Abstract

A CASE REPORT OF PREGNANCY PRESENTING WITH BILATERAL ADNEXAL MASS

Kaushik Richa*, Kumar Ashwani, Bansal Priyanka, Bhaskar Aastha and Shubhada Nanaware

ABSTRACT

Introduction: Adnexal masses in pregnancy are mostly asymptomatic, but complications like torsion, rupture, infection and labor obstruction may occur. Management, which can be conservative or surgical, mainly depends upon gestation age, clinical presentation and size of mass. Case Description: A 25 years old primi gravida women at 2 months of amenorrhea complained of heaviness in lower abdomen since 10 days on routine antenatal visit. On bimanual examination, uterine size was corresponding to the period of gestation and around 10×8 cm solid cystic, non-tender, mobile masses having smooth surface were felt through both lateral fornices and uterine mobility was not transmitting to masses. USG showed bilaterally enlarged ovaries with right ovary measuring about 13.7×7.7 cm and left ovary about 12.5×7 cm in size with a cyst of 100×67 mm with highly echogenic area of 58×57 mm right ovary and a cyst of 74×58 mm with highly echogenic areas of 42×31 mm and 48×38 mm in left ovary. Elective laparotomy was done at 17+4 weeks of gestation and bilateral ovarian cystectomy was done. Both cysts were cut open and presented with sebaceous material, hair and teeth. Histopathological report was bilateral mature cystic teratoma. Postoperative antenatal, intrapartum and postpartum course was uneventful and patient delivered vaginally at 40+3 weeks a healthy baby. Discussion: Surgical removal of all ovarian masses of size more than 10 cm size seems to be reasonable as there is substantial risk of malignancy.

Keywords: Antenatal, Adnexal mass, Dermoid cyst, Mature cystic teratoma.