Atypical Presentation of a Large Ovarian Mass as Syncope Due to Inferior Vena Cava Compression

Background: Inferior vena cava compression syndrome (IVCS) is a rare complication of large intra-abdominal masses, often presenting with lower extremity swelling, hypotension, and, in uncommon cases, syncope. This report highlights an unusual case of IVCS caused by a massive ovarian tumor, leading to dizziness and syncopal episodes. Case Presentation: A 67-year-old postmenopausal woman presented with progressive abdominal distension, dizziness, and syncope. Imaging revealed a large right ovarian multilobulated cystic mass (16 × 22 × 30 cm) compressing the inferior vena cava. She underwent exploratory laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy. Histopathology confirmed mucinous cystadenoma. Postoperatively, her symptoms completely resolved. Conclusion: Large ovarian masses should be considered in the differential diagnosis of unexplained syncope. Timely imaging and surgical intervention are crucial for symptom resolution and preventing complications.