Giant ovarian cancer weighing 100 kg with poor prognosis

Yanazume, Yumi; Yoshinaga, Mitsuhiro; Yanazume, Shintaro; Kamikihara, Tetsuya; Tokunaga, Makoto; Kitajima, Masaki; Douchi, Tsutomu

doi:10.1111/j.1447-0756.2007.00487.x

Cited by 14 publications

(22 citation statements)

References 6 publications

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“…Hemodynamic instability induced by fluid depletion and aortocaval decompression during removal of the cyst is also a concern. Some advocate progressive preoperative drainage to avoid the development of severe clinical hypotension [7,9]. Five potential problems have been associated with the resection of massive ovarian tumours: respiratory failure, intraoperative fluids shifts, adequate exposure, orthostatic hypotension and adynamic intestine.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the patient died of massive abdominal bleeding caused by disseminated intravascular coagulation 10 h postoperatively. Generally speaking, the majority of giant ovarian tumours are benign, borderline or of low malignant potential because when invasive cancer is present, clinical symptoms occur before the mass reaches a significant volume [7]. These huge neglected cysts can mimic other medical conditions on physical examination, like pregnancy, massive ascites, colonic volvulus and idiopathic megacolon [5], and they can give rise to various clinical complications resulting from local compression such as abdominal pain, hydronephrosis and aortocaval compression.…”

Section: Discussionmentioning

confidence: 99%

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Giant ovarian cystadenoma weighing 59 kg

2010

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Explanation imageIn October 2009, a 24-year-old woman was admitted to our emergency services for massive abdominal distension causing dyspnoea and inability to walk. She had noticed weight gain and progressive abdominal distension for 10 months. She delayed seeking medical advice because of social isolation resulting from family problems. The patient weighed 122 kg for a height of 165 cm and showed signs of hirsutism. Her medical history was unremarkable except for congenital bilateral clubfoot, and she was nulligravida. The CA-125 levels were increased (405.5 U/ ml n:0-35) A computerised tomography scan showed a large fluid density mass filling the entire abdominal cavity, with some papillary projections (Fig. 1).A peridural was performed, and a general anaesthesia was induced before the transfer to the surgical table. The patient was installed supine position, with the table slightly tilted to the left to avoid caval vein compression syndrome. A midline laparotomy was performed (Fig. 2). We found a large cystic mass arising from the right adnexa. The left adnexum was normal. A right salpingo-oophorectomy was performed, and a smooth-walled cystic mass measuring 50×40 cm was removed without disruption of the capsule.During the surgery after the mass had been removed, a decreased cardiac frequency and an increased ejection fraction were observed. Throughout surgery and postoperatively, respiratory and hemodynamic parameters remained stable, and the patient made an uneventful recovery. She is recovering well and is receiving psychological support. An abdominoplasty will probably be necessary in the future.Pathology diagnosed a giant mucosal-serosal cystadenoma weighing 59 kg with borderline potential in one of the papillary projections (Figs. 3 and 4). Void of its clear Fig. 1 Computed tomography scan showing a large fluid density mass with a papillary projection

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Giant ovarian cystadenoma weighing 59 kg

2010

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“…In cases where the patient compulsorily maintains a lateral position to prevent supine hypotension syndrome, operation handlings and anesthesia management become difficult. Such a massive tumor is likely to have feeding vessels or show adhesion, implying a risk of major bleeding [9,10]. En block removal is also associated with a possible risk of rupture during surgery [6].…”

Section: Discussionmentioning

confidence: 99%

A Giant Ovarian Tumor Causing Anasarca and Dyspnea Successfully Managed after Preoperative Drainage

Yamaguchi

Tashiro²,

Takaishi³

et al. 2015

Gynecol Obstet Invest

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Serious complications are likely to accompany the treatment of giant ovarian tumors, and resection with or without preoperative drainage has been previously reported. Here, we report the case of a 27-year-old Japanese woman with a significant weight gain of 50 kg, who was referred to the Kumamoto University Hospital because of gait impairment and dyspnea. Imaging tests revealed an ovarian tumor, 37 cm in diameter, with two solid components. The patient's condition improved after the removal of 31.5 l tumor fluid by using a suprapubic urinary catheter for 3 days. The tumor was subsequently resected without complications, and was diagnosed as a left mucinous ovarian tumor with malignant components, weighing 37 kg (81.5 lb). The patient was discharged after her anasarca improved, and her body weight decreased from 100 to 50 kg with accompanying considerable urination within two weeks. She was in good condition with no evidence of recurrence at 15 months after surgery. Tumor resection after preoperative drainage was effective in the management of a patient with dyspnea induced by a giant ovarian tumor. We suggest the use of a suprapubic urinary catheter for preoperative drainage because of its ease of use in preventing fluid leakage from the possibly malignant tumor.

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“…Complications associated with the removal of giant ovarian tumors have been described, including massive bleeding or re-expansion pulmonary edema. 4,5,7,[9][10][11][12] To the authors' best knowledge, 22 cases of giant ovarian tumor of > 40 kg have been reported since 1970 (Table 1). A giant ovarian mucinous cystadenoma that underwent successful intraoperative drainage over 2 hours is reported, along with a review of the literature.…”

Section: Introductionmentioning

confidence: 99%

“…1 Most cases are benign, but some cases of low-malignant-potential tumors or adenocarcinomas have been reported. [2][3][4][5][6][7] Their management, especially whether and when to drain the cysts, has been discussed over the years, but there is no clear consensus. Complications associated with the removal of giant ovarian tumors have been described, including massive bleeding or re-expansion pulmonary edema.…”

Section: Introductionmentioning

confidence: 99%

Resection of a Giant Ovarian Mucinous Cystadenoma with Intraoperative Drainage

Abe¹,

Iwaoki

Tanji³

et al. 2012

Journal of Gynecologic Surgery

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Background: Giant ovarian tumors are now rarely encountered, because of the wide availability of medical care, and most cases are benign. Case: A rare case of a giant ovarian cystadenoma in a 41-year-old woman, with such severe abdominal distension that she could not walk, is reported. Her abdominal girth was 141 cm. The patient was 151 cm tall and weighed 92.6 kg. Computed tomography (CT) showed a large, multilocular, cystic tumor that occupied the whole abdomen. The preoperative diagnosis was malignant ovarian tumor or ovarian cystadenoma. Results: On laparotomy, gradual intraoperative drainage of the tumor was first performed over 2 hours, and then total hysterectomy with bilateral salpingo-oophorectomy was performed successfully. Pathologic findings confirmed that the tumor was a mucinous cystadenoma. Conclusions: There is a lack of evidence on how to manage such giant tumors in the perioperative period; however, in the present case, intraoperative drainage and tumor resection were safely performed without complications. ( J GYNECOL SURG 28:215)

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Giant ovarian cancer weighing 100 kg with poor prognosis

Cited by 14 publications

References 6 publications

Giant ovarian cystadenoma weighing 59 kg

Giant ovarian cystadenoma weighing 59 kg

A Giant Ovarian Tumor Causing Anasarca and Dyspnea Successfully Managed after Preoperative Drainage

Resection of a Giant Ovarian Mucinous Cystadenoma with Intraoperative Drainage

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