Skip to content
2000
image of When Cysts Mislead: A Case Report of Ovarian Cyst Resembling Giant Ureterocele after Hysterectomy

Abstract

Introduction

Women undergoing hysterectomy without oophorectomy face a risk of needing re-surgery for new adnexal conditions. Additionally, large ovarian cysts in post-hysterectomy patients can complicate diagnoses, often mimicking conditions, like mesenteric cysts, massive ascites, or giant hydronephrosis.

Case Presentation

A 54-year-old para four and live four (PL) post-hysterectomy woman presented to the gynecological outpatient department with complaints of lower abdominal and back pain lasting seven days, along with difficulty urinating and burning during micturition. Her initial outside imaging, including a CECT and CT-urogram, suggested a grade three or four ureterocele, with potential differentials, such as megaureter and vesicoureteric reflux. However, upon clinical examination and further evaluation using MRI, it was found to be a large left-sided ovarian cyst of 13.8x9.5x11.3 cm causing hydroureteronephrosis (left>right). Her intraoperative findings revealed a large predominantly, tense cystic lesion of size 13x12 cm, completely occupying the lower pelvis in the midline, and it was densely adherent to the bladder and omentum anteriorly, and to the bowel posteriorly and on sides. Subsequent histopathological examination confirmed it as a mucinous cystadenoma of the ovary.

Conclusion

Large ovarian masses in post-hysterectomy patients present significant diagnostic and management challenges as they can mimic a range of conditions. This underscores the need for a multidisciplinary approach to improve diagnostic accuracy and optimize patient outcomes.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cas/10.2174/0118746098365660250423075122
2025-05-08
2025-08-18

  • From This Site

    /content/journals/cas/10.2174/0118746098365660250423075122
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Manandhar T. Sitaula S. Thapa B.D. Agrawal A. Thakur A. Prevalence of hysterectomy among gynecological surgeries in a tertiary care hospital. JNMA J. Nepal Med. Assoc. 2020 58 232 965 970 10.31729/jnma.5315 34506386
    [Google Scholar]
  2. Sakko Y. Aimagambetova G. Terzic M. Ukybassova T. Bapayeva G. Gusmanov A. Zhakhina G. Zhantuyakova A. Gaipov A. The prevalence, indications, outcomes of the most common major gynecological surgeries in Kazakhstan and recommendations for potential improvements into public health and clinical practice: Analysis of the national electronic healthcare system (2014–2019). Int. J. Environ. Res. Public Health 2022 19 22 14679 10.3390/ijerph192214679 36429398
    [Google Scholar]
  3. Orozco L.J. Tristan M. Vreugdenhil M.M.T. Salazar A. Hysterectomy versus hysterectomy plus oophorectomy for premenopausal women. Cochrane Libr. 2014 2014 8 CD005638 10.1002/14651858.CD005638.pub3 25101365
    [Google Scholar]
  4. Abdelazim I.A. Abdelrazak K.M. Elbiaa A.A.M. Farghali M.M. Essam A. Zhurabekova G. Ovarian function and ovarian blood supply following premenopausal abdominal hysterectomy. Przegl. Menopauz. 2015 4 4 238 242 10.5114/pm.2015.56312 26848295
    [Google Scholar]
  5. Öksüzoğlu A. Özyer Ş. Yörük Ö. Aksoy R.T. Yumuşak Ö.H. Evliyaoğlu Ö. Adnexal lesions after hysterectomy: A retrospective observational study. J. Turk. Ger. Gynecol. Assoc. 2019 20 3 165 169 10.4274/jtgga.galenos.2018.2018.0051 30063215
    [Google Scholar]
  6. Yang Y. Zhang X. Fan Y. Zhang J. Chen B. Sun X. Zhao X. Correlation analysis of hysterectomy and ovarian preservation with depression. Sci. Rep. 2023 13 1 9744 10.1038/s41598‑023‑36838‑2 37328539
    [Google Scholar]
  7. Movva N. Kavya M. Ovarian cysts in post hysterectomy cases – An overview. Sch Int J Obstet Gynec 2021 4 5 182 186
    [Google Scholar]
  8. Jacoby V.L. Hysterectomy Controversies. Clin. Obstet. Gynecol. 2014 57 1 95 105 10.1097/GRF.0000000000000011 24488053
    [Google Scholar]
  9. Moorman P.G. Myers E.R. Schildkraut J.M. Iversen E.S. Wang F. Warren N. Effect of hysterectomy with ovarian preservation on ovarian function. Obstet. Gynecol. 2011 118 6 1271 1279 10.1097/AOG.0b013e318236fd12 22067716
    [Google Scholar]
  10. Karp N.E. Fenner D.E. Burgunder-Zdravkovski L. Morgan D.M. Removal of normal ovaries in women under age 51 at the time of hysterectomy. Am. J. Obstet. Gynecol. 2015 213 5 716.e1 716.e6 10.1016/j.ajog.2015.05.062 26032038
    [Google Scholar]
  11. Baloglu A. Bezircioglu I. Cetinkaya B. Karci L. Bicer M. Development of secondary ovarian lesions after hysterectomy without oophorectomy versus unilateral oophorectomy for benign conditions: A retrospective analysis of patients during a nine-year period of observation. Clin. Exp. Obstet. Gynecol. 2010 37 4 299 302 21355462
    [Google Scholar]
  12. Paltaci I. Diner G. Kartufan F.F. Giant ovarian cyst that may be confused with mesentery cyst. J. Med. Cases 2014 5 6 326 328 10.14740/jmc1776w
    [Google Scholar]
  13. Kapote D. Sakhalkar A. Chavan N.N. Ajmera D. Kampoowale S. Boob M.M. An interesting case of an adnexal mass mimicking a mesenteric cyst in pregnancy. J. South Asian Fed. Obstet. Gynecol. 2023 15 2 248 250 10.5005/jp‑journals‑10006‑2209
    [Google Scholar]
  14. Yeika E.V. Efie D.T. Tolefac P.N. Fomengia J.N. Giant ovarian cyst masquerading as a massive ascites: A case report. BMC Res. Notes 2017 10 1 749 10.1186/s13104‑017‑3093‑8 29258579
    [Google Scholar]
  15. Leigh R. Sacks M.A. Won M.M. Mikael A. Moores D. Radulescu A. Large mesenteric cyst mimicking an ovarian cyst in an 8-year-old: A case report. Int. J. Surg. Case Rep. 2021 89 106566 10.1016/j.ijscr.2021.106566 34773912
    [Google Scholar]
  16. Kurniadi A. Kurniaputra M.P. Yulianti H. Kireina J. Giant hydronephrosis masquerading as ovarian tumor: A case report. Ann. Med. Surg. 2023 85 4 990 994 10.1097/MS9.0000000000000285 37113938
    [Google Scholar]
  17. Nerli R.B. Mungarwadi A. Mudegowdar A.S. Patil A. Hiremath M.B. Ghagane S. A giant hydronephrosis mistakenly diagnosed as ovarian tumor in a pregnant woman. Urol. Case Rep. 2016 4 20 21 10.1016/j.eucr.2015.10.002 26793569
    [Google Scholar]
  18. Mobeen S. Apostol R. Ovarian Cyst. StatPearls Publishing Treasure Island, FL 2024
    [Google Scholar]
  19. Fu S.C. Su H.Y. Residual ovarian syndrome: A case report with classic symptoms, imaging and pathology findings, and treatment. Taiwan. J. Obstet. Gynecol. 2018 57 5 753 754 10.1016/j.tjog.2018.08.027 30342666
    [Google Scholar]
  20. Shiber L.D.J. Gregory E.J. Gaskins J.T. Biscette S.M. Adnexal masses requiring reoperation in women with previous hysterectomy with or without adnexectomy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016 200 123 127 10.1016/j.ejogrb.2016.02.043 27031192
    [Google Scholar]
  21. Mirazimi M.S. Behnamfar F. Sichani M.M. Dashti F. Mirazimi S.M.A. Ureterocele mimicking uterine polyp in a young woman presenting with a vulvar mass: A case report. Urol. Case Rep. 2022 43 102085 10.1016/j.eucr.2022.102085 35497504
    [Google Scholar]
  22. Yacoub J.H. Clark J.A. Paal E.E. Manning M.A. Approach to cystic lesions in the abdomen and pelvis, with radiologic-pathologic correlation. Radiographics 2021 41 5 1368 1386 10.1148/rg.2021200207 34469214
    [Google Scholar]
  23. Sohaib SA Reznek RH MR imaging in ovarian cancer. Cancer Imaging 2007 7 Spec No A Special issue A S119 S129 10.1102/1470‑7330.2007.9046
    [Google Scholar]
  24. Ghanem K. Leslie S.W. Badreldin A.M. Ureterocele. StatPearls Publishing Treasure Island, FL 2025
    [Google Scholar]
  25. Braga A. Serati M. Vitelli A. Caccia G. Occasional finding of giant bladder diverticulum that simulated an ovarian cyst: A case report and literature review. J. Obstet. Gynaecol. Res. 2016 42 3 235 238 10.1111/jog.12906 26787074
    [Google Scholar]
  26. Wong H.L. Yeung V.H.W. Chu S.K. Man C.W. Torsion of ovarian dermoid cyst mimicking obstructing urinary tract stone. Urol. Case Rep. 2018 16 14 16 10.1016/j.eucr.2017.09.015 29021964
    [Google Scholar]
  27. Wu C.Y. Lee C.Y. Yang I.J. Shen H. Torng P.L. Double collecting system with ectopic ureterocele masquerading as an ovarian torsion. Taiwan. J. Obstet. Gynecol. 2018 57 6 867 870 10.1016/j.tjog.2018.10.018 30545543
    [Google Scholar]
  28. Wu F. Hu M. Cao M. Ou M. Li Q. Liu Z. Giant mesenteric mixed hemangioma misdiagnosed as ovarian cyst: A case report and a literature review. Ann. Vasc. Surg. 2020 67 567.e1 567.e4 10.1016/j.avsg.2020.03.004 32209416
    [Google Scholar]
  29. Zvizdic Z. Bukvic M. Murtezic S. Skenderi F. Vranic S. Giant paratubal serous cystadenoma in an adolescent female: Case report and literature review. J. Pediatr. Adolesc. Gynecol. 2020 33 4 438 440 10.1016/j.jpag.2020.03.010 32251838
    [Google Scholar]
  30. Estell D. Asanad K. Baker Z. Vasquez E. Mature ovarian cystic teratoma mimicking a bladder diverticulum in a 16-year-old female. Urology 2021 149 e56 e59 10.1016/j.urology.2020.08.050 32916187
    [Google Scholar]
  31. Droubi S Ovarian mucinous cystadenoma mimicking the urinary bladder. Radiopaedia.org 2021 10.53347/rID‑93814
    [Google Scholar]
  32. Dai Y. Liu G. Wang Y. Wei J. Wang Z. Wang J. Enlarging ovarian cysts mimicking malignant or borderline tumors during pregnancy. Gynecol Obstet Clin Med. 2021 1 4 228 232 10.1016/j.gocm.2021.11.001
    [Google Scholar]
  33. Mishra T.S. Jena S.K. Kumari S. Purkait S. Ayyanar P. Nayak P. Cecal dermoid masquerading dermoid cyst of ovary: A case report and review of the literature. J. Med. Case Rep. 2021 15 1 38 10.1186/s13256‑020‑02570‑y 33514417
    [Google Scholar]
  34. Olasinde A. Ogunlaja O. Olasinde Y.T. Mobolaji-Ojibara M.U. Adelaja-ojulari N. Giant ovarian cyst in a term pregnancy simulating a massive ascites: A case report. Cureus 2022 14 12 e33199 10.7759/cureus.33199 36726894
    [Google Scholar]
  35. Devasilpa Raju P.D. Lamture Y. Deshpande S.G. Gattani R.G. Endometrial cyst presenting as a vague abdominal lump in a postmenopausal woman. Cureus 2022 14 10 e29807 10.7759/cureus.29807 36337797
    [Google Scholar]
  36. Thanasa E. Thanasa A. Xydias E.M. Ziogas A.C. Kamaretsos E. Paraoulakis I. Grapsidi V. Gerokostas E.E. Kontogeorgis G. Thanasas I. Adnexal torsion of a mature cystic ovarian teratoma with hemorrhagic infarction misdiagnosed as pelvic inflammatory disease in a perimenopausal patient: A case report. Cureus 2023 15 5 e38680 10.7759/cureus.38680 37288200
    [Google Scholar]
  37. Mahfoud H. Flissate F. Tligui S. Benammi S. Etber A. Baidada A. Mesenteric cystic lymphangioma misdiagnosed as ovarian cyst in a 63-year-old female: A case report and review of literature. Int. J. Surg. Case Rep. 2024 120 109846 10.1016/j.ijscr.2024.109846 38824741
    [Google Scholar]
  38. Xu J. Lv T.F. Rupture of a giant jejunal mesenteric cystic lymphangioma misdiagnosed as ovarian torsion: A case report. World J. Clin. Cases 2024 12 4 847 852 10.12998/wjcc.v12.i4.847 38322678
    [Google Scholar]
/content/journals/cas/10.2174/0118746098365660250423075122
Loading
When Cysts Mislead: A Case Report of Ovarian Cyst Resembling Giant Ureterocele after Hysterectomy
Bentham Science Publishers ; https://doi.org/10.2174/0118746098365660250423075122
/content/journals/cas/10.2174/0118746098365660250423075122
/content/journals/cas/10.2174/0118746098365660250423075122
Loading

Data & Media loading...


  • Article Type:     Case Report
Keywords: post-hysterectomy ; ureterocele ; ovary ; hydronephrosis ; Bladder ; cyst

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test