A unique case of a giant ovarian mucinous cystadenoma causing an acute renal failure and compartment syndrome

Česká verzia

Authors: V. Bartoš ¹; M. Krištofík ²
Authors place of work: Martinské bio ptické centrum, s. r. o., Martin, Slovenská republika ¹; Gynekologicko-pôrodnícke oddelenie, Nemocnica s poliklinikou, Považská Bystrica, Slovenská republika ²
Published in the journal: Klin Onkol 2023; 36(1): 65-70
Category: Case Report
doi: https://doi.org/10.48095/ccko202365

Summary

Background: Mucinous cystadenoma of the ovary is a common gynecologic tumor that usually has a very favorable prognosis. However, if it is not early detected and removed, it can grow to a large size and may cause serious health complications. Case: A 65-year-old woman was transported to the hospital by the emergency medical service due to overall weakness, markedly enlarged abdomen reminiscent of ascites, breathing difficulties, and swollen legs with eczematous ulcers. Laboratory parameters showed an acute renal insufficiency. Imaging scans revealed a giant solid cystic tumor mass filling the whole abdominopelvic cavity, which caused a compartment syndrome of the lower limbs. After relieving puncture and drainage of 6 L of fluid from the cyst, laparotomy had been performed. Grossly, the entire abdominal cavity was filled with a huge cystic tumor originating from the left ovary. During its surgical preparation, a total of 17 L of fluid was evacuated from it. Then, adnexectomy was made. A biopsy sample consisted of an irregular, artificially teared multicystic tumor about 60 cm in the largest dimension. Histology confirmed a benign mucinous cystadenoma. After tumor removal, the patient’s health condition and laboratory parameters improved. Conclusion: We described a unique case of an extremely huge ovarian mucinous cystadenoma that led to a life-threating event of the patient. We tried to point out that even a „common“ benign tumor may lead to clinically malignant consequences and its management requires a multidisciplinary approach.

Keywords:

ovary – mucinous cystadenoma – huge size – life-threating event

Zdroje

1. Jung SE, Lee JM, Rha SE et al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics 2002; 22 (6): 1305–1325. doi: 10.1148/rg. 226025033.

2. Kurman RJ, Carcangiu ML, Herrington S et al. WHO classification of tumours of female reproductive organs. IARC: Lyon 2014.

3. Marko J, Marko KI, Pachigolla SL et al. Mucinous neoplasms of the ovary: radiologic-pathologic correlation. Radiographics 2019; 39 (4): 982–997. doi: 10.1148/rg.2019180221.

4. Bartoška P, Antoš F, Vítek P et al. Pseudomyxoma peritonei. Klin Onkol 2019; 32 (5): 329–332. doi: 10.14735/amko2019329.

5. Ben Oun M, Janáč P, Redecha M et al. Pseudo-myxoma peritonei secondary to ovarian mucinous cyst-adenoma as a form of extra-appendicular origin, a case report and review of literature. Gynekol Prax 2021; 19 (4): 191–195.

6. Akhras LN, Akhras LN, Faroog S et al. A 27- kg giant ovarian mucinous cystadenoma in a 72-year-old postmenopausal patient: a case report. Am J Case Rep 2019; 20: 1601–1606. doi: 10.12659/AJCR.917 490.

7. Nwobodo EI. Giant mucinous cystadenoma: case report. Niger J Clin Pract 2010; 13 (2): 228–229.

8. Gwanzura C, Muyotcha AF, Magwali T et al. Giant mucinous cystadenoma: a case report. J Med Case Rep 2019; 13 (1): 181. doi: 10.1186/s13256-019-21 02-z.

9. Zanini P, Cavalca A, Benatti E et al. Benign giant ovarian cystadenoma. Description of a clinical case. Minerva Ginecol 1996; 48 (5): 215–219.

10. Posabella A, Galetti K, Engelberger S et al. A huge mucinous cystadenoma of ovarian: a rare case report and review of the literature. Rare Tumors 2014; 6 (2): 5225. doi: 10.4081/rt.2014.5225.

11. Madhu YC, Harish K, Gotam P. Complete resection of a giant ovarian tumour. Gynecol Oncol Case Rep 2013; 6: 4–6. doi: 10.1016/j.gynor.2013.05.001.

12. Jones DR, Vasilakis A, Pillai L et al. Giant, benign, mucinous cystadenoma of the ovary: case study and literature review. Am Surg 1992; 58 (7): 400–403.

13. Spohn AE. Multicystic ovarian tumor weighing 328 lb. Tex State J Med 1905–1906; 1: 273–274.

14. O‘Hanlan KA. Resection of a 303.2-pound ovarian tumor. Gynecol Oncol 1994; 54 (3): 365–371. doi: 10.1006/gyno.1994.1225.

15. Alobaid A, Elamir H, Abuzaid M et al. An extremely giant ovarian mucinous cystadenoma. Gulf J Oncolog 2019; 1 (29): 83–86.

16. Müllerová Z, Müller T, Křivánková K et al. Molekulární podstata kancerogeneze epiteliálních ovariálních karcinomů. Klin Onkol 2016; 29 (Suppl 4): 46–53. doi: 10.14735/amko20164S46.