CASE REPORT: We present the case of a 72-year-old postmenopausal high-risk patient who presented with a huge abdominal distention which started gradually 1 year before. Abdominopelvic ultrasound showed a left giant multiloculated abdominal cyst. [amjcaserep.com]

Pallor was present; she was normotensive and had bilateral pitting pedal odema. On abdominal examination, abdomen was grossly distended, engorged veins present, Fluid thrill was present. Abdominal girth at the level of the umbilicus was 42 inches. [casesjournal.biomedcentral.com]

While the most common presentation is pelvic discomfort, we report the case of a 14-year-old female presenting with menorrhagia which is an unusual initial complaint for a large pelvic tumor. [journals.sagepub.com]

Presentation A young woman presents with dull, chronic pain in the lower abdomen. An ultrasound was performed. Caption: Sagittal view of right adnexa Description: A large complex cystic mass is seen in the right adnexa. [sonoworld.com]

Case presentation We present a case of a 48-year-old black African woman with a giant mucinous cystadenoma who presented to a tertiary hospital with massive abdominal distention 5 years after being referred from a district hospital for the same problem [jmedicalcasereports.biomedcentral.com]

• Dyspepsia

  "Proton Pump Inhibitor or Testing for Helicobacter pylori as the First Step for Patients Presenting with Dyspepsia? A Cluster-Randomized Trial". The American Journal of Gastroenterology. 101 (6): 1200–1208. doi : 10.1111/j.1572-0241.2006.00673.x. [en.wikipedia.org]

  The only complaint of patient was insignificant abdominal bloating attributed to dyspepsia. Vital signs and laboratory tests, including tumor markers, were within normal limits. [jmrh.mums.ac.ir]

  Patients with advanced carcinomas usually present with vague abdominal swelling or discomfort, abdominal bloating, dyspepsia and early satiety, lack of appetite, malaise, urinary frequency and weight change (either gain or loss). [atlasgeneticsoncology.org]

• Gagging

  Palatal movement and gag reflex were normal. A snout reflex was present. The gait was stiff, with bilateral scissoring and a proclivity to toe walking. He was unable to walk on his heels or tandem. [slideheaven.com]

• Adnexal Mass

  Adnexal masses are usually asymptomatic and incidentally detected. Before extensive use of ultrasound, they are usually discovered during C-section or when they become symptomatic(3). The majority of adnexal masses originate from the ovaries. [jmrh.mums.ac.ir]

  Case report First Online: 05 March 2016 Abstract Introduction Adnexal masses in pregnancy occur in 0.5–2/1000 pregnancies. (1) More than 90 % of cysts are benign. [link.springer.com]

  CASE SUMMARY In this article we present an uncommon association of three distinct ovarian pathologies in a same woman presenting with adnexal mass. A 31-year-old nulliparous woman with a large persistent adnexal mass underwent laparoscopic surgery. [wjgnet.com]

  It should be noted that metastatic cancers can sometimes initially present as adnexal masses. [aafp.org]

  Ultrasound typically large cystic adnexal mass multilocular with numerous thin septations loculations may contain low-level internal echogenicity due to increased mucin content different locules may contain various degrees of echogenicity MRI Mucinous [radiopaedia.org]

• Vaginal Bleeding

  […] en if you have a tumour of the ovary, breast, uterus, testis, pituitary gland or hypothalamus if you are allergic (hypersensitive) to follitropin beta or any of the other ingredients of Puregon if you have heavy or irregular vaginal bleeding where the [sl.glosbe.com]

  In rare cases, women who have ovarian cancer may also report vaginal bleeding, shortness of breath, and frequent urination. [knowcancer.com]

  The most common symptom of these tumors is abnormal vaginal bleeding. This happens because many of these tumors produce female hormones (estrogen). These hormones can cause vaginal bleeding (like a period) to start again after menopause. [cancer.org]

  In postmenopausal women, such cysts may cause vaginal bleeding. If corpus luteum cysts bleed, they may cause pain or tenderness in the pelvic area. [merckmanuals.com]

  The patient denied any associated symptoms such as fever, chills, nausea, emesis, dyspnea, diarrhea, constipation, dysuria or vaginal bleeding but did endorse a 30-pound weight loss over 6 months. [academic.oup.com]

• Dyspareunia

  The most common symptoms are: abnormal or heavy menstrual bleeding painful periods, often after years without pain pain with intercourse (dyspareunia) bleeding between periods on vaginal examination, the uterus feels enlarged and is often tender to touch [jeanhailes.org.au]

  Dyspareunia. Swollen abdomen, with palpable mass arising out of the pelvis, which is dull to percussion and does not disappear if the bladder is emptied. [patient.info]

  Endometriomas are associated with endometriosis, which can cause dysmenorrhea and dyspareunia. Polycystic ovarian syndrome In polycystic ovarian syndrome, the ovary often contains multiple cystic follicles 2-5 mm in diameter as viewed on sonograms. [emedicine.medscape.com]

  Nevertheless, in cases of abnormal and potentially harmful ovarian cysts, the following symptoms can arise: Irregular and painful menstrual bleeding and periods (dysmenorrhea) Pelvic pain, especially during period Pain with intercourse (dyspareunia) Nausea [drseckin.com]

(See Presentation, DDx, and Workup.) [emedicine.medscape.com]

Ultrasound workup of ovarian masses Benign Malignant Internal structure Uniform, thin walls Irregularly thickened septa Margins Smooth Indistinct borders; papillary projections Echogenicity Anechoic Hypoechoic, anechoic, and hyperechoic components Content [amboss.com]

If on the unenhanced-CT the density is equal to or below 10 HU the lesion is considered to be an adenoma and no further workup is neccessary If the density is more than 10 HU the wash out should be calculated. [radiologyassistant.nl]

• Ovarian Mass

  […] benign ovarian cyst Benign cystic lesions: Multiloculated cystic ovarian mass with a vascularized mass. [ultrasoundcases.info]

  Figure 3 Intra operative view of huge ovarian mass. Figure 4 8.5kg of huge ovarian mass. There are 4 major categories of ovarian tumor: Epithelialtumor (65%-75%) Serous or Mucinous cystadenoma or carcinoma, Clear cellcarcinoma, Brennertumor. [medcraveonline.com]

  The case was managed by abdominal hysterectomy and bilateral salphingectomy of the hematosalphinx, which had formed a tubo-ovarian mass. One ovary was preserved. [ncbi.nlm.nih.gov]

  The majority of ovarian masses are cystic, and many of them are functional which may spontaneously resolve (2). [jmrh.mums.ac.ir]

• Polyps

  For procedures in which polyps were removed, we observed an inverse correlation between mean withdrawal time and mean polyp size, as well as a weak direct correlation between withdrawal time and the incidence of diminutive polyps. [nejm.org]

  Interpretation Polyps initially missed by the endoscopist had characteristics that are sometimes difficult for skilled endoscopists to recognise. Such polyps could be detected using a high-performance CADe system during colonoscopy. [thelancet.com]

  In people with Lynch syndrome, a change or mutation in certain genes may allow the formation of small growths of tissue called polyps. Polyps in the colon are usually benign (noncancerous). [ccalliance.org]

  It is a precursor lesion of the colorectal adenocarcinoma (colon cancer).[1][2][3] They often manifest as colorectal polyps. Comparison table[edit] Incidences and malignancy risks of various types of colorectal polyps. [en.wikipedia.org]

  […] normal and polyp samples. [oncotarget.com]

The advances made in the treatment of gynecologic malignancies are due, in part, to the clinical studies performed by many of the contributors to this volume. [books.google.com]

Treatment The three basic treatment methods for ovarian cancer, including endometroid adenoma, are local surgical resection of the cancerous cells, intraperitoneal chemotherapy, (drugs are delivered directly to the affected area) and systemic chemotherapy [knowcancer.com]

In fact, earlier diagnosis is associated with less invasive treatment approaches and prevention of tissue destruction. [jmrh.mums.ac.ir]

Treatment of polycystic ovaries includes: hormone therapy with progestins oral contraceptives infertility treatments for women who want to get pregnant [cancer.ca]

Trials are often designed to treat a certain stage of cancer, either as the first form of treatment offered, or as an option for treatment after other treatments have failed to work. [oncolink.org]

Treatment and prognosis A mucinous cystadenoma is benign with excellent prognosis (c.f. borderline mucinous tumors of the ovary or mucinous cystadenocarcinoma of the ovary). [radiopaedia.org]

Clear cell cystadenoma: Clear cell cystadenoma is a benign cyst with an excellent prognosis. Complications Cystadenomas of the ovary are benign lesions that rarely recur after incomplete resection. [ncbi.nlm.nih.gov]

Etiology Thought to largely derive from ovarian epithelial inclusions, which itself is derived from fallopian tube epithelium. Location They can be bilateral in ~15% of cases. [radiopaedia.org]

Etiology Risk factors Genetic predisposition BRCA1/BRCA2 mutation HNPCC syndrome Peutz-Jeghers syndrome Hormonal imbalance and menstrual cycle Elevated number of lifetime ovulations (the contraceptive pill appears to have a protective effect) Infertility [amboss.com]

Use of transvaginal ultrasound in diagnosing the etiology of menometrorrhagia. J Reprod Med 1994; 39(5): 362–372. Google Scholar | Medline | ISI [journals.sagepub.com]

[…] the cyst lining consists of a simple epithelium, whose cells may be either:[3] be columnar and tall and contain cilia, resembling normal tubal epithelium be cuboidal and have no cilia, resembling ovarian surface epithelium Microscopical images[edit] Epidemiology [en.wikipedia.org]

References:[1][2][3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Epidemiology The estimated peak incidence is at around 30-50 years of age. [najdi.si]

A definitive pathophysiology remains uncertain, although several postulations were proposed. A 23-year-old nulliparous woman presented with transient bloating of her abdomen associated with menstruation for the last four cycles. [tandfonline.com]

Forensic Medicine (260) Internal Medicine (229) Oncology, Radiation Therapy (166) Surgery, Traumatology and Orthopaedics (163) Gastroenterology and Hepatology (149) Paediatrics, Neonatology (133) Medical Chemistry and Biochemistry (126) Physiology and Pathophysiology [portal.mefanet.cz]

Sleisenger & Fordtran's gastrointestinal and liver disease: pathophysiology, diagnosis, management. 7th ed. Philadelphia: Saunders, 2002: 2175-214. 22. Atkin WS, Morson BC, Cuzick J. [nejm.org]

The absence of suppression may constitute the pathophysiology of these tumors (15x15Shimon, I., Rubinek, T., Bar-Hava, I., Nass, D., Hadani, M., Amsterdam, A. et al. [fertstert.org]

Pathophysiology Functional cysts The median menstrual cycle lasts 28 days, beginning with the first day of menstrual bleeding and ending just before the subsequent menstrual period. [emedicine.medscape.com]

Conclusion: Proper diagnosis of masses during pregnancy can save maternal and fetal health through preventing adverse outcomes, such as abortion or preterm labor. [jmrh.mums.ac.ir]

Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012; 366: 687-696 5. Winawer SJ Zauber AG Ho MN et al. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993; 329: 1977-1981 6. [thelancet.com]

How can Benign Mucinous Cystadenoma of Ovary be Prevented? The cause of Benign Mucinous Cystadenoma of Ovary is unknown. Hence, there are no known methods to prevent the tumor occurrence. [dovemed.com]

References:[5][6] Prognosis FIGO Anatomic extension 5-year survival rate I Limited to one or both ovaries 80–90% II Infiltration of lesser pelvis 60–70% III Extension outside pelvis 30–50% IV Distant metastases 10–20% References:[5] Prevention Genetic [amboss.com]