CASE HISTORY

Patient was admitted complaining of swelling in the left side of the abdomen, which had gradually increased for the last 6 months, and of repeated attacks of violent epigastric pain, followed by a feeling of wanting to relive herself, when red blood was passed per rectum, sometimes amounting to 1 pint. These attacks recurred sometimes with the periods, but not always. There were intervals of 2 to 3 months a times. For the last year the attacks had ceased, but the lump in her abdomen had become large. Apart from this she was healthy. Menstruation had been regular, menopause 12 years ago, when she was treated for menopausal bleeding. One child, 30 years old. On examination a tumour was felt in the left inguinal fossa, tender not completely fixed and disappearing into the pelvis. PV a rectocele and cystocele were present. The vagina was healthy, nothing abnormal was found in the uterus. The right fornix was obscured by a mass from the left side. In the pouch of Douglas and left fornix, two separate tender cystic masses could be felt, the one in the left fornix was continuous with the abdominal mass. A diagnosis of bilateral ovarian neoplasm was made and a subtotal hysterectomy and bilateral salpingo-oophorectomy was performed, ovaries were found to contain semi-solid multilocular cysts, the left larger than the right. Colon appeared normal. Patient made a good recovery.

PATHOLOGY

The specimen consists of the uterus, amputated above the cervix, together with both tubes and ovaries, which both on section show the appearances of simple multilocular cystadenoma. The larger tumour of the left ovary measures about 10x16cms and its largest cavity contains rather dark pseudo-mucinous material, probably due to blood-staining, while there had not apparently been any haemorrhage into the other cavities. The right ovarian tumour is about 7x10cms in diameter. The fallopian tubes are stretched over the circumference of the tumours.