perioperative management of a patient with a giant ovarian tumor: A case report. Medicine, 99(41), e22625. https://doi.org/10.1097/MD.0000000000022625.
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Gynaecologia 