A case report of partial bowel obstruction as the first symptom of a sizeable adnexal mucinous cystadenoma.

Abstract

Objectives: Mucinous cystadenomas are among the most common benign adnexal masses. The peak incidence of mucinous cystadenoma appears between the third and fifth decades of life, but rare cases in younger and older women have also been reported. Ovarian cystic formations are usually asymptomatic at early stages, until they grow in size and various compression symptoms appear, such as abdominal discomfort, distention, nausea, vomiting, and increased urination.

Case presentation: This is a case of an 86-year-old woman with partial bowel obstruction due to a sizeable adnexal mass. The patient was submitted to exploratory laparotomy due to intestinal obstruction symptoms, the mass was removed and the final histopathological report indicated a benign mucinous cystadenoma (maximum diameter 25 cm). Physical examination was remarkable due to the large size of the mass. Computed tomography revealed the sizeable abdominal mass in contact with the uterus and the ovaries resulting in bowel compression. Exploratory laparotomy due to bowel obstruction symptoms confirmed the imaging results. The abdominal mass was removed without being ruptured, and total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy were done.

Conclusions: Our case report highlights the clinical suspicion that is required for the diagnosis and appropriate treatment of this clinical entity. These tumors are uncommon in postmenopausal women, and when they do appear, they can be difficult to differentiate from cancer.