Tumors in a pandemic era: giant ovarian mucinous cystadenomas

Abstract

Tumors in the pandemic era: giant ovarian mucinous cystadenoma. Mucinous cystadenoma is a benign tumor of the ovary originating from the surface epithelium of the ovary, characterized by mucin production. They represent 10-15% of ovarian tumors. The borderline variety represents 10% of mucinous cystadenomas. They can reach very large sizes. We present the case of a patient, aged 65, hospitalized at the end of pandemics with a giant abdominal cystic tumor (diameter 40 cm) with compression disorders. He had a subtotal hysterectomy for uterine fibroids at the age of 25. Laboratory tests are within normal limits except CA19-9 = 398 IU / ml. Abdomino-pelvic ultrasound shows a mid-abdominal liquid formation, inhomogeneous with septa inside that exceeds 30 cm. CT with the contrast substance highlights a multiloculated formation, developed from the left ovary to with iodophilic septa, with mass effect on anatomical elements, with overall dimensions of approx. 230/300/350 mm. With the suspicion of a giant left ovarian cyst suspected of being malignant, a median xipho-umbilical laparotomy was performed and a giant cystic tumor of the left ovary weighing 13 kg, reaching the supramesocolic floor without adhesions, with an ovarian pedicle one cm thick, was removed. Anexectomy was performed on the right side without complications. The postoperative evolution was simple. Histopathological examination determined the diagnosis of borderline mucinous cystadenoma. The epidemiology, clinical signs and imaging diagnosis and surgical treatment of these rare tumors with favorable evolution are discussed.