A Rare Case of Massive Ovarian Mucinous Cystadenoma With Postmenopausal Bleeding

Abstract

Mucinous cystadenomas are among the most common benign ovarian neoplasms. They are known for their massive size causing compressive effects ranging from pressure, pain, bloating, and urinary symptoms. Over time, these adnexal masses can lead to fatal complications, such as ovarian torsion or hemorrhage. Incidental findings of these tumors are common as many of these patients are asymptomatic. Pelvic examinations and imaging studies can be used to further diagnose symptomatic patients and aid physicians in developing an appropriate course of treatment. We report a rare case of a large mucinous cystadenoma, with a size of 25 × 25 cm and concurrent management of postmenopausal bleeding. We present the data from the admission of the patient to her discharge, including history and physical examination, diagnostic reports, transabdominal ultrasound, CT scan, surgical evaluation, and surgical-pathology reports. Abdominal pain can present in a variety of different scenarios, and ovarian masses only represent a small portion of the differentials. Mucinous cystadenomas constitute an even smaller percentage of these ovarian growths. As discussed in this case report, a large ovarian mucinous cystadenoma was compressing the surrounding structures resulting in a wide array of symptoms. The case describes the importance of extensive diagnostic evaluation and prompt surgical management of these ovarian tumors. It also brings attention to the significance of diagnosing a medical condition such as postmenopausal bleeding promptly to avoid potential negative outcomes.

Keywords: abdominal distension; abdominal pain; cystic mass; mucinous cystadenoma; ovarian mass.

Figure 1. Transabdominal ultrasonography showing a transverse view of the left upper quadrant (A) and lower abdomen (B) of a cystic lesion.

Figure 2. Abdominal CT in axial (A) and coronal (B) sections showing large, well-defined, unilocular cystic mass measuring 25 × 25 cm.

Figure 3. Abdominal distension of the patient before surgery (A), cyst fluid is drained with a large needle and suction tube (B, C), right ovarian cyst after fluid drainage measuring 18 × 16 cm (D).