Case Report: Diagnosis and Surgical Management of a Giant Ovarian Tumor: A Case Report

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Introduction Giant ovarian cysts are now rare in contemporary practice due to widespread access to imaging and earlier diagnosis. However, they may still present as extremely large abdominopelvic masses and pose significant diagnostic and surgical challenges. Borderline mucinous ovarian tumors are epithelial neoplasms with atypical proliferation without stromal invasion and generally favorable prognosis, but they can reach considerable size. Case presentation We report the case of a 44-year-old woman presenting with progressive abdominal distension, functional discomfort, and deterioration of general condition. Clinical examination revealed marked cachexia with massive abdominal distension (abdominal circumference 120 cm) and dilated superficial veins. Imaging demonstrated a giant 37 × 28 × 24 cm multiloculated cystic abdominopelvic mass, initially suggestive of a benign ovarian lesion. Tumor markers were within normal ranges. Laparotomy revealed a giant ovarian cyst, from which approximately 21 liters of thick greenish fluid were carefully evacuated under controlled decompression. Systematic exploration confirmed a right ovarian origin, and a right adnexectomy was performed. The postoperative course was marked by transient hypoalbuminemia, managed medically, with subsequent full recovery. Histopathological examination confirmed a borderline mucinous ovarian tumor of endocervical type without invasive components. Conclusion This case illustrates the diagnostic and surgical challenges of giant ovarian tumors in the current era of early imaging. Controlled decompression and complete surgical excision remain essential to ensure safe management and favorable outcomes while avoiding intraoperative complications.

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