Presentation
Abdominopelvic pain and progressive distension.
Patient Data
A sizable complex cystic lesion with a thick enhancing wall and multiple internal septations at the right adnexa displace the uterus and bowel loops, causing a pressure effect on the distal part of the right ureter and leading to mild hydroureteronephrosis. Some cystic components have high-density contents that could be suggestive of hemorrhage. There are no signs of local invasion and no regional lymphadenopathy.
Two 90mm and 30 mm partially calcified fibroids are in the uterus.
A small fluid-containing supra-umbilical hernia is evident.
Case Discussion
The patient went to have a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and histopathology evaluation confirmed ovarian serous cystadenocarcinoma.
Ovarian serous cystadenocarcinoma is more heterogeneous than a serous cystadenoma and usually has papillary projections, thick septations, and/or solid components.
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