A Giant Ovarian Cyst in an Adolescent

Abstract

A 12-year-old postmenarchal girl was admitted for evaluation of a 2-month history of increasing abdominal swelling and constipation. On physical examination, a smooth and firm mass filling all the abdomen was palpable. Ultrasound examination showed a giant cystic mass arising from the pelvis; magnetic resonance imaging (Figure) confirmed the finding. Blood tests and tumor markers (b-human choriogonadotropin, CA 19-9, CA-125, and carcinoembryonic antigen) were all within normal range. Suspecting either an ovarian or a paraovarian or a mesenteric cyst, surgical exploration was performed through an umbilical incision. Approximately 5 L of clear fluid were drained without any spillage from the cyst and once its origin from the right ovary was confirmed, an ovarian cystectomy was performed, preserving the ovary. Histopathology revealed a serous cystadenoma. Childhood ovarian masses are a rare and, generally, not malignant. Epithelial tumors occur most often after menarche. The most common clinical signs are rapidly expanding abdominal distension and a palpable mass; these findings may be accompanied by nonspecific abdominal pain, vomiting, constipation, ovary torsion, and rupture. A conservative procedure, namely, ovarian cystectomy, should be considered the treatment of choice to preserve fertility. 1-3 Because the clinical presentation of ovarian masses is usually nonspecific, pediatricians should consider this diagnosis both in premenarchal and postmenarchal girls. ■

A Giant Abdominal Cyst in an Adolescent

“…They may give symptoms related to compression of adjacent structures (bowel or urinary obstruction) or acute symptoms in the case of ovarian torsion. Despite being giant cysts, minimally invasive surgery and conservative treatment is mandated [2,3]. Founding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.…”