Rupture of a malignant ovarian tumor in pregnancy presenting as acute abdomen.
BACKGROUND
Ovarian neoplasms in pregnancy are usually asymptomatic rarely leading onto complications. A 30-year-old G2 P1+0+0+1 was referred at 30 weeks of pregnancy with an ultrasound diagnosis of a large multicystic ovarian cyst with no solid areas, ascites or evidence of metastasis. Antenatal corticosteroid was administered and she was advised to follow-up with reports of tumor markers. She presented a week later with acute pain abdomen and breathlessness. Clinical examination revealed a relaxed uterus and ultrasound was suggestive of rupture of the ovarian cyst. Exploratory laparotomy revealed a ruptured left mucinous ovarian cyst with no evidence of solid areas or metastasis. Left ovariotomy with infracolic omentectomy and concurrent cesarean section was done. A healthy male baby of weight 1.880 kg was delivered. Histopathology revealed stage-1c mucinous cyst adenocarcinoma of left ovary. This was followed-up, with a complete surgery done after a month. She is now receiving postoperative chemotherapy.


CONCLUSIONS
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.
Malhotra
Neena
N
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Sumana
Gurunath
G
Singh
Aprajita
A
Deka
Deepika
D
Mittal
Suneeta
S
D000006:Abdomen, Acute / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010051:Ovarian Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D010053:Ovary / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000601:surgery; D012422:Rupture, Spontaneous