Abstract
Abstract: When a young woman with primary amenorrhea, complains about acute lower abdomen pain, we initially suspect hematometra by atresia-hymenalis, aplasia of vagina and others.
We report an extremely rare case of ovarian tumor torsion with primary amenorrhea, initially diagnosed as hematometra, because it presented image finding closely resembling with hematometra.
Case Report: A 21-years-olds single woman was introduced to our department, to consult about acute lower abdominal pain. She had no menarche yet and no intercourse. She has no abnormal history such as severe weight control, hard exercise, anosmia and anorexia. In the internal examination, aplasia of vagina and atresia-hymenalis was ruled out. By the image diagnosis and her history as primary amenorrhea, we made the clinical diagnosis as hematometra in the cause of uterus cervical canal stenosis. We made dilatation of cervical canal and drainage of hematometra by trans- vaginal approach. However, bloody fluid was not aspirated and we decided on laparoscopy. Laparoscopy led to the definite diagnosis, which was the torsion of left ovarian tumor. We performed laparoscopic left salpingo- oophorectomy. The uterus was atrophic, but the right ovary was almost normal and it had many antral follicles. Pathological finding revealed that the left ovarian tumor consisted of serous cyst adenoma, and there were strong hemorrhage and hematoma in the cyst compartment and also ovarian cortex. After laparoscopy, hormonal examination was performed. The cause of primary amenorrhea was seemed to be pituitary amenorrhea. By the hormone replacement therapy by estrogen and progesterone, she had menarche.
