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Comprehensive Evaluation and Management of a Complex Ovarian Mass

A patient presents with incomplete bladder emptying, dribbling, and urinary retention over the past few months. Examination reveals an 18-week palpable mass in the suprapubic region. Imaging shows a left ovarian mass and a large right adnexal cystic mass with features suggestive of neoplasia. Surgical intervention included RT salpingo-oophorectomy, followed by TAH with BSO and pelvic lymphadenectomy. Pathology confirmed low-grade papillary cystadenocarcinoma in the right ovary amidst various findings. A detailed multidisciplinary approach is essential for managing such complex cases.

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Comprehensive Evaluation and Management of a Complex Ovarian Mass

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  1. history 34yG1L1(NVD) CC:Incomplete bladder emptying , Dribbling and hesitancy from a few months ago. Urinary Retention 2times in the past few months

  2. Exam:mass about 18wk in suprapubic palpated. • Lab data: • Tumor marker: • CA125(198) • CA9-19,AFP,BHCG,CEA:normal

  3. Sonogeraphy(TVS +TAS) • UT:7.2*5*4.6 • ET:9.3mm(secretory) • Left ovary:mass 25*19mm solid-cystic and solid compent have int.echo and cyst include compacted debri =endometrial cyst? • Right ovary not seen and huge cystic mass 17.4*14.5cm in right adnexa spreading to abdomen , include vegetative nodule 9.8*5.4cm=neoplastic complex cyst=mucinouscystadenocarcinoma?

  4. Operation: • RT Salpangoophorectomy, sent for frozensection: • Serocystoadenocarcinoma • then:TAH+BSO+OMENTECTOMY+PELVIC LYMPHADENECTOMY

  5. Pathology report • Right ovary :low grade papillary cyst adenocarcinoma, intact capsul.Fallop:normal. • Cytology:negative • Ut :early secretory endometrium.Acute on chronic cervitis.Paratubalcyst,cysticfollicol and hemorrhagic cyst in omentum. • Lymph nodes: reactive pattern.

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