A case of huge ovarian cyst in second trimester: A rare case report. (October 2022)

• Record Type: Journal Article
• Authors: Acharya, Kshitiz; Poudel, Diptee; Dahal, Sampada; kuikel, Sandip; Adhikari, Ashmita
• Is Part Of: Annals of medicine and surgery. Volume 82(2022)
• Publication Date: 2022-10
• Subjects: Ovarian cyst -- Mucinous cystadenoma -- Second trimester -- Case report; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104765
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Large cystic masses are rare in pregnancy. Corpus luteum cysts and theca lutein cysts are common are most common among all. Ovarian masses are usually discovered as an incidental finding during routine obstetric ultrasonography. Management depends upon the size of the mass, and the symptoms produced by the mass. Case presentation: Our case describes an incidental finding of a large ovarian cyst during the second trimester, in a 24-year-old female patient. Per abdominal examination revealed a huge mass in the epigastrium, left hypogastrium, and left lumbar region, along with 20 weeks sized uterus. Ultrasonography revealed a cystic mass of 11.9 cm × 11.7 cm X 15.9 cm, with multiple septations and cystic areas. After other baseline investigations, she was planned for surgical removal of the mass. Upon histopathologic examination after surgical excision, the mass was found to be mucinous cystadenoma. Discussion: Large ovarian masses are uncommon during pregnancy. The most common complications of ovarian masses in pregnancy are torsion, rupture, infection, or malpresentation of the fetus. Surgical management can be done if the mass presents with acute symptoms like torsion, or if the size of the mass is greater than 5 cm. Non-obstetric surgery for cyst removal can be done electively during the second trimester, or irrespective of the period of gestation if there are acute symptoms. Conclusion: Large ovarian masses are usually rare during pregnancy. It is necessary to properly evaluate the case of ovarian masses during pregnancy, to decide the appropriate line of management. Highlights: Large cystic ovarian masses are rare in pregnancy. Usually discovered as an incidental findings during routine obstetric ultrasonography. The most common complication of ovarian cyst during pregnancy is torsion. Non-obstetric surgery for cyst removal can be performed electively on 2nd trimester, or at any time if acute symptoms are present.