Ovarian cancer, how did the patient operated in Turin reach 70 kilos?

He was removed from the Molinette hospital in Turin a 70-pound ovarian tumor from the abdomen of a woman. She arrived in the emergency room in critical condition because her mass, of ovarian origin, had grown to the point of completely obstructing her abdomen and preventing her from breathing independently.

The clinical history

The first thing to point out, however, is that the tumor was of benign origin. It was a cystadenoma of the ovary, a non-cancerous tumor that originates from cells on the surface of the ovary and can reach large dimensions. Despite this, however, the woman’s clinical situation was very serious, and two surgeries were needed several days apart to save his life, because the mass prevented the proper functioning of the abdominal organs. The first, performed in an emergency, was aimed at removing the cystic part of the lesion, which collected about 52 liters of fluid. The drainage made it possible to extubate the patient – who, upon arrival in the emergency room, could not breathe independently -, to overcome the critical phase and perform the necessary tests for diagnosis. The second operation, on the other hand, was used to remove the actual tumor, a mass that had grown to 25 kilos, a case without precedent in the literature. After a few days in intensive care and the subsequent transfer to the ward, the woman was discharged.

“Ovarian cancer, in fact, was composed of a solid part that occupied the entire posterior part of the abdomen, and anteriorly of a cystic formation with fluid content that was predominant in size. As for dimensions, I would say over half a meter in diameter, for a total weight that exceeded 70 kilos“, tells Francesco Moro, the surgeon who performed the operation. “The neoplasm has been radically removed, also because these benign formations have an expansive and non-infiltrative growth. The function of the abdominal organs was only temporarily impaired due to the presence of the mass and was completely restored, without consequences, after excision and during the postoperative period. The risk of recurrence is not zero, but it is not high“.

How can it grow so much

Tumors like the one removed in Turin are generally asymptomatic (at least in a first phase) e they grow slowly. Abdominal pain and complications affecting other organs usually appear only when the tumor mass is already significant in size. For this reason, ovarian cystadenomas are mostly diagnosed during routine gynecological visits, after which the right treatment to remove them is decided. In the case of the woman operated on at the Molinette hospital, however, this had not happened.

“Si deals with a case that I would define infrequent, if not unique”, Comments Moro. “If it weren’t a benign tumor, it certainly could not have reached this size. Usually, they are removed much earlier: they can even weigh two or three kilos, already at ten kilos we are in the exceptional. In this case, the dimensions were really impressive and the ovarian cancer, in fact, is as if it had become malignant. Histologically, the cells were not malignant, but the fact that it put the patient’s survival at risk makes it so“.

According to the surgeon, it would not be possible not to notice a tumor of similar size. However, it does not appear that there was a diagnosis made before the emergency admission to the hospital in Turin. It takes at least two years to reach such a large size. There is no real rule, however, especially as regards the fluid component of the tumor which can increase relatively quickly.

“In generaland – explains the surgeon – when a tumor like this exceeds 10-12 centimeters it becomes evident and begins to manifest itself with physical ailments. However, it also depends on the patient’s build. If the affected person is obese, for example, but this is not the case with the patient operated on in Turin, the margin is wider and it is possible that it will be noticed later.“.