Presentation
Acute onset lower abdominal and pelvic pain associated with nausea and vomiting.
Patient Data
A large right adnexal well-defined hyperechoic mass lesion measuring about (7.6 x 6.2 cm), showing internal calcification with posterior acoustic shadowing in keeping with dermoid cyst. The right ovary is stretched and displaced by the mass lesion. It appears markedly enlarged in size with edematous heterogenous parenchyma. No appreciable internal vascularity on Doppler study. There is adjacent mild pelvic free fluid, features suggestive of ovarian torsion.
The diagnosis confirmed by exploratory laparotomy with right ovarian cystectomy. Histopathology revealed mature cystic ovarian teratoma.
Case Discussion
Ovarian torsion accounts for 2-3% of all gynecologic emergencies. The most common cause of ovarian torsion is ovarian/adnexal mass. The most common mass is terato-dermoid lesions with increased probability of torsion when the mass lesion exceeds 5 cm.
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