Unaware of a giant serous cyst adenoma: a case report

Abstract

A case of 36-year-old nonmarried virgin woman presenting a giant ovarian serous cyst adenoma weighing 9.5 kg is reported here. Ovarian neoplasms may be divided by origin cell type into three main groups: epithelial, stromal and germ cell. Taken as a group, the epithelial tumors are by far the most common type. The single most common benign ovarian neoplasm is the benign cystic teratoma; however, according to some studies it is serous cyst adenoma. A 36-year-old nonmarried virgin woman was referred to our clinic from a local medical center. When she was seen first at our outpatient clinic, she looked like a 9-month pregnant woman. Her medical history was normal. She had no serious illness or operation before. On abdominal ultrasound, a giant cyst was found which encompassed the whole abdomen. At laparotomy, a giant, totally cystic, vascularized and smooth mass attached to the right ovary was encountered, lying between the symphysis and the xiphoid. Ooferectomy was performed. On the postoperative second day, she was discharged without any problem. Her pathology report disclosed a 35 x 20 x 16 cm(3) serous cyst adenoma weighing 9.5 kg. This is the largest ovarian cyst that ever reported from our hospital and one of the largest among the reported cases in the literature.

Giant ovarian cystadenoma weighing 59 kg

“…Cysts are also detected incidentally on imaging studies or during routine gynaecological examination. The diagnosis can be overlooked because of pronounced obesity or negligence in patients who present at a late stage with giant ovarian cysts [1][2][3][4]. In 1922, Spohn reported successful treatment in a patient with a huge ovarian cyst weighing 148.6 kg [6].…”

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

“…The main subtypes are mucinous, serous, endometrioid, and teratoma. [1][2][3] Ovarian cysts may be borderline in 5%-10% of cases and malignant in 20%-25% of cases, largely depending on the age of the patient. 1 These cysts are much more common in young patients of childbearing age-as noted in the current series-and are rare before puberty or after menopause.…”

“…11,12 Giant cysts, as reported in the literature, might compress the inferior vena cava causing lower-limb edema, compression of the diaphragm with risks of atelectasis, pulmonary edema, and more seriously, abdominal compartment syndrome. 1,11,13 In 1905 Spohn reported a 328 pound ovarian tumor. 14 Since then, Abe et al identified 22 cases of ovarian tumors reported in the literature measuring between 47 kg and 134 kg.…”

“…Similarly, this drainage improves respiratory and cardiovascular function and might prevent pulmonary edema. 1,20 Thus, drainage remains relevant for some symptomatic giant cysts. However, it must be performed gradually, with the aim of avoiding long drainage tubes that carry risks of infection, peritonitis, and sudden massive bleeding.…”

“…These cysts are predominantly benign epithelial tumors in 70% of the cases and are commonly serous or mucinous cystadenomas. 1 Rare cases of low-grade malignancy and adenocarcinoma ovarian cysts have reported.…”