• Tumor markers: CA 19.9= <2 (≤37U/ml), CA 125=24 (≤35U/ml), CA 15.3=16.7 (≤31.3U/ml),  CEA=9.3 (≤5ng/ml), LDH=249 (125-220 U/L). 
• Procedure: Staging laparotomy, bilateral salpingo-oophorectomy (BSO), subtotal abdominal hysterectomy, omentectomy, lymph node sampling/biopsy and appendectomy.

Diagnosis:

1. Right ovarian mass: Mucinous cystadenoma. Negative for malignancy. (Gross description: Huge gray-white cyst weighing 5200 grams and measuring 27 x 22 x 13.5 cm. The surface is grayish-white and glistening with numerous vessels showing and traversing the surface on the inner aspect. There is attached fallopian tube 8 cm long and 0.6 cm in diameter. Cyst opening released about 3000 ml of slightly turbid, but mostly clear fluid. The inner surface of the cyst shows reticulation and the cyst appears to be multilocular. No obvious gross solid area seen).
2. Appendix: No significant abnormality.
3. Lymph node sampling: Four reactive lymph nodes histologically identified. Negative for malignancy.
4. 3 cm left hypochondrial calcified omental nodule: Dystrophic calcification. Negative for malignancy.
5. Uterus with left tube and left ovary: Uterus shows one intramural leiomyoma. No significant abnormality seen in endometrium. Cervix showed active chronic cervicitis with no evidence of significant dysplasia. Left ovary and fallopian tube show only paratubal cysts.