Giant Complex Adnexal Cyst Weighing 10 Kilograms in a 71-Year-Old Woman With Markedly Elevated Tumor Markers: A CaseReport and Literature Review

Document Type : Case Report and Review of Literature

Authors

General Surgeon, Sina Hospital, Tabriz University of Medical science, Tabriz, Iran

Abstract
Large adnexal cystic masses, particularly in elderly patients, pose significant diagnostic and therapeutic
challenges. In this report, we present the case of a 71-year-old woman with a complex 10-kg adnexal cystic
mass suspected to be either cystadenoma or cystadenocarcinoma. The patient experienced progressive
abdominal pain, distention, dyspnea, and functional impairments such as difficulty walking and sleeping over
a six-month period. Laboratory tests revealed a marked elevation of tumor markers CA-125 and CA-19-9,
supporting the suspicion of malignancy. Abdominopelvic CT scan confirmed the presence of a large septated
cystic mass extending into the upper abdomen. The patient underwent total abdominal hysterectomy with
bilateral oophorectomy, and the 10-kg mass was successfully excised without complications. Postoperatively,
she was referred to an oncologist for additional evaluation and further management. This case highlights the
importance of early diagnosis, meticulous surgical planning, and multidisciplinary management of large
adnexal masses.

Keywords