A Rare Case of Massive Ovarian Mucinous Cystadenoma With Postmenopausal Bleeding.

Manoj R Somagutta,Krystel Elliott-Theberge,Molly S Jain,Enkhmaa Luvsannyam,Amit S Grewal,Siva K Pendyala,Charles Edwards

doi:10.7759/cureus.10198

Abstract

Mucinous cystadenomas are among the most common benign ovarian neoplasms. They are known for their massive size causing compressive effects ranging from pressure, pain, bloating, and urinary symptoms. Over time, these adnexal masses can lead to fatal complications, such as ovarian torsion or hemorrhage. Incidental findings of these tumors are common as many of these patients are asymptomatic. Pelvic examinations and imaging studies can be used to further diagnose symptomatic patients and aid physicians in developing an appropriate course of treatment. We report a rare case of a large mucinous cystadenoma, with a size of 25 × 25 cm and concurrent management of postmenopausal bleeding. We present the data from the admission of the patient to her discharge, including history and physical examination, diagnostic reports, transabdominal ultrasound, CT scan, surgical evaluation, and surgical-pathology reports. Abdominal pain can present in a variety of different scenarios, and ovarian masses only represent a small portion of the differentials. Mucinous cystadenomas constitute an even smaller percentage of these ovarian growths. As discussed in this case report, a large ovarian mucinous cystadenoma was compressing the surrounding structures resulting in a wide array of symptoms. The case describes the importance of extensive diagnostic evaluation and prompt surgical management of these ovarian tumors. It also brings attention to the significance of diagnosing a medical condition such as postmenopausal bleeding promptly to avoid potential negative outcomes.

Highlights

Ovarian cysts occur commonly in women of childbearing ages [1]
Of all the ovarian tumors, mucinous cystadenomas account for 15%-20% [2]
A striking feature for these benign mucinous cystadenomas is that they could become massive in size ranging from 5 to 28 cm with larger size increasing the risk of malignancy [4]

Summary

Introduction

Ovarian cysts occur commonly in women of childbearing ages [1]. They are usually benign and tend to be asymptomatic in the majority of the population. When cysts begin to enlarge and invade surrounding structures, a patient may begin to present with varying symptoms of a mass effect from mild pain or pressure to severe life-threatening complications, such as ovarian torsion, cystic rupture, and hemorrhage [5]. The patient complained of painful intercourse and postcoital bleeding She denied nausea, vomiting, dizziness, or diarrhea. The patient did not take any regular medications, including hormonal therapy She had no family history of the bowel, breast, ovarian, and uterine cancer. The exploration of the abdomen through a small vertical incision revealed a massive right ovarian cyst, smooth and gray in color, occupying the entire pelvic and abdominal cavities up to the xiphoid process. Surgical drainage with the removal of the cyst from the abdominal cavity and total hysterectomy with bilateral salpingo-oophorectomy resulted in complete resolution of the patient's symptoms

Discussion

Findings

Conclusions

Disclosures