Diagnosis and treatment analysis of a case of pregnancy complicated with giant ovarian tumor

Pregnancy complicated with giant ovarian tumors is rare, and there is currently a lack of diagnostic and treatment guidelines or expert consensus for which. We treated a patient with pregnancy complicated by a giant ovarian tumor, and the report is as follows. The patient, 27 years old, was found to have a cystic mass of 7.5 cm × 7.4 cm in the left adnexa on ultrasound after 5 weeks of amenorrhea. At 14 weeks of amenorrhea, ultrasound showed a single live fetus in the uterus, and the cystic mass of the left adnexa increased to 18.3 cm × 19.6 cm. On the same day, the tumor marker results were as follows: The AFP value was 12.3ng/mL, slightly elevated.CEA, CA199, CA125, and HE4 were all normal. The patient had no clinical symptoms, and after ruling out the possibility of ovarian tumor malignancy and seeking the patient’s opinion, expectant treatment was adopted. At 37+ 3 weeks of pregnancy, the patient was admitted to the hospital due to being unable to lie flat for one day. Due to scarred uterus, a cesarean section was performed to terminate the pregnancy. During the operation, it was observed that the left ovary had enlarged to 40 cm × 32 cm × 10 cm, with a smooth surface and almost no normal ovarian tissue. The left fallopian tube was tightly adhered to the surface of the left ovary. After obtaining the consent of the patient and her husband, the left adnexa was removed, with a tumor mass of 13 kg. The pathological examination results showed multilocular mucinous cystadenoma in the left ovary. Follow up for one year after surgery showed good outcomes for both mother and child. Through the diagnosis and treatment of this case, our experience is that personalized plans need to be developed for the diagnosis and treatment of pregnancy complicated with giant ovarian tumors. The size of the tumor should not be a reason for early termination of pregnancy, but rather depends on whether the tumor is malignant, whether there are symptoms of acute abdomen and compression. If conditions permit, it is entirely possible for pregnancy to full-term.