Large abdominal mass of unknown origin – case report

Abstract

Case report: 52 years old women without significant abdominal pain come to ER with a CT scan describing a large heteregenous mass with regular edges and 20 cm × 18 cm × 12 cm occupying the right quadrants of the abdomen of a unknown origin. At physical examination she had no abdominal tenderness. The tumoral marker levels were negative. Was decided to perform a MRI to locate the origin of the mass. It described a multipseudonodular quistic lesion with a regular and thin capsule com 20 cm × 14 cm × 17 cm without hipervascularization or vegetations, no invasion of the organs but no conclusions about the origin. This case was discuted with the General Surgeons and was decided to perform a exploratory laparotomy with both specialities attending. The operative findings: large mass in the dependence of the right anexa without adherences to the other organs. It was realized a bilateral anexectomy, hysterectomy plus apendicectomy. The mass weighted 2800 g and the histologic work up was compatible with a quistic teratoma. Postoperative recovery was uneventful and the patient was discharged on the 4th postoperative day. Conclusion: Mature cystic teratomas or dermoid cysts are one of the most common benign ovarian tumors. Most dermoid cysts are diagnosed in women of reproductive age and are often discovered incidentally in asymptomatic women. In their pure form dermoid cysts are usually benign, however, malignant foci with squamous cell carcinoma are seen in approximately 1–2% of cases.