Giant Mucinous Cystadenoma Of The Ovary

Giant mucosal cystadenoma of the ovary is a benign tumor in most cases and usually occurs in adult and middle-aged women. It is very rare in girls or adolescents.

Between 15% and 25% of ovarian tumors correspond to a giant mucinous cystadenoma. Its main feature is the large size it can reach. That explains even the name: giant.

Experts estimate that about 85% of these tumors are benign. 6% are considered borderline or with some malignant potential, and 9% are invasive tumors. Other classifications estimate that 75% are benign and the remaining 25% are malignant.

In general, the benign type of giant mucinous cystadenoma of the ovary occurs between 20 and 50 years. Malignant tumors usually appear after the age of 50. It is often confused with pregnancy because of its size.

What is the giant mucinous cystadenoma of the ovary?

Giant mucinous cystadenoma of the ovary is defined as a neoplastic lesion. Therefore, it is a cell proliferation of a tissue that invades adjacent tissues. In this case, it is derived from the epithelial cells of the ovary.

It comes from a metaplasia or transformation of the epithelium of the cells of the layer that covers the ovary, ie the mesothelium. Due to its characteristics, it has the potential to reach a very large size.

Some mucinous cystadenomas contain intestinal epithelial tissue. They are more likely to be malignant and can eventually turn into ovarian cancer. Currently, 1 in 70 women develop this type of cancer in their lifetime.

The main features of giant mucinous cystadenoma

The presence of several glands and cysts characterizes the giant mucinous cystadenoma of the ovary. It has a diameter of 10 to 15 cm and is covered by epithelial cells with abundant amounts of mucin. This substance is the main component of mucous and salivary secretions.

The most relevant feature of this type of tumor is its potential to reach large sizes. In 1982, the presence of a giant mucinous cyst of the ovary, which weighed 87.7 kilograms, was documented, being the largest in the last 50 years. Mucinous cystadenoma weighing more than 12 kilograms is considered giant.

This type of ovarian tumor has a circular shape, a blue color and a smooth texture. Sometimes it has a translucent appearance and internal compartments. They are composed of a viscous and transparent liquid.

The ovary never loses its ability to generate tumors. For this reason, tumors can appear at any age. Ovarian tumors are one of the most common neoplasms in women and are dangerous because they are not detectable in the early stages.

Clinical manifestations

The most common clinical manifestation is an increase in abdominal circumference. An intra-abdominal mass appears, which is palpable. There is rarely pain or other manifestations, not even during the physical examination.

In some cases, excessive growth of the tumor leads to torsion, hemorrhage or rupture. This results in symptoms of abdominal distension, with oppressive pain in the hypogastrium and other gastrointestinal and urinary symptoms.

Imaging tests are needed to confirm the diagnosis and determine the malignancy or benignity of the tumor. Specialists usually perform ultrasounds and computed tomography (CT) scans. Ultrasounds provide a high reliability of this diagnosis.

If doctors suspect the presence of a malignant cyst, but cannot verify this by imaging studies, they will perform an exploratory laparotomy. If the tumor is symptomatic, specialists should evaluate it as soon as possible.

More useful information

Clinical data indicate that the highest incidence of ovarian tumors occurs in women aged 35 to 65 years. This stage corresponds to the climacteric, a phase in which the reproductive function undergoes multiple changes.

Although some tumors are hormonally active, the vast majority cause only mild symptoms until they reach a large size. Benign forms tend to be asymptomatic and are accidentally discovered.

The best treatment for giant mucinous ovarian cystadenoma in older women is bilateral salpingo-oophorectomy (removal of the ovary and its fallopian tube), followed by hysterectomy. If the patient is a young woman, the treatment always protects fertility. In general, the prognosis after surgery is a positive one.