Surgical removal of a gigantic abdominal mass: a multidisciplinary approach.
BACKGROUND
Ovarian cystadenomas are common benign ovarian neoplasms that rarely present as gigantic abdominal masses. A variety of intraoperative and postoperative challenges may be encountered in the removal of these masses.


METHODS
We review the case of a 45-year-old woman who presented with massive abdominal swelling that was later identified as two distinct bilateral serous cystadenomas with a combined weight of approximately 107 kg. A multidisciplinary team including gynecology, plastic surgery, anesthesiology, and the operating room staff convened before surgery to discuss surgical technique, physiologic considerations, and logistical issues.


CONCLUSIONS
A multidisciplinary approach had an integral role in intraoperative safety and successful recovery of our patient from this surgery.
From the Departments of Obstetrics and Gynecology and Pathology, Lyndon Baines Johnson Hospital, Houston, Texas; and the Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jordana
J
Kincey
Shannon N
SN
Westin
Bihong
B
Zhao
Michele G
MG
Curtis
Lois
L
Ramondetta
D000005:Abdomen / Q000000981:diagnostic imaging / Q000601:surgery*; D001828:Body Image; D018293:Cystadenoma, Serous / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000628:therapy; D007044:Hysterectomy; D007813:Laparotomy; D008875:Middle Aged; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D010053:Ovary / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography
Symmonds RE, Spraitz AF Jr, Koelsche GA. Large ovarian tumor. Report of a case. Obstet Gynecol 1963;22:473–7.
Hackethal A, Brueggmann D, Turovets M, Bassaly B, Stein A, Gerber EL, et al. Removal of enormous bilateral mucinous cystadenomas of the ovaries with abdominal plastic reconstruction. Arch Gynecol Obstet 2009;279:65–7.
Pretorius RG, Matory WE Jr, LaFontaine D. Management of massive ovarian tumors. Surg Gynecol Obstet 1989;169:532–6.
Bennington JL, Ferguson BR, Haber SL. Incidence and relative frequency of benign and malignant ovarian neoplasms. Obstet Gynecol 1968;32:627–32.
Kumar V. Robbins pathologic basis of disease. Philadelphia (PA): Elsevier Health Sciences; 2007.
Hunter DJ. Management of a massive ovarian cyst. Obstet Gynecol 1980;56:254–5.
Hoile RW. Hazards in the management of large intra-abdominal tumours. Ann R Coll Surg Engl 1976;58:393–7.
Buller RE, Holter H, Laros RK Jr, Hanson KH, Abele J. Massive ovarian mucinous cystadenoma of low malignant potential. Obstet Gynecol 1982;59(Suppl 6):112S–6S.
Hulvat MC, Hansen NM, Jeruss JS. Multidisciplinary care for patients with breast cancer. Surg Clin North Am 2009;89:133–76, ix.