Bilateral ovarian carcinoma in a young women

Abstract

Introduction: We present a case report of mucinous cystadenoma ovary in a 27 year old multiparous female who presented in SJH gynae outpatient department. Case Report: Patient presented with abdominal mass which was rapidly growing and associated with pain abdomen since 2 months. On General examination patient’s condition was fair and she was thin built. On palpation- an abdominal mass of around 20 cm size whose lower margins could not be reached and was firm in consistency. Tumor mass was moving side to side, it’s margins were ill defined and extending till xiphisternum and reaching iliac fossa both sides. Her CA125 levels were 219 IU/ml and S.LDH level was 553 IU/ml. All other tumour markers are normal. Ultrasound examination showed entire abdomen and pelvis was occupied by a multicystic mass which showed septae within it. No significant omental thickening noted. Uterus is normal and shows ET-4mm. ovaries cannot be visualised separately. CECT whole abdomen and pelvis showed large multiloculated multicystic lesion appears to be originating from the right adnexa of size ~19.8*10.5*21.8cm in the abdomino-pelvic region with enhancing septae and internal vascularity was seen. Few of the septae appears thickened. Another small solid cystic lesion of size 86*40*85mm is seen in left adnexa with enhancing solid component and enhancing thickened septae with internal vascularity within. Uterus is seen separately and appears normal.There is no free fluid in abdomen. Explorative laprotomy was planned. A midline incision was given and after excision of mass the specimen was sent for scrape cytology and findings were suggestive of malignant epithelial tumour (possibly mucinous) of ovary. Excision of Left sided ovarian mass and total hysterectomy with partial omentectomy was performed. The ex­amination of the pelvis, abdominal walls, diaphragmatic sur­face, and peritoneum did not show any implants or me­tastases but omental metastases were present. Free fluid was absent in the abdomen. There was no normal ovarian tissue on both sides so bilateral salpingo-oopho­rectomy was performed. Histopathological examination gave confirmatory diagnosis of mucinous cystadenoma of the ovary. Patient and relative were counselled for further treatment and prognosis. On 14th day suture removal done and patient sent for chemotherapy and was discharged in good condition. Keywords: Bilateral, Mucinous cystadenoma, CA125.