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A 75-year-old Korean woman, para 4, whose menopause had occured at 50, was admitted to Sacred Heart Hospital on May 25, 1970, because of progressive lower abdominal distension, child head sized palpable. mass, frequent urination, constipation, rough deeper as male voice and lower abdominal discomfortness of two months duration. On the admission, her pulse rate was 98; her blood pressure, 160/105; and respiration, 28 the lungs were clear with decreased sounds in both bases. Heart sounds were normal. There was an atrophic, clean cervix with a small uterus bushed laterally by a child head sized, cystic, smooth mass occupying the entire pelvis and lower abdomen which reached just below the umbilicus but clitoris was not so atrophic inspite of her age. Marked rough and deeper as male voice and atrophic breasts were evident. The hematocrit was 38, and the white blood cell count was normal. The patient`s urinalysis, liver function test, and biochemical profile were also normal. A lower median incision was made, and numerous fine adhesion between the parietal peritoneum and the cyst wall were freed easily by blunt dissection. The cyst was found to arise from the right ovary with the descending colon and ileum as well as the right uterus firmly adherent to it. The left ovary was atrophic. An egg sized round, hard mass was found on the mid ileum which should be metastasized from the ovary. The cyst was then removed with some difficulty, and a radical hysterectomy and segmental resection of ileum were performed. Post operatively, the patient did well except for one episode of urticarial reaction which lasting for a few hours. The patient left the hospital in good health on the 20th post operative day. The ovarian tumor had central necrosis. Histologic sections revealed the ovarian cyst and a tumor of ileum to be a intermediate type of arrhenoblastoma.
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