Huge Ovarian Mass in Adolescence: Is Laparoscopy an Option?

Abstract

Background: A huge ovarian cyst can be seen in a patient, due to rapid progression of its growth or late presentation. In benign cases, this poses a dilemma, especially in adolescents. Should a surgeon proceed conventionally with laparotomy or take a more appealing laparoscopic approach? This article presents a case of a huge ovarian cyst in an adolescent that was removed successfully via laparoscopic cystectomy, using a Cystofix® balloon catheter as a drainage tool. Case: A 19-year-old Indian girl, with no known medical illnesses, presented with a huge abdominal swelling. Systematic examinations were unremarkable. Imaging, including a computed tomography scan, showed a homogenous ovarian cyst with no malignant features; all of this patient's biochemical tumor markers were within normal values. Therefore, a laparoscopic cystectomy with a possible oophorectomy was planned. Initial cystic decompression was performed with a Cystofix balloon puncture set and this procedure was followed by a laparoscopic cystectomy in usual manner. Results: The laparoscopic operation was uneventful and use of the Cystofix balloon facilitated the decompression without causing any spillage of the cysts content. The operation lasted 75 minutes with minimal blood loss in the patient. The patient recovered well and her cyst was benign. Conclusions: With good patient selection and proper preoperative evaluation of the nature of an ovarian cyst, even an enormous ovarian cyst can be removed by laparoscopy using this method, especially in a young patient. (J GYNECOL SURG 34:167)