YU.V. ORLOV, A.I. MINNEKHANOVA, D.D. ABDULLINA

 Kazan State Medical University, Kazan

Contact details:

Orlov Yu.V. — PhD (Medicine), Head of the Center for Accreditation and Simulation, Associate Professor of the Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev

Address: 49 Butlerov St., Kazan 420012, Russian Federation, tel.: +7 (843) 236-12-70, e-mail: scenter@kazangmu.ru

 The article presents a clinical case of a giant serous cystadenoma of the left ovary in an 18-year-old patient of early reproductive age. The clinical picture was characterized by atypical manifestations: dull lower abdominal pain, progressive abdominal enlargement, menstrual delay, and episodes of nausea, initially interpreted by the patient as signs of pregnancy. Ultrasound examination revealed a cystic mass measuring 32 × 23 cm with a mural solid component (O-RADS 4). Laboratory tests excluded pregnancy (β-hCG 1.0 mIU/ml), and CA-125 levels remained within normal limits. Organ-preserving surgical treatment was performed: lower midline laparotomy with excision of a 30 × 20 cm cystadenoma while preserving ovarian tissue and the uterine tube. Histological examination confirmed the diagnosis of serous cystadenoma without cytological atypia or mitotic activity. This clinical case highlights the trend toward “younger onset” of benign ovarian tumors, underscores the importance of differential diagnosis with pregnancy, and demonstrates the advantages of organ-preserving surgical approaches in young patients to maintain reproductive potential.

Key words: serous cystadenoma, ovary, giant tumor, reproductive age, organ-preserving surgery, differential diagnosis

REFERENCES

1. Winata I.G.S., Sabatini E.P., Purnomo F.S. Diagnosis and treatment of benign ovarian tumors. Eur. J. Med. Health Sci, 2022, vol. 4 (2), pp. 1–3. DOI: 10.24018/ejmed.2022.4.2.1286
2. Adamyan L.V., Sibirskaya E.V., Bogdanova E.A., Koltunov I.E., Smal′ T.A., Shutkova A.Yu. Benign tumors and tumor-like formations of the ovaries in children and adolescents (literature review). Problemy reproduktsii, 2016, vol. 22, no. 2, pp. 73–77 (in Russ.). DOI: 10.17116/repro201622273-77
3. Wang Z., Gao S., Wei S., Jiang Y., Li M. Bilateral serous surface papillary borderline ovarian tumor with non-invasive implantation: a case report. Front. Oncol, 2026, vol. 16, p. 1705073. DOI: 10.3389/fonc.2026.1705073
4. Kalashnikova M.F., Likhodey N.V., Tyul′pakov A.N., Fedorova E.V., Bryunin D.V., Bakhvalova A.A. et al. Virilizing ovarian tumor: problems of differential diagnosis. Problemy endokrinologii, 2019, vol. 65, no. 4, pp. 273–277 (in Russ.).
5. Sibirskaya E.V., Karachentsova I.V., Sharkov S.M., Kudryavtseva E.V., Mikhaylova E.A. Giant ovarian tumor in a 16-year-old girl. Effektivnaya farmakoterapiya, 2023, vol. 19, no. 7, pp. 64–69 (in Russ.). DOI: 10.33978/2307-3586-2023-19-7-64-69
6. Odumeru E.A., Afodun A., Njoku C. et al. Giant serous cystadenoma masquerading as ascites in an adolescent by ultrasound: a case report and review of diagnostic challenges, 2025. DOI: 10.21203/rs.3.rs-7735568/v1
7. Li T., Hou N., Mao L., Liu F., Ma Z., Wang L. et al. Tumor markers in differential diagnosis of benign ovarian masses. Int. J. Women’s Health, 2024, vol. 16, pp. 1517–1531. DOI: https://doi.org/10.2147/IJWH.S47105812
8. Anagha B.R., Mathew R. Serous cystadenoma of the broad ligament mimicking an ovarian cyst: a diagnostic challenge. Int. J. Reprod. Contr. Obstet. Gynecol, 2026, vol. 15, pp. 768–770. DOI: 10.18203/2320-1770.ijrcog20260209
9. Tjokroprawiro B.A., Novitasari K., Ulhaq R.A., Sulistya H.A. Clinicopathological analysis of giant ovarian tumors. Eur. J. Obstet. Gynecol. Reprod. Biol. X, 2024, vol. 22, p. 100318. DOI: 10.1016/j.eurox.2024.100318
10. Raut S.T., Meera T.P. Bilateral incidental benign Brenner’s tumors with unilateral mucinous cystadenoma of ovary — a rare case report. Int. J. Reprod. Contr. Obstet. Gynecol., 2026, vol. 15, pp. 759–763. DOI: 10.18203/2320-1770.ijrcog20260207
11. Koirala D., Mishra B., Agrawal Y., Dhakal Y., Shrestha R. Giant ovarian cyst presenting with reversible cardiac compromise: a case report. Int. J. Surg. Case Rep, 2026. DOI: 10.1097/RC9.0000000000000212
12. Guidelines for the management of adnexal masses. Int. J. Gynecol. Obstet, 2022, vol. 155 (suppl. 1), pp. S1–S32. DOI: 10.3389/fmed.2022.913549
13. Lukanova A., Kaaks R. Obesity, diet and risk of ovarian cancer. Maturitas, 2005, vol. 52 (3–4), pp. 256–265.
14. Faroun A., Gharbia B.A., Sarahna A. Coexistence of giant serous cystadenoma and hemorrhagic corpus luteal cyst in a 12-year-old: diagnostic and fertility-sparing surgical approach. BMC Pediatrics, 2025, vol. 25, p. 559. DOI: 10.1186/s12887-025-05932-x
15. Ghose Biswas A., Hiwale K. A rare case of serous cystadenocarcinoma of the ovary with a benign teratoma in the other ovary. Front. Med, 2026, vol. 13, p. 1729956. DOI: 10.3389/fmed.2026.1729956