Unusual Cause of “Constipation”
-
James Lee
A 60-year-old woman with no known medical history presented to the emergency department with 5 days of constipation and lower abdominal cramping. She reported nausea and 1 episode of nonbloody, nonbilious emesis, along with a 50-lb weight loss, which she attributed to lifestyle changes. Physical examination revealed suprapubic tenderness, right abdominal distension, and mild lower extremity edema. Computed tomographic findings (images A and B) revealed a large cystic mass arising from the pelvis and extending into the abdomen, with multiple septations. The patient underwent resection of 2 separate masses. Pathologic testing identified a benign ovarian cystadenoma. On follow-up, the patient's symptoms had resolved.
A gynecological mass can often be grouped based on a patient's reproductive status and age. In women of reproductive age, the most common benign neoplasms are cystadenomas and mature cystic teratomas.1 At least 30% of ovarian masses in postmenopausal women are malignant.2
References
1. Seidman JD , MehrotraA. Benign ovarian serous tumors: a re-evaluation and proposed reclassification of serous “cystadenomas” and “cystadenofibromas.” Gynecol Oncol. 2005;96(2):395-401. doi:10.1016/j.ygyno.2004.10.014Search in Google Scholar PubMed
2. Kinkel K , LuY, MehdizadeA, PelteM-F, HricakH. Indeterminate ovarian mass at US: incremental value of second imaging test for characterization—meta-analysis and Bayesian analysis. Radiology. 2005;236(1):85-94. doi:10.1148/radiol.2361041618Search in Google Scholar PubMed
© 2018 American Osteopathic Association
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