A Challenge No More

Removing a Giant Tumour

THE CASE

A 19-year old unmarried girl visited Nanavati Super Speciality Hospital with complaints of abdominal distension and pain. On clinical examination, a mass arising from her pelvis, going up to her right hypochondrium abdominal distension was noticed. A CT scan was conducted that suggested the presence of a large multilocular multiseptate predominantly cystic mass arising from pelvis and extending up to upper abdomen of 19.7 x 10.3 x 26.1 cm in size. The imaging features depicted left side malignant ovarian mucinous cystic neoplasm and minimal free fluid in the pelvis area.

The mass effect on right lower ureter caused mild right hydronephrosis and hyrdoureter. The mass had displaced the uterus to the left and posterior. Further investigations were carried out which showed a very high Alpha Fetoprotein (AFP) result at 15694. Other investigations such as Beta Human Chorionic Gonadotropin (Beta HCG), Carcinoembryonic Antigen (CEA) and Carcinoid Antigine (CA) showed normal results.

THE PROCEDURE

Post investigations, Exploratory Laparotomy was done which included removal of the left-sided tubo-ovarian mass measuring about 12 x 10 cm, weighing 3.3 kg. The entire mass was removed in totality and sent for histopathology.

THE RESULT

The right ovary and uterus were normal, the left sided mass was removed and the patient had an uneventful course in the ward and was discharged on post operative day eight. Suture removal was carried out on day ten.

Dr. Suruchi Desai
Sr. Consultant- Gynaecology
Nanavati Super Speciality
Hospital, Mumbai