NATIONAL JOURNAL OF MEDICAL RESEARCH print ISSN: 2249 4995│eISSN: 2277 8810 Volume 3│Issue 2│Apr – June 2013 Page 187 CASE REPORT OVARIAN HUGE SEROUS CYSTADENOMA IN ADOLESCENT GIRL: A CASE REPORT Ilhan Ciftci 1 , Tamer Sekmenli 2 , Serdar Ugras 3 Authors’ Affiliation: 1 Department of Pediatric Surgery, University of Selcuk, Selcuklu Medical Faculty, Konya, Turkey; 2 Department of Pediatric Surgery, Konya Research and Training Hospital; 3 Department of Pathology, University Of Selcuk, Selcuklu Medical Faculty, Konya, Turkey. Correspondence: İlhan Ciftci, M.D., E-mail: driciftci@yahoo.com ABSTRACT Ovarian cysts are an extremely common gynecological problem in adolescent. Majority of ovarian cysts are benign with few cases being malignant. Ovarian serous cystadenoma are rare in children. A 14-year-old presented with abdominal pain and severe abdominal distention. She underwent laparotomy and after surgical removal, the mass was found to be ovarian serous cystadenoma on histology. In conclusions, germ cell tumors the most important causes for the giant ovarian masses in children. Epithelial tumors should not be forgotten in the differential diagnosis. Keyword: Adolescent; Ovarian Cysts/diagnosis*; Cystadenoma, Serous/surgery; Ovarian Neoplasms/surgery; Ovarian cystadenoma INTRODUCTION Cystic lesions of the ovary are most common during infancy and adolescence, which are hormonally active periods of development 1 . Cysts are mostly non- neoplastic in children and could be categorized as follicular, simple, and corpus luteum cysts. 1 Ovarian cysts rarely grow immense. Ultrasonography scanning permits early detection and appropriate treatment. Occasionally, ovarian cysts reach enormous dimensions without raising any symptoms. A few cases of giant ovarian cysts have been sporadically reported in the literature 1 . We presented a case of a giant ovarian cyst in a 14-year- old girl, with characteristics of ovarian serous cystadenoma both grossly and microscopically. CASE The patient is a 14-year-old female who presented at our surgical department with a gradually increasing abdominal swelling first noticed one year ago. The swelling was accompanied by vague abdominal pain and constipation since six months before admission. There was no history of colicky pain, fainting attacks, vomiting or other gastrointestinal attacks. She had no previous history of any illnesses, allergies or operations. She had normal regular menses. Based on sonographic examinations, a giant abdominal cystic mass that occupied all of the abdomen and pelvic cavity was noted. On general examination she weighed 52 kg. and vital signs were normal. There was no icterus, edema, or lymphadenopathy. Abdominal examination showed general distension (Figure 1). Intestinal sounds were normal. External genital examination was normal. Abdominal ultrasonography was suggestive of a giant abdominal cystic mass. Uterus was normal. Bowels were compressed by the mass, and a mild left hydronephrosis was seen. Abdominopelvic computerized tomography (CT) findings were consistent with a large abdominopelvic cystic mass (Figure 2). The patient underwent laparotomy with a midline incision, under and up to the umbilicus. After opening the layers, a large tense, smooth- surfaced cystic mass was noted. The mass was removed from the incision (Figure 3). The cyst measured 35 × 25 × 25 cm, extended up to the undersurface of the left diaphragm, and totally weighed 4 kg. The mass originated from the right ovarian region. We excised the cyst with the ipsilateral fallopian tube and ovary. The left fallopian tube was adherent to the surface of the cyst. The right ovary and fallopian tube was explored and normally noted. There was no free fluid in the abdomen. In pathologic examination: Cyst is lined by a single layer of epithelium overlying a fibrotic wall (Hematoxylin- eosin stain, original magnification, X 100) (Figure 4). Pathology confirmed serous benign cyst of the ovary. The postoperative period was uneventful and the patient was discharged on the third day after the operation. After the post-operative six-month period, she is healthy with no recurrence of the disease.