Successful Management of a Giant Ovarian Cyst: A Case Report

Case Report

Austin Gynecol Case Rep. 2017; 2(1): 1012.

Successful Management of a Giant Ovarian Cyst: A Case Report

Kassidi F¹, Moukit M¹*, Ait El Fadel F¹, El Hassani ME¹, Guelzim K¹, Babahabib A¹, Kouach J¹, Moussaoui RD¹ and Dehayni M²

¹Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Morocco

²Pole of Gynecology and Visceral Surgery, Military Training Hospital Mohammed V, Morocco

*Corresponding author: Mounir Moukit, Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Hay Riyad, 10100, Rabat, Morocco

Received: January 23, 2017; Accepted: March 02, 2017; Published: March 10, 2017


Giant ovarian cysts have become rare in current medical practice in both developed and developing nations. We report the case of a 32-yearold Moroccan woman, presented for progressive abdominal distension. Physical examination was difficult due to a massive abdominal pelvic swelling. Laparotomy was performed confirming the diagnosis of a giant ovarian cyst. Reporting such cases helps to increase the suspicion of its possibility and avoid any misdiagnosis or improper treatment.

Keywords: Giant ovarian cyst; Abdominal distention; Laparotomy


Nowadays, ovarian cysts rarely grow immense due to availability of better imaging modalities permits early detection and appropriate treatment and only a few cases have been sporadically reported in the literature [1,2]. The massive size of tumour may splint the diaphragm and exert mass effect onto adjacent thoracoabdominal organs. Occasionally, they can have enormous dimensions without raising any symptom. We present a case of giant ovarian cyst, which was removed successfully without any complication despite a delay in diagnosis.

Case Report

A 32-year-old Moroccan housewife presented in our department with chief complaints of a gradually increasing huge abdominal swelling noticed 5 months before. She denied any genito-urinary or gastrointestinal symptoms. On general examination, she was a febrile, with normal vital signs. There was no icterus or edema. Abdominal examination showed general distension with a dull note on percussion. The liver and spleen were not palpable. Based on sonographic examinations, a huge abdominal echogenic mass occupied the entire abdomen and pelvic cavity was seen. Abdominopelvic Magnetic Resonance Imaging (MRI) revealed a giant cyst, measured 62×45cm, displacing liver and spleen supero-laterally, kidneys posteriorly and bowel loops peripherally (Figure 1). Uterus was seen separately, but ovaries were not seen. There was no free fluid in peritoneal cavity. Tumor markers (CEA, a-fetoprotein and CA-125) were normal. An exploratory laparotomy was arranged for diagnostic and therapeutic purposes. Low midline incision extending up to the umbilicus was realized under general anaesthesia. After opening the parietal peritoneum, an irregular, hemorrhagic, necrotic and dark red in appearance cystic mass was noted (Figure 2). The mass was so large that it could not be excised without a large abdominal incision, so we drained the intra-cystic fluid (6 litres of hematic fluid) after creation of a small hole in the mass until we could excise the cystic mass (Figure 3). The left ovary was included in the mass and the left fallopian tube was adherent to the surface of the cyst. Complete excision of the cyst with left salpingo-oophorectomy was performed. Histopathological report revealed mucinous cystadenoma of the ovary. The postoperative period was uneventful and the patient was discharged on the fourth day after surgery.