Spontaneous subcapsular and perirenal haemorrhage with retroperitoneal haematoma in a patient with ovarian melanoma metastases

BMJ Case Rep. 2021 Jan 27;14(1):e238983. doi: 10.1136/bcr-2020-238983.

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.

Keywords: gynecological cancer; obstetrics and gynaecology; radiology; ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Blood Transfusion
  • Female
  • Hemorrhage / diagnostic imaging*
  • Hemorrhage / etiology
  • Humans
  • Kidney Diseases / diagnostic imaging*
  • Kidney Diseases / etiology
  • Kidney Neoplasms / complications
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / secondary*
  • Melanoma / complications
  • Melanoma / diagnostic imaging
  • Melanoma / secondary*
  • Melanoma / surgery
  • Melanoma, Amelanotic / complications
  • Melanoma, Amelanotic / diagnostic imaging
  • Melanoma, Amelanotic / secondary*
  • Melanoma, Amelanotic / surgery
  • Middle Aged
  • Ovarian Neoplasms / diagnostic imaging
  • Ovarian Neoplasms / secondary*
  • Ovarian Neoplasms / surgery
  • Retroperitoneal Space
  • Shock / etiology
  • Skin Neoplasms / pathology*
  • Tomography, X-Ray Computed