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July 16, 1982

A Large Radiolucent Pelvic Mass in an 81-Year-Old Woman

Author Affiliations

From the Departments of Radiology, Montefiore Hospital and Medical Center-North Central Bronx Hospital Affiliation and the Albert Einstein College of Medicine, Bronx, NY.

JAMA. 1982;248(3):357-358. doi:10.1001/jama.1982.03330030063032

History  An 81-year-old woman was admitted to the hospital with a complaint of weakness and constipation. Her temperature was 38.7 °C and her WBC count was 38,300/cu mm. Physical examination suggested the presence of a large pelvic tumor. An abdominal roentgenogram showed a large, spheroid, radiolucent mass, extending from the pelvis into the lower abdomen (Fig 1).

Diagnosis  Squamous cell carcinoma arising in benign ovarian cystic teratoma, with fistulous communication to the sigmoid colon.A barium enema (Fig 2) showed passage of barium into the radiolucent mass. The patient underwent a resection of the pelvic mass and sigmoid colon, colostomy, hysterectomy, and bilateral salpingo-oophorectomy. The tumor was dumbbell-shaped, with a small solid portion containing a few teeth and a large gas-filled portion. The latter was lined by squamous cell carcinoma, which was also present in the fistulous communication to the sigmoid. The patient's postoperative course was complicated by cardiac arrhythmia