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A ruptured ovarian cystadenofibroma presenting with life-threatening sepsis and an incidental synchronous endometrial stromal sarcoma
  1. Alistair Boyd1,
  2. Hemant Sheth2,
  3. Faris Kubba3 and
  4. Mohammad Aziz4
  1. 1Surgery, London North West Healthcare NHS Trust, London, UK
  2. 2Surgery, London North West Healthcare Trust, Ealing, London, UK
  3. 3Histopathology, North West London Hospitals NHS Trust, Southall, London, UK
  4. 4Obstetrics and Gynaecology, London North West University Healthcare NHS Trust, London, UK
  1. Correspondence to Alistair Boyd; alistair.boyd{at}


A woman in her 60s presented with a rare complication of an ovarian cyst which many clinicians may not consider at first presentation. She was admitted with life-threatening staphylococcus aureus sepsis. She presented shocked with a collapse following a 2-day history of diarrhoea, vomiting and pain in the right iliac fossa. She was taken to theatre where a ruptured, widely infarcted left ovarian serous cystadenofibroma was discovered with over 2 litres of purulent fluid exuding from the cyst into the abdomen. She had a left cyst removal, hysterectomy and bilateral salpingo-oophorectomy performed. Histological analysis and molecular gene testing of an incidentally discovered uterine neoplasm revealed an undifferentiated uterine sarcoma. She successfully recovered as an inpatient and was discharged under the care of an oncology team for ongoing management.

  • cancer - see oncology
  • gynecological cancer
  • pathology
  • surgery

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  • Contributors AB was the main author of the manuscript. HS was the operating surgeon for the case presented. FK was the histopathologist involved with diagnosis of the pathology presented in this case. MA was also an operating surgeon involved in management of this case.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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