[PELVIC ORGAN PROLAPSE AND INGUINAL HERNIA AGGRAVATED BY OVARIAN FIBROTHECOMA WITH ASCITES]

Area of Science:

• Gynecology
• Oncology
• General Surgery

Context:

• A 61-year-old woman presented with worsening pelvic organ prolapse and symptoms suggestive of an incarcerated inguinal hernia.
• Initial diagnosis included Stage III cystocele, treated conservatively, but symptoms rapidly progressed.
• Imaging revealed a large pelvic mass with ascites, initially raising suspicion for ovarian cancer.

Purpose:

• To report a case of pelvic organ prolapse and inguinal hernia exacerbated by a benign ovarian tumor with ascites.
• To discuss the diagnostic and therapeutic challenges posed by this rare clinical presentation.
• To emphasize the importance of considering intra-abdominal pathology in patients with prolapse and hernia.

Summary:

• A patient with pelvic organ prolapse and inguinal hernia was found to have a large, benign ovarian fibrothecoma with ascites.
• Surgical management included hysterectomy, bilateral salpingo-oophorectomy, and colposuspension, leading to resolution of ascites and prolapse.
• The inguinal hernia recurred later, requiring separate surgical repair, demonstrating a delayed but related complication.

Impact:

• This case underscores the potential for benign ovarian tumors to cause significant secondary pelvic floor and abdominal wall issues.
• It highlights the clinical presentation and management of fibrothecoma with ascites, mimicking malignant conditions.
• The findings emphasize the need for comprehensive evaluation of intra-abdominal masses in patients presenting with pelvic organ prolapse and hernias.