Challenges in Anaesthesia Management of a 15-Year-Old Female With Ovarian Teratoma for Exploratory Laparotomy: A Case Report

Rarely, an ovarian tumour will develop the growing teratoma syndrome. Growing teratoma syndrome of the cystic type has been linked to difficulties with anaesthesia because of the abdominal pressure the tumour exerts on the thorax. There haven't been any reports of this kind of ovarian tumour associated with ascites and bilateral pleural effusion in a paediatric age group. Here, we describe our anaesthetic experience in a case of developing solid-type ovarian teratoma syndrome with deranged lung status and haemodynamics. The patient was a 15-year-old female who was diagnosed with ovarian teratoma. She was scheduled for surgery when she arrived at our hospital with a 13 cm solid mass and respiratory distress. The patient's liver profile was abnormal; she had ascites, pleural effusion and a severely worsened lung condition. The patient was planned for an exploratory laparotomy and debulking surgery after preoperative optimisation. To prevent the re-expansion pulmonary oedema (RPO) following the excision of the tumour, a volume-restricted postoperative ventilation strategy was planned. Following enhanced recovery after surgery (ERAS) protocol and specific anaesthetic measures, we successfully managed the anaesthesia in a case of teratoma syndrome with a large abdominal tumour with successful recovery and early discharge from hospital.