Wardha doctors remove pumpkin-sized ovarian cyst of 38-year-old patient

PUNE: Doctors at a hospital attached to a medical college in Wardha removed a pumpkin-size ovarian cyst weighing 18.5kg on September 27.
This was the largest ovarian cyst ever reported from Maharashtra and among the three instances reported in the medical literature of the country so far.

The patient, a 38-year-old woman, had initially delayed reaching the hospital because of financial constraints.She approached the doctors only after her huge stomach bulge started causing pain and breathlessness.
The cyst type is medically termed as “serous cystadenoma”. In the past, medical literature in India had reported women with massive cysts weighing 56kg and 23kg. Both the patients were from north India. The cases were reported in 1996 and 2009.
“This is the first reported case of a giant cyst weighing 18.5kg in Maharashtra. The case will soon be published in a medical journal,” hospital’s gynaecologist Arpita Jaiswal told TOI.
The tumour in the woman’s right ovary had grown into the massive cyst in a span of seven months. “The cyst was so big that it took up 95% of the patient’s abdomen,” Jaiswal said.
The huge mass had blown the woman to 105cm in girth. “We removed the whole mass intact. Outside the abdomen, the fluid-filled mass had spread out horizontally and measured 135cm,” she said.
The surgery was a challenge, as its removal without spilling the fluid contents in the abdominal cavity required expertise. “The surgery was planned and completed without complications,” the gynaecologist said.
Jaiswal carried out the surgery along with gynaecologists Deepika Devani and Abhishek Kothule at Acharya Vinoba Bhave Rural Hospital at Sawangi village. The hospital is run by Datta Meghe Institute of Medical Sciences, Wardha district.
Before the surgery, the doctors ran a battery of tests to confirm the nature of the cyst. “The CT scan revealed that there was no free fluid in the woman’s abdomen. This was suggestive that the cyst was not cancerous (malignant),” Kothule said.
“The woman's right ovary had merged in the mass. Her right fallopian tube had thinned out. The tube had stretched over the surface of the cyst,” he added.
Her food intake had significantly reduced over the last two months. “The patient was not fit for general anaesthesia because she was malnourished. We opted for spinal as well as epidural anaesthesia,” said hospital’s senior anaesthetist, Jayashri Sen.
There were chances of the patient slipping into hypotensive (low blood pressure) shock immediately after removal of the cyst. Ot was important to remove the massive cyst gradually from the limited the space without rupturing it.
“We took out the cyst by taking an incision of 2cm above the pubic bone to the belly button,” Kothule said. The woman weighed 57kg at the time of surgery. Post-surgery, her weight came down to 37.6kg.
“The patient’s food intake has improved after the surgery and she will be discharged in a day or two,” Kothule said.
Spine surgeon Ajay Chandanwale, joint director, Department of Medical Education and Research, Maharashtra , said, “The successful removal of the giant cyst at hospital in Sawangi shows the capabilities and expertise of our doctors working in rural interiors.”