A Rare Case of Dysgerminoma in Pregnancy Presenting with Hemoperitoneum

Dysgerminoma, a malignant ovarian tumor, was rarely associated with pregnancy, and its diagnosis was often complicated by the physiological and anatomical changes that occurred during gestation. Managing dysgerminomas during pregnancy was a complex process that required careful consideration of factors such as tumor stage, the patient's desire for future fertility, and gestational age.

This case presents a rare case of ovarian dysgerminoma diagnosed during pregnancy following hemoperitoneum. The patient, a 33-year-old woman, presented with hemodynamic shock and abdominal pain during a 23-week pregnancy. She had undergone a cesarean section three years prior for a placental anomaly.

During surgery, a large tumor measuring 24 × 29 cm was found in the left ovary. The tumor had entirely replaced the ovary but did not adhere to nearby organs. There was also 4.5 L of bloody ascitic fluid, which came from a bleeding ovarian vessel on the tumor's surface. Histological analysis confirmed that the tumor was a dysgerminoma.

Hemoperitoneum, although rare, can be a serious complication that may lead to the discovery of ovarian dysgerminoma. Since this type of tumor is usually of low malignancy, emergency adnexectomy proved to be an effective treatment in this case, resulting in good outcomes for both the mother and fetus. However, larger studies are needed to understand the prognosis of dysgerminoma during pregnancy better.

(Source: Clin Case Rep, 13: e70203. https://doi.org/10.1002/ccr3.70203 )