CASE HISTORY

The patient, a primigravida, attended in routine examinations was found to have a pelvic tumour separate from the uterus. This had not caused symptoms and there were not other physical signs. She was thought to have an ovarian cyst complicating pregnancy and it was decided to do a caesarian section at term and remove the tumour. At 40 weeks gestation a lower segment caesarian section was done and on examining the tumour it was decided to proceed to a total hysterectomy with salpingo- ovarectomy. She made a normal recovery and the baby did well. A course of prophylactic deep x-ray therapy was given and the patient was well 3 months later.

PATHOLOGY

The specimen consists of the front half of the uterus together with the left appendage. The uterus shows the fresh caesarian section incision and the position of the placental attachment at the fundus. The left ovary has been replaced by an irregular cluster of small cysts which individually resemble the small cysts within the bigger cysts of the other ovary.