Mucinous Cystadenoma in Pregnancy: A Case Report of Successful Surgical Management

Dr. Samia Nasreen¹, Dr. Javeria Asghar¹, Maryam Moazzam²

 ¹Combined Military Hospital Malir ²Bahria University Health Sciences Campus (Karachi)

Introduction:

Benign mucinous cystadenomas ⟶ 80% of all mucinous ovarian neoplasms. [1]

Often unilateral, multilocular, and may reach considerable sizes. [1,2]

Presenting complains: pelvic pain, bloating, or abdominal discomfort. [1,2]

Detection more common in pregnancy due to routine ultrasonography. [3]

Management: consideration of the tumor’s size, symptoms, and complications such as torsion or rupture. [2,3]

Surgery ⟶ symptomatic cases or those posing obstetric risks. [2,3]

Objective:

To highlight the diagnostic challenges and surgical management of a massive mucinous cystadenoma during pregnancy, emphasizing the importance of timely intervention to prevent maternal and fetal complications while ensuring optimal pregnancy outcomes.

Case Presentation:

28-year-old woman 

27 + 3 weeks (G7 P4+2 L4)

Polyhydramnios

Large abdominal mass

Ultrasound: massive multiloculated right ovarian cyst (7000 mL)

Management:

Laparotomy at 28 weeks of gestation

Torsioned right ovarian cyst with areas of necrosis 

Right salpingooophorectomy. Left tube ligated

Fluid for cytology: mucinous cystadenoma

Uneventful pregnancy ⟶ Spontaneous vaginal delivery

Discussion: 

Mucinous cystadenomas can grow significantly ⟶ pose risks such as preterm labor, miscarriage, adnexal torsion, and labor dystocia. [3,4,5]

Adnexal torsion (in this case) is a surgical emergency. [3,5]

Ultrasound: first-line diagnostic tool. MRI: evaluation of malignancy. [2,3]

Surgery during pregnancy carries risks; elective surgical management minimizes complications. [2,3,5]

Conclusion:

This case underscores the importance of individualized management for large ovarian masses in pregnancy. Timely surgical intervention ensured maternal and fetal safety, highlighting the need for multidisciplinary planning in similar scenarios.

References:

1.Limaiem F, Mlika M. Ovarian Cystadenoma. [Updated 2023 Jun 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://ncbi.nlm.nih.gov/books/NBK536950/

2.Thang NM, Anh NT, Quang HT. Giant ovarian mucinous cystadenoma complicating term pregnancy: a rare case report. Annals of Medicine and Surgery. 2024 Nov 1;86(11):6819- 23.

3.Cathcart AM, Nezhat FR, Emerson J, Pejovic T, Nezhat CH, Nezhat CR. Adnexal masses during pregnancy: diagnosis, treatment, and prognosis. American journal of obstetrics and gynecology. 2023 Jun 1;228(6):601-12.

4.Kolling LR, Nienkotter LC, Michels AC. Mucinous Cystadenoma of the right ovary in a pregnant patient: A case report. Caderno de ANAIS HOME. 2023 Dec 6. 

5.Martone S, Troìa L, Luisi S. Adnexal masses during pregnancy: management for a better approach. Gynecological Surgery. 2021 Dec;18(1):3.