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Case Reports
. 2025 Jul 23;17(7):e88608.
doi: 10.7759/cureus.88608. eCollection 2025 Jul.

Ovarian Torsion in Patients With Polycystic Ovary Syndrome Without Ovulation Induction or an Adnexal Mass: A Report of Two Cases

Abbas Abuelhassan  1
Affiliations
Case Reports

Ovarian Torsion in Patients With Polycystic Ovary Syndrome Without Ovulation Induction or an Adnexal Mass: A Report of Two Cases

Abbas Abuelhassan. Cureus. .

Abstract

Ovarian torsion is a gynaecological emergency, often linked with adnexal masses or cysts. Nonetheless, emerging reports indicate that torsion may also occur in polycystic ovary syndrome (PCOS), even in the absence of overt structural abnormalities. We present two cases of ovarian torsion in women with PCOS, neither of whom had large cysts, masses, or prior ovulation induction. These cases emphasize the need for heightened clinical suspicion when evaluating lower abdominal pain in PCOS patients. Incorporating imaging findings, surgical interventions, and a review of current literature, we aim to reinforce awareness of this uncommon but critical scenario.

Keywords: anovulation; diagnostic laparoscopy; ovarian cyst torsion; ovarian detorsion; polycystic ovary syndrome (pcos).

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. TVUS showing an enlarged right ovary (approximately 7-8 cm, arrow) with peripheral follicles and increased stromal echogenicity.
TVUS, Transvaginal ultrasound
Figure 2
Figure 2. Laparoscopy confirming right ovarian torsion with three twists (arrow).
Figure 3
Figure 3. Detorsion is performed as indicated by the arrow.
Figure 4
Figure 4. Ovarian ligament is shortened using 2-0 Vicryl suture to reduce the risk of future ovarian torsion (arrow).
Figure 5
Figure 5. TVUS showing a right ovary measuring 60 mL with classic PCOS morphology: peripherally arranged follicles (arrow).
TVUS, Transvaginal ultrasound; PCOS, Polycystic ovary syndrome
Figure 6
Figure 6. Diagnostic laparoscopy revealing a torted right ovary with no overt cysts or masses (arrow).
Figure 7
Figure 7. The ovary and tube are viable and successfully detorted (arrow).
See this image and copyright information in PMC

References

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