Huge Abdominal swelling with distention.

A 22 year old nulliparous female came for increasing abdominal distention, fatigue, and indigestion over the past 6 months. Over the course of this time, she also began having severe nausea, primarily limited to her menses, only relieved with prescription anti-emetics. She had regular cycles, was sexually active with one partner, used condoms and denied dyspareunia, fever or chills. On physical exam, her abdomen was non-tender, but significantly distended with a palpable mass to the level of the xiphoid process. Pregnancy test was negative. Her complete blood count, electrolytes, liver function tests and thyroid panel were normal. CT scan was done revealing a massive, simple, cystic mass extending into the upper abdomen measuring 23x13.3x27cm. In addition, a left ovarian mass with a small calcification, measuring 8x 5x7.3cm was identified, suspicious for a teratoma. Right ovarian tissue could not be definitively identified. What do you find in CT? Dx? Mx?

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Paraovarian Cysts. Paraovarian cysts are epithelium-lined fluid-filled cysts in the adnexa adjacent to the fallopian tube and ovary. The terms are used interchangeably. Ovarian cyst symptoms are very similar to those found in women with PCOS, such as irregular or non-existent periods, acne and weight gain.
Right ovarian tumor. Tumor markers to be done followed by laparotomy. If suspicious of malignancy then staging laparotomy should be done
Huge cystic swelling yes agreed paraovarian cystic mass Needs tumor markers
Thanx dr Pushkar ji Bhomia
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Paraovarian cyst
Hydatid cyst
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. ... The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
It is suggesting ovarian/paraovarian mass. Malignancy needs to be rule out by Marker studies. May need diagnostic cum curative laparotomy.
DD Ovarian cyst Mesenteric cyst Hydadid cyst CT ANGIO/ MRI / PET CT , CA125, CEA, CA19-9 Lap cystectomy
Rt ovarian cyst 23×13×27 cm Lt ovarian cyst 8×5×7.3 cm
Can be a Mesenteric cyst D/d Hydatid cyst.
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