Incidental discovery of a giant ovarian cystadenoma.

INTRODUCTION: Serous cystadenomas account for approximately 25% of benign ovarian tumors in patients of childbearing age. Their growth is insidious, and the diagnosis can be difficult as they are often asymptomatic, Patients with serous cystadenoma often experience symptoms only if the lesion is twisted or has a mass effect because of its size.This was the case in our patient, whose cough and low back pain prompted her To consult a doctor, which led to the definitive diagnosis and treatment.

MATERIALS AND METHODS: We report a case of a patient admitted for strangulated umbilical hernia with fortuitous discovery of a giant ovarian mass in the P35 visceral emergency department at the CHU ibn rochd hospital in Casablanca, Morocco.

RESULTS: the patient were operated in the emergency room, approached by laparotomy with the exploration we found umbilical hernia with a 6 cm long neck and necrotic bowel content a left latero-uterine mass of 40 cm of solid-cystic aspect and tube and right ovary without abnormalities and uterus of normal size the patient had an Segmental resection of 10 cm at 2.60 m from the ADJ and 1 m from the JIC with T-T grelo-grelic anastomosis and a left adnexectomy with a left latero-uterine mass of 45 cm and Epipoic and parietal peritoneum biopsy and Examination of the patient's spicemen showed serous cystadenoma weighing 10 kg and measuring 30 × 36*20 cm adjoining a tubular formation measuring 11 × 10*5 cm with bowel resection showed ischemic and hemorrhagic necrosis related to the occlusion with acellular ascites fluid.

DISCUSSION: Very Cystadenomas There are 2 types: Pleudomucinous cystadenomas or mucoid cysts, These are the most frequent neoplastic cysts of the ovary which are, in general, lumpy, multilocular, producing a gelatinous substance [8]. Their consistency is variable, some taut and firm, others semi-solid, spongy, thick, hollowed out "honeycomb" parts, which contain thick, stringy mucus. The coloration is variable: grayish white when the wall is thick, translucent in some places, with yellowish or white reflections, blue-black or reddish if there is spilled blood, grayish if there is cholesterol. on the other hand Serous cystadenomas or papillary cysts A little less frequent than mucoid cysts. Usually unilocular or paucicular, round or relatively flat, they contain protein-rich serous fluid. The coloration varies according to the content and thickness of the wall: light yellow or brown if the wall is thin, purplish red if there is blood, greyish white if the wall is thick. Consistency clearly fluctuates on the whole but can be hard in places, semi-solid, if there are abundant vegetations inside.

CONCLUSION: Very large tumors have become curiosities in industrialized countries where the health care system is well developed. On the other hand, they are not rare in developing countries. The delay in diagnosis is most often due to the patient herself who does not consult out of ignorance or refusal of her pathology. But it can happen, and this is serious.