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Spontaneous subcapsular and perirenal haemorrhage with retroperitoneal haematoma in a patient with ovarian melanoma metastases
  1. Stefania Malmusi,
  2. Mirvana Airoud,
  3. Manuela Bellafronte and
  4. Maria Cristina Galassi
  1. Obstetrics and Gynecology, Sassuolo Hospital, Sassuolo, Emilia-Romagna, Italy
  1. Correspondence to Dr Stefania Malmusi; s.malmusi{at}ospedalesassuolo.it

Abstract

A 47-year-old woman was admitted to our clinic for intensive pain in the left flank region. The transvaginal ultrasound showed a left adnexal solid mass with ascites. She had undergone surgical removal of skin melanoma in 2008, but in September 2019, intracardiac metastasis resulting from it had been discovered. CT performed in March 2020 had been negative for other metastases. A full abdomen ultrasound was not performed. During the night, the patient began to show signs and symptoms of hypovolaemic shock. The patient was urgently transferred to the operating room for a video laparoscopy. A vast left retroperitoneal haematoma was diagnosed along with voluminous enlargement of the left ovary. We proceeded with a left adnexectomy and blood transfusion. Subsequent contrast-enhanced CT revealed a left subcapsular, perirenal haematoma and a voluminous retroperitoneal haematoma. Kidney metastasis was also seen. The final histological diagnosis was metastatic amelanotic malignant melanoma of the ovary.

  • obstetrics and gynaecology
  • ultrasonography
  • radiology
  • gynecological cancer

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Footnotes

  • Twitter @stefania malmusi

  • Contributors SM and MA conceived of the presented idea. SM and MB developed the theory and performed the computations. MCG encouraged SM to investigate the rare clinical case and supervised the findings of this work. All authors discussed the results and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.