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The patient underwent laparotomy, with the caudal mass left in situ within the pelvis. She subsequently had a regular obstetric follow-up and an elective caesarean delivery, resulting in an excellent maternal and neonatal outcome.<\/jats:p>\n                  <jats:p>In cases of large symptomatic masses during pregnancy, comprehensive evaluation using bimanual examination and safe imaging modalities, such as ultrasound and non-contrast MRI, is essential. Surgical management should be considered only in the presence of oncological suspicion or clinical complications, always aiming to preserve pregnancy and avoid overtreatment. The mode of delivery should depend on the size, number and anatomical location of uterine masses.<\/jats:p>","DOI":"10.1136\/bcr-2024-264323","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:55:26Z","timestamp":1770216926000},"page":"e264323","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of atypical complicated abdominal masses in the second trimester of pregnancy"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3486-2237","authenticated-orcid":false,"given":"Rosalba","family":"De Nola","sequence":"first","affiliation":[{"name":"Department of Biomedical and Human Oncological Science (D.I.M.O), Division of Obstetrics and Gynecology, Universit\u00e0 degli Studi di Bari Aldo Moro, Bari, Italy"},{"name":"Ginecologia ed Ostetricia, Ospedale \u201cDi Venere\u201d, ASL Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Bassi","sequence":"additional","affiliation":[{"name":"Ginecologia ed Ostetricia, Ospedale \u201cDi Venere\u201d, ASL Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cataldo","family":"Paletta","sequence":"additional","affiliation":[{"name":"Ginecologia ed Ostetricia, Ospedale \u201cDi Venere\u201d, ASL Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Vicino","sequence":"additional","affiliation":[{"name":"Ginecologia ed Ostetricia, Ospedale \u201cDi Venere\u201d, ASL Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"2026071910151228000_19.2.e264323.1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s00404-018-4948-5","article-title":"Use of pre-operative imaging for symptomatic uterine myomas during pregnancy: a case report and a systematic literature review","volume":"299","author":"Valenti","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"2026071910151228000_19.2.e264323.2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/01443615.2020.1734781","article-title":"Ovarian cysts in pregnancy: a narrative review","volume":"41","author":"Senarath","year":"2021","journal-title":"J Obstet Gynaecol"},{"key":"2026071910151228000_19.2.e264323.3","first-page":"69","article-title":"Ovarian cancer diagnosed during pregnancy: clinicopathological characteristics and management","volume":"35","author":"Grigoriadis","year":"2014","journal-title":"G Chir"},{"key":"2026071910151228000_19.2.e264323.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.amsu.2021.103007","article-title":"Case of suspected torsion and amputation of myoma during pregnancy","volume":"71","author":"Shin","year":"2021","journal-title":"Ann Med Surg"},{"key":"2026071910151228000_19.2.e264323.5","doi-asserted-by":"publisher","DOI":"10.1159\/000053903"},{"key":"2026071910151228000_19.2.e264323.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.12.008"},{"key":"2026071910151228000_19.2.e264323.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003295","article-title":"The diagnostic performance of CA125 for the detection of ovarian and non-ovarian cancer in primary care: A population-based cohort study","volume":"17","author":"Funston","year":"2020","journal-title":"PLoS Med"},{"key":"2026071910151228000_19.2.e264323.8","doi-asserted-by":"crossref","unstructured":"Augustin G . Degenerating uterine myomas. In: Augustin G , ed. Acute abdomen during pregnancy. 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