Alexandru Cărăuleanu, Adina Elena Tanase, Iustina Petra Solomon-Condriuc, Andrei Ionuț Cucu, Claudia Florida Costea, Daniela Maria Tănase
Abstract
Purpose: Ovarian tumors often present in different forms. When we diagnose an ovarian cyst in a young woman, it is usually a functional cyst that disappears within a few months with or without treatment. The situation changes at menopause, when the incidence of cysts with a diameter of more than 7 cm is lower and requires additional investigations. Materials and methods: We performed a statistical analysis over a period of 5 years, during the period 2019-2024, of a total of 541 tumor formations classified as benign ovarian tumors, of which 77 were hospitalized for ovarian tumor pathology associated with ascites and unpredictable evolution, with benign or borderline pathological results with paraffin-embedded reserve. Patients complained of non-specific abdominal pain associated with dysmenorrhea and dyspareunia. On gynecological examination, in the majority of cases, we found a mass protruding in the posterior vaginal wall, the upper limit of which was difficult to assess due to the irregular contour and firmness of the tumor or due to marked abdominal adipose tissue. Results: The transvaginal ultrasound examination showed in 80% of the cases – cervical canal of normal appearance, the uterine body with normal dimensions, a normal endometrium, and a unilateral ovarian mass transformed into a mixed tumor. The abdominal ultrasound confirmed the tumor covering the topography of the involved ovarian adnexa. Patients were advised to undergo surgery due to the size of the ovary involved, and surgical exploration was prompted when the tumor was larger than 7 cm in size. Tumor markers, including ROMA scoring and specifically CA 125 were within normal limits, and surgical exploration revealed in all cases a moderate amount of ascites and the final anathomopathologic diagnosis of cystadenofibroma. The patients were discharged with a mean hospital stay of seven days with normal parameters, with the recommendation to return in two months for the final pathologic results. Discussion: Meigs syndrome or pseudo-Meigs, in the absence of pleural effusion, associates free abdominal fluid, interpreted as ascites, and a benign ovarian mass that could be related to a cystadenofibroma, or more commonly, solid tumors, such as fibrothecomas. Conclusions: The presence of a moderate amount of fluid can be alarming during surgery, when a benign outcome for the patient is expected. Fortunately, the patients were diagnosed with a benign tumor, with an excellent prognosis, but it must be considered that ascites is an unfavorable prognostic factor when it comes to ovarian tumors.
DOI : 10.62610/RJOR.2025.1.17.20
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