Management of Giant Ovarian Cysts: A Review of 5 Case Reports

Abstract

Background: Articles on giant ovarian cysts have become less common in medical literature. These cysts mimic ascites, presenting with abdominal distension and shifting dullness. They are predominantly serous and mucinous cystadenomas. Rare cases of low-grade of malignant tumors and adenocarcinomatous ovarian cysts have been reported. Materials and Methods: This was a retrospective descriptive study of 5 cases recruited between 2009 and 2012. The selected patients had large ovarian cysts extending to the epigastric region. Solid, mixed, or predominantly solid ovarian cysts were excluded from the study. Results: The mean age of the patients was 28, with extremes of ages 22 and 39. Ascites was detected clinically with transabdominal fluid thrills in all cases. Cysts were unilocular in 4 cases and multilocular in 1 case. Oophorectomy and salpingectomy were performed without preoperative drainage. Histology testing showed serous cystadenoma in 4 cases and mucinous low-grade adenocarcinoma in 1 case. The average follow-up time was 54 months. No recurrences were observed. Conclusions: Imaging (ultrasound, computed tomography, and/or magnetic resonance imaging) is paramount for planning management of giant ovarian cysts as imaging facilitates the distinction between ascites and pseudoascites as well as the identification of any suspicious features of malignancy (multiple partitions, and endo-or exocystic vegetations). Complete excision without opening the cyst is the procedure of choice. ( J GYNECOL SURG 32:162)

Giant Ovarian Cysts: A Case Series

“…It is reported that over 70% of these tumors are benign. They are said to be mainly serous or mucinous cyst 3,12,13 adenomas. Malignancies are less common (20-25%).…”

“…However, when the tumor grows from been a pelvic mass to not just an abdominal-pelvic mass but up to the epigastric region, abdominal pains from cyst accidents and obstruction with associated nausea, vomiting, early satiety, constipation, respiratory difficulty etc could be some of the presenting features of 2,3 the affected patient. If not properly evaluated, the gross abdominal distention could be diagnosed to be massive 3,4,5 ascites such as the case reported by Yeika et al Most of these tumors are benign serous or mucinous cyst adenomas; although few cases of low-grade malignant 3 (adenocarcinomas) have been diagnosed.…”

“…Advocates of pre-operative drainage support their decision on relieving the patient from respiratory and cardiovascular complications. Some clinicians had reported laparoscopic approach to surgical3,11…”

Minimally invasive drainage of a giant ovarian mucinous cystadenoma associated with a mature cystic teratoma

“…Giant ovarian tumors are a known entity, but very rare in developed countries given that most ovarian masses are discovered early on routine medical visits. Most reported cases are from developing regions such as India [ 3 ] or Africa [ 4 ]. Mucinous cystadenomas are typically unilateral, benign tumors of epithelial origin lined by tall columnar, non-ciliated epithelial cells with apical mucin and basal nuclei.…”

Alternative Back-Up Approach for Inaccessible Laparoscopy in Cases of Huge Probably Benign Cystic Adnexal Masses

“…Gynecologists shouldn't ignore clinical, ultrasonographic, biochemical and possible MRI evaluation of patients [9]. Imaging is paramount for planning management of giant ovarian cysts as imaging identifies any suspicious features of malignancy e.g., multiple partitions, and endo-or exocystic vegetations [16]. Moreover, meticulous intraoperative naked-eye assessment of the ovary and the ipsilateral ovary are good assuring steps.…”