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

Ovarian neoplasms in pregnancy are usually asymptomatic rarely leading onto complications
Introduction
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
.
Authors: Malhotra N1, Sumana G, Singh A, Deka D, Mittal S.

Recommended By (co-author):
DR APRAJITA SINGH, MD,DNB,MNAMS
OBSTETRICS & GYNAECOLOGY
Consultant, Director & Founder
Aaditri Multispeciality Clinic
R-274, Greater Kailash Part-1, New Delhi 110048 (INDIA)
aaditriclinic@gmail.com +91-11-65658647

Attending Consultant
Indraprastha Apollo Hospitals, New Delhi
https://in.linkedin.com/in/dr-aprajita-singh-md-dnb-mnams-86713749