Introduction: Ovary is located inside peritoneal cavity. However, a huge malignant ovarian tumor may get involved with retroperitoneal structures.
Case report: We reported a case of a 70-year-old woman presented with a 2-month history of increased abdominal distention and was subsequently found to have a giant abdominal mass. A huge low signal intensity mass with the involvement of retroperitoneal structures was showed on MRI. At operation, we found that the tumor pushed mesentery and small bowel upwards with the encasement of 10 cm jejunum and was fixed posteriorly to vena cava, aorta, right iliac vessels, and right ureter. It was dissected from the retroperitoneal structures and resected en bloc with the involved jejunum.
Conclusion: Although ovary is located inside peritoneal cavity, a huge malignant ovarian tumor may get involved with retroperitoneal structures. So, great care should be taken not to injury the retroperitoneal structures as vena cava, mesenteric vessels, iliac vessels, and ureters.