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Conservative treatment of epithelial ovarian cancer in a 19‐year‐old girl. Case report

A 19-year-old nulliparous unmarried Asian girl presented to the general surgical unit on 28.5.81 with a 2-month history of generalized abdominal distension and constant pain which had localized to the right lower quadrant and become severe in the last 2 weeks before admission. She had no gynaecological symptoms, her periods were regular and she had never had intercourse. The abdomen was grossly distended, tense and dull to percussion centrally with no clinical evidence of ascites. There were no other abnormal signs. The provisional diagnosis was of a large benign ovarian cyst. A laparotomy was performed by a general surgeon on 1.6.81 through a Pfannenstiel incision. A huge smooth-capsuled non-adherent left ovarian cyst completely filled the entire abdominal cavity. There was no free fluid. The cyst was aspirated through a purse-string suture and 10 litres of mucoid fluid were drained. There was some peritoneal spill. A left oophorectomy was performed. The right ovary was conserved but contained a small cyst. The abdominal cavity was otherwise normal. The aspirated ovary measured 20 X 16 X 8cm and weighed 740g. Histologically the tumour was a well-differentiated papillary mucinous cystadenocarcinoma with no capsular invasion but with some small foci of poorly differentiated adenocarcinoma. The clinical staging was FIG0 stage I(a)i. Postoperatively one of us (M.K.D.) was consulted regarding her further management. The