Anuria and confusion
D'Souza, N Winter-Roach, Brett
D'Souza, N
Winter-Roach, Brett
Citations
Altmetric:
Abstract
Background The differential diagnoses of postoperative disorientation
and anuria can be streamlined with prompt initiation
of the management protocol to investigate these
symptoms. This case report describes a woman who underwent
primary cytoreductive surgery for an ovarian mass
and the postoperative events that lead to the diagnosis of
an incidental intra-cranial meningioma.
Case A 61 year old woman was diagnosed with a large
left ovarian mass on evaluation of abdominal pain. Primary
cytoreductive surgery was performed. On the first
postoperative day, she developed anuria and disorientation
associated with a creatinine rise despite being haemodynamically
stable. A CT head done as part of the delirium
screen revealed an extra-axial bilobed mass favouring a
meningioma rather than a metastasis. Despite the brain
mass, she had no neurological symptoms. Her renal function
was closely monitored and recovered by the fifth
postoperative day. It was thought to be likely due to postsurgical
ureteric oedema related to ureteric catheterisation.
She underwent craniotomy at a tertiary care centre 2
months after the laparotomy. Histopathology of the ovarian
mass was grade 2 endometrioid adenocarcinoma,
FIGO Stage 1C2; the cranial tumour was an anterior cranial
fossa meningioma (benign). She had no neurological
deficit and had completed adjuvant chemotherapy a year
after these events.
Conclusion Synchronous ovarian and brain tumours can
be a diagnostic challenge and are best managed by a multidisciplinary
team. Meningiomas can be asymptomatic
despite their size. A high index of suspicion is required to
aid early detection in order prevent loss of functional ability
Authors
Affiliation
Description
Date
2021
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
D'Souza N, Winter-Roach B. Anuria and confusion. BJOG: An International Journal of Obstetrics and Gynaecology. 2021;128:138.