An Ovarian Tumour with an Initial Presentation of RIF Pain

Clinical History

A 76-year old lady presented with a few weeks history of right sided abdominal pain, tenderness, and bloating. Although the blood results were normal, the patient was referred to have an ultrasound of the abdomen and pelvis to rule out cholelithiasis or ovarian abnormality.

Case Description

Ultrasound (TA and TV) revealed a large heterogeneous mass in the right adnexa with cystic and solid components and some internal vascularity. The right renal pelvis was also mildly dilated at 10 mm in AP calibre, suggesting mass effect on the right ureter by the mass.

Treatment/ Follow up

The patient was referred to have a pelvic MRI then whole body CT scan for staging prior to surgery. Subsequently, the patient had a total abdominal hysterectomy with bilateral salpingo oophorectomy. Future MRI scans revealed no evidence of disease recurrence.

The post-operative histology analysis of the right ovary revealed a low grade serous carcinoma arising in a borderline serous tumour.