Removal of massive ovarian tumor: case report and a critical review of surgical management and postoperative care1
A 31-year-old woman had a massive ovarian tumor and multiple associated metabolic abnormalities. Preoperative care included correction of cachexia-induced dehydration, hyperkalemia, azotemia, anemia, and hypoproteinemia. Hyperalimentation was also instituted because of profound malnutrition. Complete cardiovascular monitoring was used preoperatively to maximize her status and specifically to improve intravascular volume and cardiac output. At surgery, a 60–65kg ovarian mucinous cystadenocarcinoma of low malignant potential was removed, and a Swan-Ganz catheter was inserted to monitor therapy for resultant hypovolemic and splanchnic shock. Postoperative complications included adult respiratory distress, sepsis, hemorrhagic ulcerative cytomegalic virus colitis, and acute tubular necrosis. Eventually the patient died of hemorrhagic necrotizing cytomegalic virus pneumonitis. The surgical therapy of massive ovarian tumors and resultant complications are reviewed.