Segawa A, Kakinuma T, Miyazawa C, Takeuchi J, Tamura M, Morita A, Takae S, Suzuki N, Ariizumi Y. Successful perioperative management for a giant ovarian tumor in older adults: A case report. World J Clin Cases 2026; 14(4): 116737 [DOI: 10.12998/wjcc.v14.i4.116737]
Corresponding Author of This Article
Toshiyuki Kakinuma, MD, PhD, Professor, Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811, Japan. tokakinuma@gmail.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 6, 2026 (publication date) through Feb 11, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Segawa A, Kakinuma T, Miyazawa C, Takeuchi J, Tamura M, Morita A, Takae S, Suzuki N, Ariizumi Y. Successful perioperative management for a giant ovarian tumor in older adults: A case report. World J Clin Cases 2026; 14(4): 116737 [DOI: 10.12998/wjcc.v14.i4.116737]
Arimi Segawa, Toshiyuki Kakinuma, Chinatsu Miyazawa, Jun Takeuchi, Midori Tamura, Akari Morita, Seido Takae, Nao Suzuki, Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Kanagawa 241-0811, Japan
Yasushi Ariizumi, Department of Diagnostic Pathology, Saint Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Kanagawa 241-0811, Japan
Author contributions: Segawa A, Kakinuma T, Miyazawa C, Takeuchi J, Tamura M, Morita A, Takae S, Suzuki N, and Ariizumi Y contributed to data analysis; Segawa A and Kakinuma T contributed to manuscript writing and editing; Kakinuma T contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Both written and verbal informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiyuki Kakinuma, MD, PhD, Professor, Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811, Japan. tokakinuma@gmail.com
Received: November 20, 2025 Revised: December 19, 2025 Accepted: January 21, 2026 Published online: February 6, 2026 Processing time: 77 Days and 18.9 Hours
Abstract
BACKGROUND
Accurate preoperative assessment of physical function is vital for determining surgical indications and selecting appropriate procedures in older adults. In potentially malignant cases of giant ovarian tumors, tumor capsule intraoperative rupture can cause upstaging and increase malignant ovarian tumor recurrence risk; thus, avoiding it is essential.
CASE SUMMARY
An 81-year-old woman with a giant ovarian tumor underwent preoperative evaluation using the estimation of physiologic ability and surgical stress (E-PASS) scoring system and the FRAIL scale. Laparoscopy-assisted surgery was performed using the Aron alpha method, and postoperative management followed the enhanced recovery after surgery (ERAS) protocol, resulting in successful perioperative management without complications. The patient exhibited a 30 cm cystic mass in the ovary identified on abdominal computed tomography. Preoperative assessment using E-PASS and FRAIL Scale yielded a preoperative risk score, surgical stress score, and comprehensive risk score of 0.49, 0.41, and 0.53, respectively, corresponding to a 4.2% in-hospital mortality rate. The FRAIL scale indicated a state of frailty. Following an anesthesiology consultation on the overall condition and surgical feasibility, the Aron alpha method was performed. Postoperatively, ERAS-based management was implemented, and the patient was discharged on postoperative day 5. Activities of daily living or cognitive function remained unchanged.
CONCLUSION
Detailed preoperative evaluation and the Aron alpha method could assist older women with giant ovarian tumors, with suspected malignancy.
Core Tip: When planning surgical treatment for elderly patients, their overall health and postoperative risks must be appropriately assessed using the estimation of physiologic ability and surgical stress scoring system and the FRAIL scale. Accordingly, the treatment plan and perioperative management may be implemented using the enhanced recovery after surgery protocol. Furthermore, the Aron alpha method for giant ovarian tumors enables minimal invasive surgery without leaking the ovarian tumor contents into the abdominal cavity. This surgical technique helps elderly patients with giant ovarian tumors of uncertain malignancy.
