Ovarian mass in pregnancy: a case report

Pushpa Dahiya, Latika .


Most common ovarian masses encountered during pregnancy are functional cysts of ovary and luteomas being unique to pregnancy. The other ovarian masses in order are benign cystic teratomas, serous cystadenoma, paraovarian cyst, mucinous cystadenoma and endometrioma. Torsion of ovarian cyst is the commonest complication during pregnancy. Incidence of ovarian torsion is 5 per 10000 pregnancies. The diagnosis is established by the characteristic history, presenting complaints of patient, examination findings and it is confirmed by the transvaginal ultrasound. Whenever this complication is encountered, it’s important to go for immediate surgery. The surgical options available are laparoscopy or laparotomy. Here we report about a patient who was G5P4L4 with 18 weeks period of gestation. She presented in casualty with the chief complaints of acute pain abdomen on and off since morning. The patient was taken up for the ultrasound which showed a live foetus of 16 weeks gestation with adenexal mass. In view of probable diagnosis of torsion of adenexal mass, the patient was taken up for emergency laparotomy and ovarian cystectomy was performed. Patient’s post-operative period was uneventful and on histopathological examination the ovarian mass was found to be mucinous cystadenoma. Although, it is well established fact that surgery; if performed during second trimester is safer in case of an ovarian mass, nevertheless there is always small amount of risk to the growing foetus. Therefore, it is important to have choice of management for such cases depending on various factors viz. surgical indication, patient’s condition, period of gestation. The appropriate decision should be taken after weighing all the risks and taking well informed consent. Whenever complications like torsion, rupture of cyst, infarction arise, than emergency surgery has to be taken up irrespective of period of gestation. 


Ovarian mass in pregnancy, Mucinous cystadenoma

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Cunningham F. Gary, Leveno Kenneth J, Bloom Steven L, Hauth John C, Rouse Dwight J, Spong Catherine Y. Reproductive tract abnormalities. In: Cunningham F. Gary, Leveno Kenneth J, Bloom Steven L, Hauth John C, Rouse Dwight J, Spong Catherine Y, eds. William Obstetrics. 23rd ed. New York: McGraw-Hill; 2010: 912-925.

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.

Ventolini G, Hunter L, Drollinger D, Hurd WW. Ovarian torsion during pregnancy, September 2005. Available at: Accessed 8 December 2007.

Leiserowitz GS, Xing G, Cress R, Brahmbhatt B, Kalrymple JL, Smith LH. Adnexal masses in pregnancy: how often are they malignant? Gynecol Oncol. 2006;101(2):315-21.

Bignardi T, Condous G. The management of ovarian pathology in pregnancy. Best Pract Res Clin Obstet Gynecol. 2009;23:539-48.

Lee CH, Raman S, Sivanesaratnam V. Torsion of ovarian tumors: a clinicopathological study. Int J Gynaecol Obstet. 1989;28:21-5.

Hermans RHM, Fischer DC, van der Putten HWHM, van de Putte G, Einzmann T, Vos MC, et al. Adnexal masses in pregnancy. Onkologie. 2003;26:167-72.

Goffinet F. Ovarian cyst and pregnancy. J Gynecol Obstet Biol Reprod. 2001;30:100-8.

Ioffe OB, Simsir A, Silverberg SG. Pathology. In: Berek JS, Hacker NF, eds. Practical Gynecologic Oncology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins Company; 2000: 213-214.

Rosales Aujang E. Giant ovarian cyst and pregnancy. Case report and literature review. Ginecol Obstet Mex. 2011;79:235-8.

Duic Z, Kukura V, Ciglar S, Podobnik M, Podgajski M. Adnexal masses in pregnancy: a review of eight cases undergoing surgical management. Eur J Gynaecol Oncol. 2002;23:133-4.

Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152:456-61.

Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, et al. Risk analysis of torsion and malignancy for adnexal masses during pregnancy. Fertil Steril. 2009;91(5):1895-902.