Management of a Giant Ovarian Cyst during COVID-19 Epidemic: A Case Report

Giant cysts of the ovary are defined as tumors with a diameter greater than ten centimeters. They’ve become rarer lately because of an earlier diagnosis and management due to availability of imaging modalities and routine checkups. Surgery remains the main form of treatment and the only curative one. We report the case of a 72-year-old woman who was brought to the emergency department for a weight gain of 47 kg, a recently worsening dyspnea and an abdominal distension making her unable to remain supine. Once the assessment was completed, a laparotomy was scheduled. A cystectomy with bilateral oophorectomy was performed and cytology was carried out. At first, histopathology revealed a borderline mucinous tumour, but additional analysis concluded to a mucinous cystadenoma with borderline areas and a transition zone progressing on to an atypical proliferative mucinous tumour and with an expansile mucinous cystadenocarcinoma focally which size was less than 1 cm. Post-operatively, the patient remained dyspneic with desaturation and also had fever. At this point, we suspected her to be positive to the COVID-19 virus. The chest CT scan showed an image of frosted glass, but the polymerase chain reaction (PCR) test was negative. In this report, we will conduct a literature review of the pathology and also discuss its outcome, prognosis and treatment. We shall also cover the anesthetic risk in these women. Such cases are very rare and their management is a real challenge for the anesthesiologist, the surgeon and the pathologist.

Author(s):

Kalaji M, Weerts J , Bindelle S and Markiewicz S

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