A Giant Ovarian Tumor Causing Anasarca and Dyspnea Successfully Managed after Preoperative Drainage

Abstract

Serious complications are likely to accompany the treatment of giant ovarian tumors, and resection with or without preoperative drainage has been previously reported. Here, we report the case of a 27-year-old Japanese woman with a significant weight gain of 50 kg, who was referred to the Kumamoto University Hospital because of gait impairment and dyspnea. Imaging tests revealed an ovarian tumor, 37 cm in diameter, with two solid components. The patient's condition improved after the removal of 31.5 l tumor fluid by using a suprapubic urinary catheter for 3 days. The tumor was subsequently resected without complications, and was diagnosed as a left mucinous ovarian tumor with malignant components, weighing 37 kg (81.5 lb). The patient was discharged after her anasarca improved, and her body weight decreased from 100 to 50 kg with accompanying considerable urination within two weeks. She was in good condition with no evidence of recurrence at 15 months after surgery. Tumor resection after preoperative drainage was effective in the management of a patient with dyspnea induced by a giant ovarian tumor. We suggest the use of a suprapubic urinary catheter for preoperative drainage because of its ease of use in preventing fluid leakage from the possibly malignant tumor.

Postmenopausal giant ovarian tumor: a rare case report and literature review

“…When the ovarian mass expands further, it can cause chest compression and subsequent respiratory impairment. In addition, edema or deep venous thrombosis may be formed by suppression of venous perfusion through pressure on the inferior vena cava 7 . The patient in this study also neglected the symptoms of ovarian tumors because of economic problems and insufficient cancer knowledge.…”

“…The ovary is an organ inside the pelvis. If abnormal ovarian growth in or on the ovaries is left untreated, the ovarian tumor may continue to expand outside the pelvis 7 . Because of her poor financial situation and psychological state, our patient did not have regular physical examinations.…”

“…In addition, edema or deep venous thrombosis may be formed by suppression of venous perfusion through pressure on the inferior vena cava. 7 The patient in this study also neglected the symptoms of ovarian tumors because of economic problems and insufficient cancer knowledge. She decided to visit the hospital after the tumor had so large as to affect her physical activities.…”

“…Although drainage was first performed to reduce the volume of the giant ovarian tumor in the abdominal cavity, there has been no unified standard for drainage of giant ovarian cysts so far. Some scholars recommend complete removal of ovarian tumors/cysts without rupture to prevent the risk of tumor fluid spilling into the peritoneum 7 . Moreover, preoperative drainage is also recommended to reduce intra-abdominal pressure, thereby reducing the risk of cardiopulmonary complications, such as cardiovascular dysfunction caused by aortocaval compression and respiratory dysfunction caused by diaphragm elevation 12,13 .…”

Removal of a 40-kg ovarian tumor and the ensuing complex postoperative complications

“…It has been recommended that tumor be gradually reduced preoperatively to minimize risk of respiratory and circulatory complications, which can be achieved by drainage of the cyst over several hours or sometimes even a few days [7]. A study conducted in Japan concluded that use of a suprapubic catheter for preoperative drainage of the ovarian cyst decreases the risk of intraperitoneal fluid leakage which may facilitate the spread of potentially malignant cells [8].…”