This document presents a case report of a 60-year-old woman in Papua New Guinea who presented with a massive abdominal distension caused by a giant ovarian mucinous cystadenoma measuring 30x30x25cm and weighing 25kg. Mucinous cystadenomas are benign ovarian tumors that typically affect middle-aged women. Surgical removal of the entire left ovary and tube was performed due to the large size of the tumor and involvement of the entire left ovary. Histological examination found the tumor to be a benign mucinous cystadenoma with intestinal-like epithelium. The patient had an uneventful recovery and was scheduled for follow up appointments to monitor for any recurrence of the tumor.
A Case of Abdominal Pregnancy, Primary vs Secondary – Radiological Workupiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Natural history of caesarean scar pregnancy on prenatal ultrasound the cross...Võ Tá Sơn
Natural history of caesarean scar pregnancy on prenatal ultrasound the cross-over sign Cali 2016
Dấu hiệu cross-over trong siêu âm tiền sản tiên lượng tiến triển của thai ở sẹo mổ lấy thai, võ tá sơn
Endometriosis is a disease restricted usually to the female genital tract. Involvement of the bowel by this disease can lead to a diagnostic dilemma due to the great variation in the symptomatology. Awareness of the pathophysiology, clinical features and diagnostic modalities is of utmost importance to decide the modality of treatment. Hormonal manipulation and surgical resection are the two modalities of treatment. The choice depends upon critical analysis of clinical and radiological findings and the desire to have pregnancy in cases associated with infertility.
4 cases of pelvic mass are discussed .Adnexal mass invilves masses arisinf from ovary,fallopian tube,uterus,bowel and some miscellenious masses.USG is used to detect its size and the origin.Histopathological findings are diagnostic.
A Case of Abdominal Pregnancy, Primary vs Secondary – Radiological Workupiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Natural history of caesarean scar pregnancy on prenatal ultrasound the cross...Võ Tá Sơn
Natural history of caesarean scar pregnancy on prenatal ultrasound the cross-over sign Cali 2016
Dấu hiệu cross-over trong siêu âm tiền sản tiên lượng tiến triển của thai ở sẹo mổ lấy thai, võ tá sơn
Endometriosis is a disease restricted usually to the female genital tract. Involvement of the bowel by this disease can lead to a diagnostic dilemma due to the great variation in the symptomatology. Awareness of the pathophysiology, clinical features and diagnostic modalities is of utmost importance to decide the modality of treatment. Hormonal manipulation and surgical resection are the two modalities of treatment. The choice depends upon critical analysis of clinical and radiological findings and the desire to have pregnancy in cases associated with infertility.
4 cases of pelvic mass are discussed .Adnexal mass invilves masses arisinf from ovary,fallopian tube,uterus,bowel and some miscellenious masses.USG is used to detect its size and the origin.Histopathological findings are diagnostic.
Uterine fibroid - Case scenarios and DiscussionHaynes Raja
This presentation is prepared to meet out the undergraduate medical student needs especially to understand the practical aspects of uterine fibroid and to rapidly revise some important viva questions.
Dedicated to my Great Teachers in the Dept. of Obstetrics & Gynaecology Dr. Lavanya Kumari and Dr. Sangeereni, Inspiring Friends Dr. Paulin Benedict, Dr. Jeyakumar Meyyappan and Dr. Hannah Jane and our REVELLIONZ 08’ batch.
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
A case of an ovarian tumour pre-operatively thought to be malignant, which was per-operatively diagnosed as benign and later confirmed as a mucinous cystadenoma.
Ob-Gyn Department, BIRDEM-2 General Hospital, Shegunbagicha, Dhaka, Bangladesh
Uterine fibroid - Case scenarios and DiscussionHaynes Raja
This presentation is prepared to meet out the undergraduate medical student needs especially to understand the practical aspects of uterine fibroid and to rapidly revise some important viva questions.
Dedicated to my Great Teachers in the Dept. of Obstetrics & Gynaecology Dr. Lavanya Kumari and Dr. Sangeereni, Inspiring Friends Dr. Paulin Benedict, Dr. Jeyakumar Meyyappan and Dr. Hannah Jane and our REVELLIONZ 08’ batch.
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
A case of an ovarian tumour pre-operatively thought to be malignant, which was per-operatively diagnosed as benign and later confirmed as a mucinous cystadenoma.
Ob-Gyn Department, BIRDEM-2 General Hospital, Shegunbagicha, Dhaka, Bangladesh
Case Report:Massive Ovarian Cyst in a Adolescent GirlTana Kiak
For benign tumours adhesion prevention strategies should be used. Surgical intervention should as much as possible be directed towards preservation of ovarian tissue. There is scarcity of published literature on this subject.
We need bigger studies to address the issue of how much fertility preservation is safely possible.Irrespective of indication for surgery, it is always preferable to attempt conservative, fertility sparing surgery in adolescents.
Abstract
This case report describes the diagnosis and management of a large mesenteric cyst in a 55 year old lady who presented with abdominal distension & with mass in the left upper quadrant. Mesenteric cysts are rare, benign, abdominal tumors to which <1000 cases have been reported in the literature. While 40% of cases are incidental findings found either through physical examination or imaging, they can cause non-specific abdominal symptoms including pain, altered bowel habits, nausea/vomiting or anorexia. Less commonly, 10% of cases can present with bowel obstruction, volvulus, torsion or shock. In general, the lack of characteristic clinical and radiological features presents as a diagnostic difficulty.
The mainstay in imaging is computerized tomography (CT). CT identifies and helps aid the decision to pursue a laparoscopic or open laparotomy approach, where complete surgical resection is the ultimate goal. In our patient a CT Abdomen & Pelvis showed a large, loculated cystic mass measuring 30cm in cranio-caudal length and 16cm in the transverse and anterior/posterior diameter. While different approaches have been described in the literature to surgically resect such cysts, our approach was largely reflective of size and adherence to surrounding structures in this case. A laparotomy was performed using an upper mid-line 7 cm incision; 4500cc of fluid was aspirated from the cyst which was found to originate from the small bowel mesentery. A complete resection of the multi-loculated cystic sac was done that included the resection of the middle mesenteric vein. The post-operative period was uneventful. The patient was discharged on post-operative day 2. The Histopathology identified the mass as a multi-loculated peritoneal inclusion-type cyst.
International Journal of Pharmaceutical Science Invention (IJPSI) inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Mesenteric cystic lymphangioma is an uncommon, slowly growing tumor derivate from lymphatic vessels, which is rarely found
as an intra-abdominal masses usually located in small bowel mesentery. A two year old girl was presented in our service because of abdominal pain, recurrent vomiting and back pain. In the regional hospital an ultrasound has revealed a supravesical mass. We repeated an ultrasound followed by abdominal MRI which showed a cyst 12x7 cm without infi ltration aspect. We planned surgery within 3 days but this girl was returned in our service a day later because of severe pain and abdominal distention making surgery an emergency.She underwent to intervention and a large cystic formation was removed and send to pathology service. Follow up was unrevealed. The
response of pathology was compatible with a mesenteric cyst lymphangioma Lymphangiomas’ account for 5-6% of all benign tumors in children. 50% involve the head and neck, only 10 % occurring in internal organs. 60% of these masses are present at birth. Abdominal cystic lymphangioma are very uncommon. Almost 90% are detected by the mean age of 2 years, and most occurs in the mesentery of the small bowel.They result from an embryological failure of the lymphatic system; lack of communication between small bowel lymphatic tissue and the main lymphatic vessels during fetal development result in
blind cystic lymphatic spaces lined by endothelial layers. Mesenteric cystic lymphangioma frequently affect young children and are usually symptomatic making surgery sometime emergency. The diagnosis is well established by ultrasound, CT, MRI. To prevent recurrence, complete excision of the cyst with or without intestinal resection is mandatory.
Spontaneous rupture of endometriotic cyst in 3rd trimester of pregnancyApollo Hospitals
Endometriosis is a well established cause of female infertility and may be associated with early pregnancy losses. Association of endometriosis with pregnancy is rare. Ruptured endometriotic cyst presenting as acute abdomen in pregnancy is even a rarer presentation.
We present hereby a rare and interesting case, presented in our hospital, of Spontaneous rupture of endometiotic Cyst in 3rd trimester of pregnancy and its subsequent management.
Introduction
Cutaneous metastases from abdominal malignancies are rare and have been reported in less than 5% of patients [1]. Furthermore, metastases in patients suffering from colorectal neoplasia are even rarer entity. Tan et al, among 2538 of the new cases of colorectal cancer over the period of 6 years, reported only 3 cases (0.1%) with cutaneous deposits [1]. Presentation varies from cutaneous or subcutaneous small nodules, rash or large fungating lesions [1-4]. Inevitably, their presence implies the disease progression, and poor prognosis with the reported survival between 1 to 34 months [2,3,5].
We report a case of an elderly patient who initially was thought to present with a simple skin infection. Subsequently, the patient was diagnosed with the moderately differentiated mucinous adenocarcinoma and required the right hemicolectomy. This case highlights that a high index of suspicion is recommended in an unresolving skin erythema.
Isolated Splenic Metastases from Rectal Carcinoma Five Years after Surgery: C...semualkaira
Primary splenic tumors and splenic metastases are uncommon, and
metastatic splenic tumors are even rarer [1]. According to reports,
the most common source of splenic metastases include melanoma,
tumors of the breast, lung, ovary, colon, stomach, and pancreas [2-
3]. Splenic metastases after rectal cancer surgery is very rare. This
paper reports a case of a patient with splenic metastases from rectal cancer 5 years after surgery. We discuss the route of metastasis
and treatment of this case.
Tubular Adenoma of the Breast: A Rare Case Presentation and Review of Literat...Crimsonpublisherssmoaj
Tubular Adenoma of the Breast: A Rare Case Presentation and Review of Literature by Emmanuel Owusu Ofori* in Crimson Publishers: Surgery Open Access Journal
Tubular adenomas are a rare breast entity constituting 0.3-1.7% of all benign tumours first described in 1968 typically affecting women in their reproductive ages (15-49 years). Few cases have been reported in the literature. They are rarely found before menarche or after menopause. Preoperatively, tubular adenomas are difficult to differentiate from fibroadenoma, phyllodes and tubular carcinoma. We report the case of a 25-year-old female who reported to our clinic with 4-month history of painless left breast mass which had not seen any significant changes in size. Histological findings were consistent with tubular adenoma.
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Breast Desmoid Tumor with Spectacular Evolution : A Case Report and Review of...semualkaira
Desmoid tumors or aggressive fibromatosis of the breast, are a rare entity, representing less than
0.2% of all primary breast tumors. The clinical presentation and evolution can mimic a malignant
carcinoma, with the notable difference that a desmoid tumor cannot generate distant metastases. The
aim of the treatment is to achieve local control of this tumor, which can be highly aggressive by
deeply infiltrating surrounding structures, and frequently reoccurs after resection. Both the tumor and
its treatment may cause significant morbidity, causing a real therapeutic challenge.
Breast Desmoid Tumor with Spectacular Evolution : A Case Report and Review of...semualkaira
Desmoid tumors or aggressive fibromatosis of the breast, are a rare entity, representing less than 0.2% of all primary breast tumors. The clinical presentation and evolution can mimic a malignant carcinoma, with the notable difference that a desmoid tumor cannot generate distant metastases.
Breast Desmoid Tumor with Spectacular Evolution : A Case Report and Review of...semualkaira
Desmoid tumors or aggressive fibromatosis of the breast, are a rare entity, representing less than 0.2% of all primary breast tumors. The clinical presentation and evolution can mimic a malignant carcinoma, with the notable difference that a desmoid tumor cannot generate distant metastases
Paget's disease of the breast is an extremely challenging problem. It not only poses a diagnostic dilemma but a therapeutic as well. The paper describes the diagnostic and therapeutic challenges.
Austin Journal of Clinical Case Reports is an open access scholarly journal. The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments by publishing case reports in all aspects of Clinical Medicine. Case Reports is an open access journals. The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments by publishing case reports in all aspects of Clinical Medicine.
The aim of this open access journal is to offer service for scientists and academicians to promote, share, and discuss various new issues and developments by publishing clinical case reports in all aspects.
Austin Journal of case repots are a reflective analysis of one, two, or three clinical cases. All clinical case reports submitted must have been approved by an ethics committee or institutional review board.
Austin Journal of Clinical Case Reports is an open access scholarly journal. The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments by publishing case reports in all aspects of Clinical Medicine. Case Reports is an open access journals. The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments by publishing case reports in all aspects of Clinical Medicine.
Pedunculated Lipoma of the Caecum Causing Colocolic Intussusception in an AdultKETAN VAGHOLKAR
Introduction: Colocolic intussusception in adults is uncommon and poses both a diagnostic
and therapeutic dilemma. The association of an underlying malignancy necessitates a preoperative
confirmation of diagnosis. The presenting features are variable. Hence contrast enhanced
computed tomography of the abdomen is pivotal for diagnosis. An en bloc resection
of the specimen in accordance with standard oncological principles is the mainstay of treatment.
Case report: A case of colocolic intussusception in an adult is presented to highlight the
difficulties in preoperative diagnosis and in selecting the best surgical option for treatment.
Conclusion: Adult bowel intussusception is a diagnostic dilemma with preoperative diagnosis
being the biggest challenge. CT scan of the abdomen is an excellent diagnostic modality with
high diagnostic accuracy. Explorative laparotomy with en bloc resection is mainstay of treatment
in adults.
Jadella Implant is a form family planning which comes in two silicon rods,implan subdermal Over the years it release progestin to prevent ovulation thus prevent pregnancy
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
1. A MASSIVE CYSTIC ADENOMA: A CASE REPORT
PREPARED BY DR. KIAK. MENDI GENERAL HOSPITAL. SEPTEMBER 2014
Ovarian mucinous cystadenoma is a benign tumor that arises from the surface
epithelium of the ovary. It is a multilocular cyst with smooth outer and inner surfaces.
It tends to be huge in size. Of all ovarian tumors, mucinous tumors comprise 15%1, 2.
About 80% of mucinous tumors are benign, 10% are border-line and 10% are
malignant. Although benign ovarian mucinous tumors are rare at the extremities of
age, before puberty and after menopause 2, they are common between the third
and the fifth decades 4. The most frequent complications of benign ovarian cysts, in
general, are torsion, haemorrhage and rupture. As it contains mucinous fluid, its
rupture leads to mucinous deposits on the peritoneum (pseudo-myxoma peritonei).
This report presents a case of a giant ovarian mucinous cystadenoma in a Papua
New Guinean woman.
Case Report
A 60-year-old Melanesian woman from Papua New Guinea was referred to our
gynecology clinic with massive abdominal distension, urinary frequency and
constipation. She was married with 5 children and completed her menopausal 15
years back. Although the patient has noticed gradual abdominal enlargement few
years back, she never seek any medical help until 2 weeks ago she complained of
having urinary symptoms, having difficulty passing stool and complained of
abdominal fullness. The patient consulted their clinician at the nearest healthcare
facility in their area, which they suspected a huge abdominal tumor and decided to
refer the patient to Mendi General Hospital for further investigation and
management.
The patient had no previous medical diseases or surgical operations. She could not
remember her menarche but thought it was at the age of 13-14 years with
subsequent regular cycles. She was treated with antibiotics and pain medications
before her referral.
General examination revealed normal vital signs. Her body weight was 82 kg, her
height was 166 cm and her abdominal circumference was 164 cm. On abdominal
examination, a huge ill-defined pelvic-abdominal mass was noticed, extended up to
2. xiphisternum and towards the left upper quadrant. The abdomen was non-tense on
palpation and without tenderness or shifting dullness (Figure 1).
Figure 1. A giant pelvic-abdominal mass noticed on abdominal examination.
Pelvic examination revealed normal sized non-pregnant firm uterus and fullness in the
cul-de-sac and both adnexae. Abdominal ultrasonography verified a massive multi-loculated
cyst without solid components or surface papillary projections, extended
up to the pancreas and spleenic area, with minimal free intraperitoneal fluid. The
patient laboratory investigations included full blood count (Hb 10.5g/dl), (WCC
8,400/mm3), (Plts 278,000/L), (Mono 3%), (Lymp 14% ) and (Neut 83%) all within the
normal range.
The patient was counseled and signed informed consent for surgical exploration.
Under general anesthesia, an initial midline subumbilical incision was done where a
huge cystic mass was noticed arising from the left ovary (Figure 2). Due to the size of
the tumor, the incision was extended up, about 4 cm below xiphisternum, to deliver
the cystic mass intact without exposed it to the risk of rupture intraperitoneally (Figure
3). The outer surface of the mass was smooth and intact all-around with few patches
of ruptured sections exposing the jelly-like substance but with no adhesions. The
uterus, right adnexa, and appendix were looking healthy. No ascites or enlarged
para-aortic lymph nodes were discovered. Left salpingo-oophorectomy was
performed as the whole ovary was involved in the mass and the left tube was
abnormally dilated and adherent to the mass (Figure 4). The size of the tumor was 30
× 30 × 25 cm with 25 kg in weight. A segment of the tissue was taken and sent for
histo-pathological studies (Figure 5). Postoperative recovery was uneventful and the
patient was discharged on the 5th postoperative day to be followed-up every 3
3. months. The gross picture shows of the intact ovarian tumor with smooth outer
surface with jelly-like substance.
Figure 2. Midline Subumbilical incision Figure 3. Delivery of the cystic mass
Figure 4. Left Salpingo-oophorectomy Figure 5. Ruptured sections exposing
the jelly-like substance
DISCUSSION
Giant ovarian tumours have become rare in current medical practice, as most cases
are discovered early during routine check-ups. Detection of ovarian cysts causes
considerable worry for women because of fear of malignancy, but fortunately the
majority of ovarian cysts are benign.
Mucinous cystadenoma is a benign ovarian tumor. It is reported to occur in middle-aged
women. It is rare among adolescents5 or in association with pregnancy 6. On
gross appearance, cysts of variable sizes without surface invasion characterize
mucinous tumors. Only 10% of primary mucinous cystadenoma is bilateral 7. In our
case, the tumor was unilateral, affecting the left ovary. The cyst was filled with sticky
gelatinous fluid rich in glycoprotein.
4. Histologically, tall columnar non-ciliated epithelial cells with apical mucin and basal
nuclei line mucinous cystadenoma. They are classified according to the mucin-producing
epithelial cells into three types 4. The first two, which are always
indistinguishable, include endocervical and intestinal epithelia. The third type is the
müllerian, which is typically associated with endometriotic cysts 8. Our case has
epithelium of intestinal-like type as many goblet cells were noticed.
Management of ovarian cysts depends on the patient's age, the size of the cyst and
its histo-pathological nature. Conservative surgery as ovarian cystectomy and
salpingo-oophorectomy is adequate for benign lesions 8. In our patient, left salpingo-oophorectomy
was performed, as there was no ovarian tissue left and the tube was
unhealthy. After surgery, the patient should be followed-up carefully as some tumors
recur 5. Although the tumor was removed completely and intact with the affected
ovary, our patient was given appointments to be reviewed every 3 months for a
year.
CONCLUSIONS
This case report emphasizes the significance of thorough evaluation of all women
presented with vague abdominal pains. Although the condition is extremely rare, it is
a potentially dangerous in its massive form if not timely diagnosed and managed
properly. With the increasing awareness of such conditions, more and more cases
could be detected and reported early
CONSENT
A written informed consent was obtained from her for publication of this case report
and its accompanying images.
5. REFERENCE
1. Vizza E, Galati GM, Corrado G, Atlante M, Infante C, Sbiroli C. Voluminous
mucinous cystadenoma of the ovary in a 13-year-old girl. J Ped Adoles
Gynecol. 2005;18(6):419–422. doi: 10.1016/j.jpag.2005.09.009. [PubMed] [Cross
Ref]
2. Mittal S, Gupta N, Sharma A, Dadhwal V. Laparoscopic management of a
large recurrent benign mucinous cystadenoma of the ovary. Arch Gynecol
Obstet. 2008;277(4):379–380. doi: 10.1007/s00404-007-0556-5. [PubMed] [Cross
Ref]
3. Crum CP, Lester SC, Cotran RS. In: Robbins' Basic pathology. 8. Kumar V,
Abbas A, Fausto N, Mitchell R, editor. Ch 19. Elsevier Company, USA; 2007.
Pathology of female genital system and breast.
4. Ioffe OB, Simsir A, Silverberg SG. In: Practical Gynaecologic Oncology. Berek
JS, Hacker NF, editor. Lippincott Williams & Wilkins Company; 2000. Pathology;
pp. 213–214.
5. Ozgun MT, Turkyilmaz C. A giant ovarian mucinous cystadenoma in an
adolescent: a case report. Arch Med Sci. 2009;5(2):281–283.
6. Yenicesu GI, Cetin M, Arici S. A huge ovarian mucinous cystadenoma
complicating pregnancy: a case report. Cumhuriyet Med J. 2009;31:174–177.
7. Alobaid AS. Mucinous cystadenoma of the ovary in a 12-year-old girl. Saudi
Med J. 2008;29(1):126–128. [PubMed]
8. Young RH. In: Sternberg's Diagnostic Surgical Pathology. Mills SE, Carter D,
Greenson JK, Reuter E, editor. Raven Press, NY; 2009. The ovary; p. 2195.