A unique case of a giant ovarian mucinous cystadenoma causing an acute renal failure and compartment syndrome.

Background: Mucinous cystadenoma of the ovary is a common gynecologic tumor that usually has a very favorable prognosis. However, if it is not early detected and removed, it can grow to a large size and may cause serious health complications.

Case: A 65-year-old woman was transported to the hospital by the emergency medical service due to overall weakness, markedly enlarged abdomen reminiscent of ascites, breathing difficulties, and swollen legs with eczematous ulcers. Laboratory parameters showed an acute renal insufficiency. Imaging scans revealed a giant solid cystic tumor mass filling the whole abdominopelvic cavity, which caused a compartment syndrome of the lower limbs. After relieving puncture and drainage of 6 L of fluid from the cyst, laparotomy had been performed. Grossly, the entire abdominal cavity was filled with a huge cystic tumor originating from the left ovary. During its surgical preparation, a total of 17 L of fluid was evacuated from it. Then, adnexectomy was made. A bio-psy sample consisted of an irregular, artificially teared multicystic tumor about 60 cm in the largest dimension. Histology confirmed a benign mucinous cystadenoma. After tumor removal, the patient's health condition and laboratory parameters improved.

Conclusion: We described a unique case of an extremely huge ovarian mucinous cystadenoma that led to a life-threating event of the patient. We tried to point out that even a "common" benign tumor may lead to clinically malignant consequences and its management requires a multidisciplinary approach.