Ovarian cancer causing upper and lower urinary tract obstruction

BACKGROUND: Cervical cancer is the gynecologic malignancy most commonly associated with urinary tract obstruction. Ovarian cancer rarely causes this problem, but when it does, the obstruction is due to impedance of flow in the pelvic ureters. CASE REPORT: A 34 year old female treated by total abdominal hysterectomy with ovarian preservation 9 months earlier for presumed stage IV endometriosis and menorrhagia presented with a recurrent pelvic mass along with symptoms of bladder outlet obstruction. Intravenous urography and computed tomography showed bilateral hydronephrosis and confirmed the bladder outlet obstruction. Laparotomy revealed a large pelvic mass, grossly resembling endometriosis, obstructing the right ureter and impinging upon the urethrovesical junction. Final pathological analysis revealed a mucinous cystadenocarcinoma of the ovary. CONCLUSION: Urinary tract obstruction, including both urethrovesical junction and ureteral obstruction, may be caused by ovarian cancer.