Investigating a large ovarian cyst

Size rather than suspicion of malignancy led to a timely referral for a large septated cystic mass occupying most of the abdominal cavity

Susan, a 34-year-old female, was referred following a six-month history of early satiety, abdominal distension and increased urinary frequency.

Her past history includes BMI of 31.7kg/m2, and an abdominal myomectomy, via laparotomy, which was complicated by bladder injury.

She consulted her GP and, after abdominal and vaginal examination, was referred for a pelvic ultrasound, which showed a cystic abdominal mass.

Tumour markers were investigated, revealing a CA125 of 11ku/L and CEA of 0.9kU/L (both normal).

The GP referred Susan for an abdominal CT, which revealed a large septated cystic mass occupying most of the abdominal cavity (figure 1).

Figure 1. CT (coronal) showing filling of the abdomen by a cystic mass with multiple septae. The

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