A case of the parovarian cystic torsion with an ipsilateral ovarian cyst.

Abstract

Parovarian cysts account for about 10% of adnexal tumors and the frequency of torsion is considered to be about 5% of adnexal tumors. The unilateral torsion of an ovarian tumor in a case of bilateral ovarian tumors was diagnosed pre-operatively as torsion in a parovarian cyst coincident with an ipsilateral tumor of the left ovary. The patient, a 29 year old gravid 1, nulliparous woman with no remarkable Family History. She was diagnosed as having bilaterally enlarged ovaries two months earlier at a examination for a Pap smear for Cervical Cancer. A vaginal ultrasonography at this time revealed a mass which was 6.3×8.4cm and was highly serous in nature in the vesicouterine space, and a 8.3×9.3cm mass in the pouch of Douglas which was suspected as being a dermoid cyst. Evaluation of Tumor Marker were within normal. She experienced Acute Abdomen, and since we suspected torsion of an ovarian tumor, we performed an Emergency Laparoscopic Surgery. We found an 8cm parovarian cyst of the left ovary, twisted 540°counterclockwise. The left ovary was enlarged to about 9cm, but was not involved in the torsion. Histopathology showed (1) Left parovarian cyst with hemorrhage, (2) Focal hemorrhagic necrosis in the left salpinx, (3) Mature cystic teratoma in left ovary.