Global Journal of Medical Research, E: Gynecology and Obstetrics, Volume 21 Issue 3

10 Year 2021 Global Journal of Medical Research Volume XXI Issue III Version I ( D ) E © 2021 Global Journals A Study of Giant Ovarian Tumors Presenting with Higher Incidence of Torsion: A Journey of my Experience in Covid-19 Pandemic at Tertiary Care Centre procedures, conversion of hospitals to COVID designated centres, led to a decreased accessibility of immediate medical help to these patients. • As a result of which despite having symptoms they had a delay in the management of their cases. However administrative regulatory activities like lockdown were a need of hour in order to contain the rampant spread of the COVID -19 and reduce the morbidity and mortality associated with it. • The epithelial and non epithelialtumors showed a greater incidence of torsion of adnexal mass with tumor thereby leading to gangrenous and necrotic changes and an acute abdomen. In the modern era of medicine, such huge mucinous ovarian tumours have become rare in the current medical practice, as most of the cases are detected early during routine gynaecological examinations or on ultrasound. However this was not the case during lockdown. Conservative surgery as ovarian cystectomy and salpingo-oophorectomy is satisfactory for benign lesions.4 Frozen section is very significant to know the malignant variation of this tumour and that helps in the management of the patient. As in the huge tumours, the anatomical planes get distorted, so the surgical expertise is required to prevent the complications (3) Management of ovarian tumors depends on the patients age, the size of the cyst and its histopathological nature for large ovarian masses with a risk of malignancy and hence a staging laparotomy and intraoperative frozen section has their importance.(4) The ovarian tumors both benign as well as malignant can undergo torsion and have been reported in numerous studies. Patient can present with acute abdomen due to torsion. In a case presenting with acute abdomen with lump abdomen, ovarian mass with torsion should be considered as differential diagnosis. (5) The disruption of services has resulted into health being affected in all ways including family planning services. It has been studied that there is a huge unmet need of contraception available. Hence a proper mitigation of family planning is of utmost demand, although restraining of COVID 19 pandemic is also important (6) IV. C onclusion Although the measures like lockdown have been imposed for the containment of the COVID 19 infection, the increased cases of torsion of adnexal masses was reported in my experience. With proper management protocols and with all universal safety precautions the cases were managed with a great surgical expertise. Non epithelial ovarian cancers mainly granulosa cell tumours have excellent prognosis. Sex cord stromal tumours with an indolent course have good short-term prognosis, but with a greater risk of relapse. • More and more studies are needed to be devised to study their clinical presentations, course, prognosis and role of different adjuvant therapies. Such studies are required at an international level for increasing the disease free survival rates, reducing relapse rates and to decrease the morbidity and mortality associated with such rare ovarian cancers. • The management of such cases was challenging because the effects of COVID pandemic and effect of lockdown that restricted the availability and easy accessibility of health services thereby increasing the incidence of torsion of ovarian tumors. Acknowledgements: None Conflict of interest- NONE R eferences R éférences R eferencias 1. World Health Organisation. https://www.who.int/ 2. Goyal M, Singh P, Singh K, Shekhar S, Agrawal N, Misra S. The effect of the COVID ‐ 19 pandemic on maternal health due to delay in seeking health care: Experience from a tertiary center. International Journal of Gynecology & Obstetrics. 2020 Jan 1. 3. Katke RD. A huge benign mucinous cystadenoma of ovary: a case report and review of literature. Int J ReprodContraceptObstetGynecol2014; 3: 456-9. 4. Katke RD. A huge ovarian mucinous cystadenoma (8.5kg) leading to bilateral hydronephrosis: a case report and review of literature. MOJ Clin Med Case Rep. 2017; 7(1):166-168. 5. Katke RD. Torsion of a Huge Ovarian Fibroma Presented as Acute Abdomen. Journal of Case Reports. 2015 May 11; 5(1):195-8. 6. Katke RD, et al. Knowledge, Attitude and Practices of Family Planning in Antenatal Women in a Tertiary Care Hospital during COVID-19 Pandemic: Indian Perspective. J Gynecol 2021, 6(1): 000215.