PMC6151194_01
(a, b) CT abdomen showing large septated ovarian mass.
CRIID2018-9805702.001.jpg
PMC6151194_01_CRIID2018-9805702.001.jpg
fig1
CRP, and slightly elevated CA-125 and CA-19.9 (Table 1). CT scan showed a 22 x 13 cm multiseptated cystic lesion almost certainly of ovarian aetiology, as well as omental fat hazing, raising the possibility of an acute omental infarction (Figures 1(a) and 1(b)).
(a, b) Follow-up CT showing ruptured ovarian cyst.
CRIID2018-9805702.002.jpg
PMC6151194_01_CRIID2018-9805702.002.jpg
fig2
A repeat CT scan showed the large ovarian cyst had likely ruptured with new generalised ascites and peritoneal enhancement, concerning for disseminated disease (Figures 2(a) and 2(b)).
Intraoperative findings. (a) Large ovarian cyst with smooth surface; (b) characteristic nodules on surface of omentum and inflammatory changes of small bowel.
CRIID2018-9805702.003.jpg
PMC6151194_01_CRIID2018-9805702.003.jpg
fig3
The cyst had a small leak, and 3.5 L of fluid was drained from the cyst and sent for histology (Figure 3(a)). Inflammatory changes on the surface of the pelvis, and multiple inflammatory deposits overlying small bowel mesentery were noted (Figure 3(b)).