24 May 2023 : Case report
[In Press] Successful Surgical Removal of a Giant Serous Ovarian Cyst in a 52-Year-Old Woman with Presurgical Body Mass Index of 50.5: A Case Report and Review of the Literature
Rare diseaseMichele Peiretti1ABDE, Valerio Mais1ABD, Gianmarco D'Ancona 1BDEF, Maria Luisa Fais1ADE, Enrico Erdas2BD, Andrea Figus3AC, Stefano Angioni1ADEF
Am J Case Rep In Press; DOI: 10.12659/AJCR.939697
Available online: 2023-05-24, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Giant ovarian tumors (GOTs) are rarely observed in current gynecological practice. They are mostly described as benign, with a mucinous subtype, whereas the borderline type constitutes only 10% of all GOTs. Due to the lack of data regarding this histological GOT subtype, the main goal of this paper is to highlight some critical aspects of the management of borderline GOTs, which are associated with life-threatening complications. Moreover, we review other cases of borderline GOTs published in the literature, to improve the knowledge of this rare condition.
We present the multidisciplinary management of a 52-year-old symptomatic woman with a giant serous borderline ovarian tumor. Preoperative assessment showed a multiloculated pelvic-abdominal cyst responsible for compression of the bowel and retroperitoneal organs, and dyspnea. All tumor markers were negative. Together with anesthesiologists and interventional cardiologists, we decided to perform a controlled drainage of the cyst of the tumor, to prevent hemodynamic instability. Subsequent total extrafascial hysterectomy, contralateral salpingo-oophorectomy, and abdominal wall reconstruction, followed by admission to the intensive care unit, were also conducted by the multidisciplinary team. During the postoperative period, the patient experienced a cardiopulmonary arrest and acute renal failure, which were managed by dialysis. After discharge, the patient underwent oncologic followup, and after 2 years, she was found to be completely recovered and disease free.
Intraoperative controlled drainage of GOT fluid, planned by a multidisciplinary management team, constitutes a valid and safe alternative to the popular choice of “en bloc” tumor resection. This approach avoids rapid changes in body circulation, which are responsible for intraoperative and postoperative severe complications.
Keywords: Case Reports; Ovarian Cysts; Ovarian Neoplasms; Patient Care Team
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