Conservative laparoscopic management of ovarian teratoma torsion in a young woman

Abstract

Benign cystic tumors, specifically dermoid or mucinous cysts, are the most frequent causes of ovarian torsion. In clinical practice, adnexal torsion is usually subjected to adnexectomy to prevent embolism of thrombosed ovarian veins and its sequelae. However, this intervention is unsatisfactory for young women who want to preserve their fertility. In such situations, conservative management with untwisting of the adnexa, followed by cystectomy to preserve part of the ovary, would be a better option. In this report, we present a case of adnexal torsion due to cystic teratoma. A 25-year-old unmarried woman with lower abdominal pain and nausea was referred to our emergency room with suspicion of an ovarian mass. Ultrasonography showed a left ovarian mass measuring 9.7 x 6.5 x 6.2 cm with heterogeneous components within it. Laparoscopy showed an enlarged, dusky left ovary with torsion. Detorsion was performed and followed by cystectomy. The pathology revealed cystic teratoma of the ovary. We report this case to emphasize that untwisting of potentially viable adnexa, followed by cystectomy, in patients with adnexal torsion appears to be a safe procedure. This conservative approach should be encouraged in women of childbearing age to reduce the possibility of premenopausal loss of ovarian function.