A giant ovarian mass in a 68-year-old female with persistent abdominal pain and elevated serum CA-125 level

Abstract

Introduction: Ovarian masses are common findings in general gynecology. However giant ovarian mass is a rare finding. In the literature, a few cases of giant ovarian mass have been mentioned sporadically, especially in elderly patients.

Case report: We report a 68-year-old postmenopausal woman with a giant right ovarian mass measuring 38 × 31 × 29 cm. She presented to our department with complaints of massive abdominal distention which started gradually 6 months ago. The patient also complained of difficulty in breathing and ambulation. There were no other gastrointestinal, urinary, or gynecological symptoms CA-125 marker was slightly elevated. Because of elevation of serum CA-125 levels, ovarian malignancy was included in differential diagnosis. We performed an ovarian cystectomy without any significant complication. On histopathological examination, the mass was confirmed as benign serous cystadenoma of the right ovary.

Conclusions: Giant ovarian mass is a rare finding in general gynecology. Physicians must maintain heightened awareness and index of suspicion when approaching a woman with pain in any region of the abdomen or pelvis. Further investigation with abdominal and pelvic ultrasonography and magnetic resonance imaging or computed tomography is necessary. Benign lesions can be found even in patients presenting with giant masses and higher CA-125 than normal levels.

Keywords: CA-125; cystadenoma; mass; ovarian; serous.

Fig. 1

Abdominal and pelvic MRI revealed a giant mass arising from the right ovary

Fig. 2

Completely resection of the ovarian mass that weighed 9 kg and measured 38 × 31 × 29 cm