Ovarian Carcinoma Presenting as Intra-abdominal Hemorrhage

• Published in: Gynecologic oncology Vol. 53; no. 3; pp. 380 - 381
• Main Authors: Geisler, John P., Denman, Beki J., Cudahy, Terence J., Lee, T.Howard, Geisler, Hans E.
• Format: Journal Article
• Language: English
• Published: San Diego, CA Elsevier Inc 01.06.1994; Elsevier
• Subjects: Abdomen, Acute - etiology; Adult; Biological and medical sciences; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Hemoperitoneum - diagnosis; Hemorrhage - etiology; Humans; Medical sciences; Mixed Tumor, Mesodermal - complications; Ovarian Neoplasms - complications; Tumors; Case study; Human; Ovarian diseases; Ovary; Carcinoma; Clinical form; Digestive diseases; Malignant tumor; Hemorrhage; Female genital diseases; Abdomen
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.1994.1153

Ovarian carcinoma commonly has an insidious onset. By the time the diagnosis is made, advanced disease is usually present. Rarely does a patient have acute symptoms which require immediate medical attention and lead to the correct diagnosis. A 40-year-old white female presented with lower abdominal pain, nausea, and light-headedness. Physical examination revealed a markedly tender lower abdomen with the right lower quadrant slightly more tender than the left. Hemoglobin level was noted to have decreased 2.6 g/dl over 16 hr. At exploratory laparotomy, 1500 cc of blood and a ruptured right ovarian mass were found. Pathologic analysis revealed a malignant mixed mesodermal tumor of the right ovary and an endometrioma of the left ovary. In conclusion, ovarian carcinoma may present as an acute abdomen because of intra-abdominal hemorrhage. It should be part of the differential diagnosis in a woman with an acute surgical abdomen and a hemoperitoneum.