A case of fallopian tubal torsion caused by an endometriotic cyst growing in the fallopian tube, which was difficult to diagnose

Abstract

　Tubal torsion is a rare disease. We report a case of fallopian tubal torsion caused by an endometriotic cyst growing in the fallopian tube, which was difficult to diagnose. The patient was 14 years old and had never had sexual intercourse. She presented to her primary care physician with sudden onset of abdominal pain, and a right-sided functional ovarian cyst was suspected based on transabdominal ultrasonography and computed tomography. She was referred to our outpatient clinic for surgery. Contrast-enhanced pelvic magnetic resonance imaging (MRI) revealed a 10-cm tumor on the right side of the uterus, which was suspected to be a right ovarian hemorrhagic cyst or right ovarian cyst stalk torsion. One month after the onset of symptoms, the patient was prepared for laparoscopic ovarian cyst enucleation for right ovarian cyst torsion as a standby procedure. There were extensive adhesions in the peritoneal cavity due to inflammation. After removing the adhesions and exposing the tumor, the epidermis was incised and the cyst was enucleated. The cyst ruptured during the procedure. The fluid was dark red and serous. Further dissection of the adhesion revealed a normal right ovary. The enlarged mass was diagnosed as a tumor of the twisted right fallopian tube. The right ovary was preserved and the right fallopian tube was removed. Final pathology revealed that the tumor in the right fallopian tube was an endometriotic cyst. The patient had a good postoperative course.