Ovarian cancer diagnosed during pregnancy: clinicopathological characteristics and management

The aim of this study was to discuss the diagnostic and therapeutic dilemmas in cases of pregnant women with adnexal masses, reporting an interesting case with synchronous literature review. The patient, a gravida 2, para 1, 37 year-old woman was diagnosed with a large unilateral adnexal lesion during a scheduled third trimester ultrasound assessment. A large papillary papule with a network of blood vessels showing decreased resistance in blood flow was noticed as well. Surgical intervention revealed ascitic fluid and a large cystic mass arising from the right ovary. Cesarean section and right salpingooophorectomy, including the mass, were performed. Frozen section biopsy was positive for malignancy. Total hysterectomy and left salpingo-oophorectomy, total omentectomy, biopsies from the pelvic peritoneum, pelvic/para-aortic lymphadenectomy and appendicectomy followed. Histology showed mucinous ovarian adenocarcinoma Grade I Stage Ic according to FIGO classification. Surgical intervention, in cases of persisting adnexal lesions, is often necessary, even during pregnancy.