Rupture of a malignant ovarian tumor in pregnancy presenting as acute abdomen

Abstract

This is the first reported case of a ruptured malignant ovarian tumor in pregnancy. Torsion or rupture of ovarian masses is an important differential diagnosis of abdominal or pelvic pain during pregnancy.

Acute Abdomen Secondary to Ruptured Epithelial Ovarian Cancer during Pregnancy: The Relevance of Teamwork

“…To our best knowledge, after an extensive literature review (in the PubMed, Google Scholar, LILACS, and Scopus databases), this is the first case of a ruptured epithelial ovarian cystadenocarcinoma during pregnancy favorably resolved in the primary surgery with a cesarean section and a radical surgical procedure. There are two previous reports, one of an endometrioid ovarian carcinoma, and the other of a mucinous cystadenocarcinoma, of cases that presented with rupture during pregnancy 4,5 , and in both cases, definitive diagnosis and surgical radical treatment for ovarian cancer were performed after the emergency was solved. 4,5 Acute abdominal pain during pregnancy entails a huge challenge, 1 and when indicated according to specific clinical features, laparotomy is the best way to preserve the lives of the mother and the fetus.…”

“…There are two previous reports, one of an endometrioid ovarian carcinoma, and the other of a mucinous cystadenocarcinoma, of cases that presented with rupture during pregnancy 4,5 , and in both cases, definitive diagnosis and surgical radical treatment for ovarian cancer were performed after the emergency was solved. 4,5 Acute abdominal pain during pregnancy entails a huge challenge, 1 and when indicated according to specific clinical features, laparotomy is the best way to preserve the lives of the mother and the fetus. 1 However, oncologic procedures during pregnancy are an enormous challenge.…”

Spontaneous rupture of ovarian cystadenocarcinoma: pre- and post-rupture computed tomography evaluation

“…Some of these tumors may present complications such as rupture, torsion, hemorrhage ( 3 ) or metastasis ( 8 ) . Such tumors rupture is frequently reported as occurring intraoperatively in cases where a large lesion is attached to adjacent organs ( 2 ) .…”

“…Such tumors rupture is frequently reported as occurring intraoperatively in cases where a large lesion is attached to adjacent organs ( 2 ) . Spontaneous rupture rarely occurs, generally as a result either from internal tumor bleeding or from increased intralesional pressure in association with some risk factor ( 3 , 4 , 6 ) , such as anticoagulant therapies. A previous study reports spontaneous rupture of an ovarian cystadenocarcinoma in a patient with congestive heart failure and undergoing treatment with heparin who progressed with hemoperitoneum, characterized by the presence of hyperdense (65-70 Hounsfield units) fluid in the peritoneal cavity, but without clearly demonstrate the tumor lesion, probably because the scan was performed without using an intravenous contrast agent ( 6 ) .…”

“…Few reports are found in the literature about spontaneous rupture of ovarian cystadenocarcinoma and these reports are mainly regarding pregnant women ( 3 - 5 ) and patients using anticoagulant drugs ( 6 ) . The authors report the first case of spontaneous rupture of ovarian serous cystadenocarcinoma documented by computed tomography both before and after the event.…”