Eighteen-Year-Old Nulliparous Woman with Massive Mucinous Cystadenoma in Pregnancy: Case Report

Abstract

Background: Ovarian mucinous cystadenoma is rare in adolescents. We report the diagnosis and management of a massive ovarian mucinous cystadenoma in a pregnant adolescent. 
Case Presentation: An 18-year-old G1PO was referred by a midwife to the Komfo Anokye Teaching Hospital on account of excessive abdominal distension at 25 weeks’ gestation and an ultrasound scan finding of a large non-septate cystic adnexal mass. She, however,
reported to the hospital 6 weeks later with a complaint of worsening abdominal distension and discomfort. A transabdominal ultrasound scan revealed single intrauterine gestation and a large non-septate cystic adnexal lesion measuring more than 19 cm in its widest plane. She had a conservative in-patients management followed by emergency caesarean delivery, exploratory laparotomy and unilateral salpingo-ophorectomy at 33 weeks 1 day. The outcome of the delivery was a 1.8 kg female infant with Apgar score of 4 and 6 at 1 and 5 minutes respectively. A 6.8 kg cystic ovarian mass measuring about 40 cm at its widest diameter was removed.
Conclusion: Although pregnancy-associated adnexal masses are not uncommon, significant socio-economic challenges may render the diagnosis and treatment of extremely large pelvic masses in pregnant adolescents difficult. The decision to optimize maternal and fetal outcomes is essential in managing rare conditions in marginalized obstetric populations.