Giant Ovarian Cystadenoma in A Postmenopausal Woman; Diagnosis and Management Challenges. A Case Report in Lindi Southern Tanzania.

Abstract

Background: A giant ovarian cyst is a fluid-containing sac in the ovary which is larger than 10cm, as determined by radiological evaluation or if it extends above the umbilicus during physical examination (1). In current time of medicine, ovarian cysts are diagnosed in early stage due to the improvement of investigations; therefore, it is rare to encounter larger ovarian cysts. Case Summary: A 75 years old post-menopausal woman sought care at our center, complaining of abdominal swelling, reduced ability to stand and to walk, accompanied with difficulty in breathing. On examination, the patient was found to have an abdominal-pelvic mass measuring about 32 cm from the symphysis pubis; the patient underwent abdominopelvic ultrasound, which was inconclusive. Therefore, a diagnosis was made after doing an abdominal-pelvic CT scan. She thereafter underwent open laparotomy, whereby left salpingoophorectomy was done. The ovarian mass, which weighed 10.3 kg, was removed. The biopsy was sent for histopathology at the National Tumor Pathology Center at Ocean Road Cancer Institute. Histopathology results were a benign ovarian cystadenoma of mucinous type with calcifications. Conclusion: Abdominal and pelvic mass has several differential diagnoses which can be either gynecologic or non-gynecologic. Giant cysts of ovary are rare and lack distinctive clinical features; therefore, they pose difficulties in making an accurate diagnosis. Thorough history taking, physical examination and radiological evaluation for all women with unspecific symptoms and signs are essential for early diagnosis.