A Giant Ovarian Serous Cystadenoma in Pregnancy: A Case Report

Diagnosis of ovarian mass during pregnancy may be postponed because they may mimic physiological signs of pregnancy. Ovarian masses can lead to complications such as overgrowth, torsion or cyst rupture. Therefore, to inform health providers concerning symptoms, safe diagnostic methods and proper management seem appropriate.
Case report: A 19-year-old primigravida was presented to our clinic in the 16th week of gestation with an ultrasound document revealing a giant solid-cystic mass extending from pelvis to diaphragm, which was probably an ovarian cyst. During the ultrasound assessment of pregnancy, the mass was discovered incidentally. The only complaint of patient was insignificant abdominal bloating attributed to dyspepsia. Vital signs and laboratory tests, including tumor markers, were within normal limits. During laparotomy, an ovarian multilocular cyst extending beneath the diaphragm and measuring about 50 cm and 10 kg using was removed using a different technique. The volume of the cyst was decreased before the removal by inserting an angio catheter and withdrawing some fluid. Through this procedure, we prevented spillage of cystic fluid into the abdomen and pressed pregnant uterus during mass extraction. Ovarian serous cystadenoma was confirmed by pathology evaluation. Pregnancy passed normally until the delivery of a 3100-gm baby in the 38th week of gestation.
Proper diagnosis of masses during pregnancy can save maternal and fetal health through preventing adverse outcomes, such as abortion or preterm labor. Therefore, pregnant women’s complaints and precise physical examination should be taken into account in prenatal care centers. Also, surgical intervention with the least uterine manipulation is recommended in these cases.