Leite Cláudia, Barbosa Bruno, Santos Natália, Oliveira Ana, Casimiro Carlos
General Surgery, Centro Hospitalar Tondela-Viseu, 3504-509, Viseu, Portugal.
General Surgery, Centro Hospitalar Tondela-Viseu, 3504-509, Viseu, Portugal.
Int J Surg Case Rep. 2020;72:549-555. doi: 10.1016/j.ijscr.2020.06.085. Epub 2020 Jun 24.
Most abdominal cysts derive from the ovary. The range of differential diagnoses is wide. Unfortunately, imaging studies not always determine its origin.
The authors present the case of a 20-year-old female patient, admitted to the emergency department due to abdominal pain and distension, whose imaging studies revealed a gigantic abdominal cyst of unknown origin. She underwent an exploratory laparotomy that disclosed an ovarian cyst that was removed by a left adnexectomy. It weighed 10Kg and was 60 cm wide. The pathology report showed a mucinous cyst adenoma.
Once a patient present with an abdominal cyst, one should always consider the extensive list of differential diagnoses. In premenopausal women, ovarian cysts are very frequent. Cysts may grow to considerable size. Our patient was symptomatic, malnourished and dehydrated. Neither ultrasonography nor computed tomography were able to define the origin of the cyst. Persistent ovarian cysts larger than 10 cm, particularly if symptomatic, should be considered for surgery.
Progressive abdominal distension in premenopausal women should raise suspicion of an ovarian tumor, such as mucinous cystadenoma. These tumours are benign, but when their size is considerable, complications do arise and their surgical removal may be life threatening.
大多数腹部囊肿起源于卵巢。鉴别诊断范围广泛。不幸的是，影像学检查并不总能确定其起源。
作者报告了一例20岁女性患者，因腹痛和腹胀入住急诊科，其影像学检查发现一个来源不明的巨大腹部囊肿。她接受了剖腹探查术，发现一个卵巢囊肿，并通过左侧附件切除术将其切除。该囊肿重达10千克，宽60厘米。病理报告显示为黏液性囊腺瘤。
一旦患者出现腹部囊肿，应始终考虑广泛的鉴别诊断清单。在绝经前女性中，卵巢囊肿非常常见。囊肿可能会长到相当大的尺寸。我们的患者有症状，营养不良且脱水。超声检查和计算机断层扫描均无法确定囊肿的起源。持续存在的大于10厘米的卵巢囊肿，特别是如果有症状，应考虑手术治疗。
绝经前女性进行性腹部膨隆应引起对卵巢肿瘤（如黏液性囊腺瘤）的怀疑。这些肿瘤是良性的，但当它们体积较大时，确实会出现并发症，手术切除可能会危及生命。
