Gonca İmir YENİCESU, Meral ARICI, Meral ÇETİN

A huge ovarian mucinous cystadenoma complicating pregnancy: A case report

Müsinöz kistadenomlar büyük boyutlara ulaşabilir ve gebelik sırasında hormonlara cevap verebilir. Kırk haftalık hamile 25 yaşındaki bir bayan doğum eylemi ile başvurdu. Ultrasonografide uterusun sağ tarafında multiloküle, 38 cm çapında iri kistik kitle saptandı. Sezaryen doğum ile fetus doğurtulduktan sonra ovaryen kistektomi yapıldı. Histopatolojik olarak müsinöz kistadenoma ve luteal bulgular tespit edildi. Bu vaka, literatürde intrauterine gelişme kısıtlılığı ile komplike olan, gebelikte stromal luteinizasyon bulgulu üçüncü iri müsinöz kisadenoma olgusudur. Kistlerin yan etkileri nedeniyle gebelikte bütün ovaryen kistler ultrasonografi ile takip edilmelidir.

Gebeliği komplike eden iri ovaryen müsinöz kistadenoma: Olgu sunumu

Mucinous cystadenomas may reach a large size and may also tend to be hormonally responsive during pregnancy. A 25-year-old woman was presented with the labour pain at 40 weeks of gestation. Sonographic examination demonstrated a multiloculated, 38 cm in diameter, huge cystic mass at the right side of the uterus. After delivery of baby with cesarean section, ovarian cystectomy was performed. Histopathologically, mucinous cystadenoma findings and luteal changes were detected. This is the third reported case of huge ovarian mucinous cystadenoma with stromal luteinization complicated with intrauterine growth restriction. All ovarian cysts during pregnancy should be followed up by ultrasonography due to possibility of adverse effects of the cysts on pregnancy.

PDF

___

1. Qublan HS, Al-Ghoweri AS, Al-Kaisi NS, Abu-Khait SA. Benign mucinous cystadenoma with stromal luteinization during pregnancy: a hormonally responsive tumor and a rare cause of fetal intrauterine growth restriction. J Obstet Gynaecol Res 2002; 28: 104-7.
2. Ioffe OB, Simsir A and Silverberg SG. Pathology. In: Berek JS, Hacker NF, eds. Practical Gynecologic Oncology, LA: Lippincott Williams & Wilkins; 2000: 213-4.
3. Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol 1999; 181: 19-24.
4. Katz VL, Watson WJ, Hansen WF, Washington JL. Massive ovarian tumor complicating pregnancy. A case report. J Reprod Med 1993; 38: 907-10.
5. Pascal RR, Grecco LA. Mucinous cystadenoma of the ovary with stromal luteinization and hilar cell hyperplasia during pregnancy. Hum Pathol 1988; 19: 179-80.
6. Choudhury TK, Sen A. Periampullary carcinoma with bilateral ovarian cystadenoma in pregnancy. Indian J Gastroenterol 1998;17:65-6. Antoniou N, Varras M, Akrivis Ch, Demou A, Bellou A, Stefanaki S. Mucinous cystadenoma of the ovary with functioning stroma and virilization in pregnancy: a case report and review of the literature. Clin Exp Obstet Gynecol. 2003; 30: 248-52.
7. Balat O, Kutlar I, Erkilic S, Sirikci A, Aksoy F, Aydin A. Unthreatened late pregnancy with a huge mucinous cyst adenoma of the left ovary: report of an unusual case. Eur J Gynaecol Oncol 2002; 23: 84-5.
8. Fang YM, Gomes J, Lysikiewicz A, Maulik D. Massive luteinized follicular cyst of pregnancy. Obstet Gynecol 2005; 105: 1218-21.
9. Colgan TJ, Norris HJ. Ovarian epithelial tumors of low malignant potential: a review. Int J Gynecol Pathol 1983; 1: 367-82.
10. Dunn JM. A large mesenteric cyst complicating pregnancy. JAMA 1967; 200: 1129-30.
11. Vanek VW, Phillips AK. Retroperitoneal, mesenteric, and omental cysts. Arch Surg 1984; 119: 838-42.
12. Cohen I, Altaras M, Lew S, Jaffe R, Ben-Aderet N. Huge mesenteric mucinous cystadenoma in normal pregnancy. Obstet Gynecol 1988; 71: 1030-2.
13. Kato M, Kubota K, Kita J, Shimoda M, Rokkaku K, Inaba N, Fukasawa I, Honma K. Huge mucinous cystadenoma of the pancreas developing during pregnancy: a case report. Pancreas 2005; 30: 186-8.
14. Agarwal N, Parul, Kriplani A, Bhatla N, Gupta A. Management and outcome of pregnancies complicated with adnexal masses. Arch Gynecol Obstet 2003; 267: 148-52.
15. Usui R, Minakami H, Kosuge S, Iwasaki R, Ohwada M, Sato I. A retrospective survey of clinical, pathologic, and prognostic features of adnexal masses operated on during pregnancy. J Obstet Gynaecol Res 2000; 26: 89-93.
16. Boriboonhirunsarn D, Sermboon A. Accuracy of frozen section in the diagnosis of malignant ovarian tumor. J Obstet Gynaecol Res 2004; 30: 394-9.