Large adnexal tumour in a young woman presenting with cardiac-related signs and symptoms

Abstract

Adnexal tumours constitute a wide range of conditions that are frequently faced in gynecological practice, and this include benign cysts, as well as malignant tumours. Although the majority of ovarian tumours are asymptomatic or have localized symptoms, very large adnexal tumours may have systemic effects because of their size and location. This report describes a rare case of a young woman with a very large adnexal tumour presenting with predominantly cardiovascular-related symptoms. A 21 year old nulligravid woman presented to our emergency department with progressive history abdominal distension, swelling of the lower limbs, and cardiorespiratory distress due to an adnexal tumour noted intra op to be measuring 30 x 40 cm. Initial investigations revealed a tumour originating from the pelvis extending to the epigastrium. Further investigations revealed cardiovascular compromise tumour with an ejection fraction of 43% on echocardiogram. A multidisciplinary team consisting of gynaecological oncologists, physicians and anaesthetists were involved in the management of the patient. Fertility sparing surgery was performed and serial echocardiograms post-operatively showed improvement in the patient’s cardiovascular status.