Laparoscopic surgery for massive ovarian edema during pregnancy: A case report

Abstract

Massive ovarian edema (MOE) is a rare non-neoplastic clinicopathologic disease that is characterized by stromal edema and is caused by the partial or intermittent obstruction of venous and lymphatic drainage. The literature on MOE contains approximately 200 cases, but only 12 cases of MOE during pregnancy have been reported to date. We report a case of MOE at 22 weeks of gestation that was diagnosed preoperatively, and the patient underwent laparoscopic surgery. Accurate preoperative diagnosis of MOE is important because it enables the selection of a therapeutic option, such as fundamental surgery, including adnexectomy; conservative surgery, including the release of torsion and ovarian biopsy; and conservative treatment without surgery. MOE should be considered as a differential diagnosis for an enlarged ovary during pregnancy. Laparoscopic surgery may be a useful therapeutic option for MOE, especially during pregnancy.

Keywords: Laparoscopic surgery; Massive ovarian edema; Pregnancy.

Fig. 1

Transabdominal ultrasonography revealed a non-homogeneous low-echoic mass in the right adnexal region.

Fig. 2

Magnetic resonance imaging (Left; T2-weighted image/sagittal, Right; T1-weighted image/axial). Multiple ovarian follicles were noted in the periphery of the mass on the T2-weighted image.

Fig. 3

Trocar position. Two trocars were inserted through the left side to handle the right ovarian mass.

Fig. 4

Microscopic finding (hematoxylin and eosin, ×100). Edematous stroma is shown.