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Times of India
22 February 2011
By Umesh Isalkar
Pune, India

Her belly distension was so huge that it almost looked like a full–term pregnancy. Upon examination, it turned out to be a massive ovarian cyst (pseudomucinous cyst adenoma) – a fluid–filled sac that develop in a woman’s ovaries. The cyst covered the woman’s entire abdomen, measuring 30cm and contained 7 litres of fluid. A team of doctors from a city hospital successfully removed the cyst. The difficult extraction was done through a laparoscopic surgery, cutting away from the conventional method of removing it by performing an open surgery.

"The patient, a 21–year–old woman, with complaints of unusual abdominal distension was referred to us by a general practitioner recently. Examinations (Ultra Sonography and Color Doppler test) in the hospital revealed that the reason for her massively swollen abdomen was an ovarian cyst. Certain tumour markers and Doppler test confirmed it to be a benign ovarian cyst, which is harmless," said gynaecologist and IVF consultant Amit Shah, who performed the surgery at Inamdar multi–specialty hospital in Fatimanagar on January 20.

"It was a rare case where a cyst grew phenomenally large. The tumour must have been developing six to eight months prior to her visit to our hospital. The woman had even started wearing loose–fitting dresses to conceal her unusual belly distension. ," Shah said.

Traditionally, such huge ovarian cysts are removed by making an incision of 7 to 10 cm over the abdomen. "This increases a patient’s post–surgical stay in the hospital. In this case, we removed the cyst through a laparoscopic surgery and the patient was discharged the same day. She even joined her college on the third day of the operation."

Generally, a standard method (open surgery) is done to extract a cyst. Shah, who routinely performs laparoscopy surgery, said, "This case was somehow complicated because the cyst had occupied the full abdomen, so abdominal entry was absolutely difficult. Therefore, I inserted a direct trocar into the cyst and the fluid was drained out and the cyst collapsed. The, abdominal entry was made and the cyst was removed in an endo–bag through the umbilical incision."

"It was only after six months that I too became conscious of my abdomen’s condition. I thought my stomach was protruding because of my habit of eating rice. Seeing the jar containing the extracted fluid, both my mother and uncle were taken aback. Never in my dream did I think such a condition would arise", said the patient.

What is ovarian cyst?
Ovarian cysts affect women of all ages but they occur most often during a woman's childbearing years. Ovarian cysts are small fluid–filled sacs that develop in a woman’s ovaries. Most cysts are harmless, but some may cause problems such as rupturing, bleeding, or pain; and surgery may be required to remove the cyst(s).

The cyst contains only fluid and is surrounded by a very thin wall. The vast majority of ovarian cysts are considered functional (or physiologic). This means they occur normally and are not part of a disease process. Most ovarian cysts are benign, meaning they are not cancerous, and many disappear on their own in a matter of weeks without treatment.

While cysts may be found in ovarian cancer, ovarian cysts typically represent a harmless (benign) condition or a normal process. Sometimes the cyst can be cancerous for those women who are in extremes of their age group i.e. 10 – 25 years and 55 – 65 years.

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