Large ovarian mucinous cystadenoma and gestation: a case report
DOI:
https://doi.org/10.24265/horizmed.2025.v25n2.14Keywords:
Cystadenoma, Mucinous, Pregnancy , UltrasonographyAbstract
Adnexal masses are most commonly diagnosed during pregnancy using ultrasound; however, the presentation of large tumors during this stage is rare. It is worth mentioning that ultrasound is the first-line auxiliary examination used to differentiate the morphology of the masses, enabling appropriate follow-up and management. Most of these masses are benign, asymptomatic and resolve spontaneously. Nevertheless, persistent, symptomatic, large masses or those with malignant characteristics require surgical management. We report the case of a 30-year-old female patient who was referred for sporadic abdominal pain and a voluminous abdominopelvic mass. Ultrasound evaluation revealed a multiloculated cystic mass dependent on the right adnexa, associated with a single 15-week pregnancy. During hospitalization, the study was complemented with laboratory tests, imaging studies and tumor marker assessments. The IOTA ADNEX model was applied to predict the risk of malignancy, yielding a benign result. Due to the persistence of the mass during the second trimester of pregnancy and its large volume, elective surgery was performed via laparotomy, during which a right ovarian 12.8 kg tumor was removed. Histologic examination revealed a mucinous cystadenoma without malignant features. Postoperative progress was favorable, and the pregnancy continued with prenatal checkups and obstetric ultrasounds, all of which showed no abnormalities. The pregnancy was completed at 39 weeks via cesarean section by obstetric indication, with a favorable maternal and neonatal course.
Downloads
References
Mcminn E, Schwartz N. Adnexal Masses in Pregnancy. Clin Obstet Gynecol [Internet]. 2020;63(2):392–404.
Sherard GB, Hodson CA, Williams HJ, Semer DA, Hadi HA, Tait DL. Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol [Internet]. 2003;189(2):358–62.
Koo YJ, Kim TJ, Lee JE, Kwon YS, Kim HJ, Lee IH, et al. Risk of torsion and malignancy by adnexal mass size in pregnant women. Acta Obstet Gynecol Scand [Internet]. 2011;90(4):358–61.
Balci O, Gezginc K, Karatayli R, Acar A, Celik C, Colakoglu MC. Management and outcomes of adnexal masses during pregnancy: A 6-year experience. J Obstet Gynaecol Res [Internet]. 2008;34(4):524–8.
Aggarwal P, Kehoe S. Ovarian tumours in pregnancy: a literature review. Eur J Obstet Gynecol Reprod Biol [Internet]. 2011;155(2):119–24.
Zanetta G, Mariani E, Lissoni A, Ceruti P, Trio D, Strobelt N, et al. A prospective study of the role of ultrasound in the management of adnexal masses in pregnancy. BJOG Int J Obstet Gynaecol [Internet]. 2003;110(6):578–83.
Hoover K, Jenkins TR. Evaluation and management of adnexal mass in pregnancy. Am J Obstet Gynecol [Internet]. 2011;205(2):97–102.
Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, et al. Risk analysis of torsion and malignancy for adnexal masses during pregnancy. Fertil Steril [Internet]. 2009;91(5):1895–902.
Canavan TP. Sonographic Tips for Evaluation of Adnexal Masses in Pregnancy. Clin Obstet Gynecol [Internet]. 2017;60(3):575–85. 10. Lee SJ, Oh HR, Na S, Hwang HS,
Lee SM. Ultrasonographic ovarian mass scoring system for predicting malignancy in pregnant women with ovarian mass. Obstet Gynecol Sci [Internet]. 2022;65(1):1–13.
Rabiej-Wronska E, Wiechec M, Pitynski K, Wiercinska E, Kotlarz A. Ultrasound differentiation between benign versus malignant adnexal masses in pregnant patients. Ginekol Pol [Internet]. 2022;93(8):643–9.
Alalade AO, Maraj H. Management of adnexal masses in pregnancy. Obstet Gynaecol [Internet]. 2017;19(4):317–25.
Shetty MK. Abdominal Computed Tomography During Pregnancy: A Review of Indications and Fetal Radiation Exposure Issues. Semin Ultrasound CT MR [Internet]. 2010;31(1):3–7.
Sarandakou A, Protonotariou E, Rizos D. Tumor Markers In Biological Fluids Associated With Pregnancy. Crit Rev Clin Lab Sci [Internet]. 2007;44(2):151–78.
Mancuso A, Broccio G, Angio LG, Pirri V. Adnexal torsion in pregnancy. Acta Obstet Gynecol Scand [Internet]. 1997;76(1):83–4.
Yacobozzi M, Nguyen D, Rakita D. Adnexal Masses in Pregnancy. Semin Ultrasound CT MR [Internet]. 2012;33(1):55–64.
Van Calster B, Van Hoorde K, Froyman W, Kaijser J, Wynants L, Landolfo C, et al. Practical guidance for applying the ADNEX model from the IOTA group to discriminate between different subtypes of adnexal tumors. Facts Views Vis ObGyn [Internet]. 2015;7(1):32–41.
Czekierdowski A, Stachowicz N, Smoleń A, Kluz T, Łoziński T, Miturski A, et al. Sonographic Assessment of Complex Ultrasound Morphology Adnexal Tumors in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems. Diagnostics [Internet]. 2021;11(3):414.
Acharya K, Poudel D, Dahal S, kuikel S, Adhikari A. A case of huge ovarian cyst in second trimester: A rare case report. Ann Med Surg [Internet]. 2022;82:104765.
Mishra S, Yadav M, Walawakar SJ. Giant Ovarian Mucinous Cystadenoma Complicating Term Pregnancy. JNMA J Nepal Med Assoc [Internet]. 2018;56(210):629–32.
Villafán-Cedeño L, Vega-Malagón G, Rivera M, Romo-Rodríguez MR, Becerril-Santos A. Cistoadenoma seroso gigante de ovario y embarazo a término. Reporte de un caso. Clin Invest Gin Obst [Internet]. 2015;42(4):180–2.
Dessole S, Capobianco G, Milia L, Cherchi PL. Giant ovarian tumor complicating late pregnancy: A case report. Acta Obstet Gynecol Scand [Internet]. 2001;80(7):665–7.
Agah J, Davari Sani SJ, Salmani K. A Giant Ovarian Serous Cystadenoma in Pregnancy: A Case Report. J Midwifery Reprod Health [Internet]. 2018;6(4):1486–90.
Didar H, Najafiarab H, Keyvanfar A, Hajikhani B, Ghotbi E, Kazemi SN. Adnexal torsion in pregnancy: A systematic review of case reports and case series. Am J Emerg Med [Internet]. 2023;65:43–52.
Zou G, Xu P, Zhu L, Ding S, Zhang X. Comparison of subsequent pregnancy outcomes after surgery for adnexal masses performed in the first and second trimester of pregnancy. Int J Gynecol Obstet [Internet]. 2019;148(3):305–9.
Goh WA, Rincon M, Bohrer J, Tolosa JE, Sohaey R, Riaño R, et al. Persistent ovarian masses and pregnancy outcomes. J Matern Fetal Neonatal Med [Internet]. 2013;26(11):1090–3.
Oprescu ND, Ionescu CA, Drăgan I, Fetecău AC, Said-Moldoveanu AL, Chirculescu R, et al. Adnexal masses in pregnancy: perinatal impact. Rom J Morphol Embryol [Internet]. 2018;59(1):153–8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 1970 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
