Massive Edema of the Ovary: A Case Report and Review of the Pertinent Literature

Lara‐Torre, Eduardo; Geist, Ruth R.; Rabinowitz, Ron; Zuckerman, Boris; Shen, O.; Reinus, Constantin; Beller, U.

doi:10.1016/j.jpag.2005.05.008

Cited by 25 publications

(13 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It mainly resulted from partial or intermittent torsion of the ovary with obstruction of venous and lymphatic drainage. MOE is a rare disease and few reports have demonstrated magnetic resonance (MR) findings of MOE in pregnancy (Kalstone et al 1969; Geist et al 2005; Hall et al 1993; Gustafson et al 1954; Chervenak et al 1980; Weinreb et al 1986; Lambert and Lessard 1987; Schmidt et al 2007; Coakley et al 2010). We report here a case of MOE in a patient at 12 weeks’ gestation.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management

et al. 2016

View full text Add to dashboard Cite

IntroductionMassive ovarian edema (MOE) is a rare disease and few reports have described the magnetic resonance (MR) imaging manifestations in pregnancy.Case descriptionWe report here a case of MOE in a patient at 12 weeks’ gestation. Abdominal T2-weighted MR images showed asymmetric ovarian enlargement in a teardrop configuration, hyperintense peripherally displaced follicles, and twisting of the vascular pedicle between the enlarged ovary and uterus. The diagnosis of MOE due to ovarian torsion was confirmed by exploratory laparotomy. Preoperative imaging, especially the MR imaging could distinguish MOE from other conditions and demonstrate the relations of adjunct organ, and allowed for untwisting during laparotomy with successful preservation of the ovary.Discussion and evaluationUltrasonography is important in detecting, evaluating, and determining the malignant potential of adnexal masses in pregnancy, but its findings may be nonspecific and then MR may assist characterization. This case was tentatively diagnosed as typical MOE by preoperative imaging, but the shape and location of the hugely enlarged ovarian mass suggested torsion of the ovarian pedicle. In our case, the diagnosis was confirmed by exploratory laparotomy and the pedicle was successfully untwisted.ConclusionMR imaging proved useful for decisions on expectant management of MOE in pregnancy, and the patient’s affected ovary could be preserved.

show abstract

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Data supporting conservative treatment in massive ovarian oedema advocate a strong degree of clinical suspicion when women in the reproductive age group present with painful abdomen, radiological evidence of multiple peripheral ovarian follicles in a solid ovarian tumour-like mass and normal biochemical tumour markers. Definitive surgical treatment should be undertaken only after confirmed pathological diagnosis [8, 28]. The role of frozen section needs to be emphasised in preventing unnecessary catastrophic reproductive outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The most common presenting symptoms are pain, distension or mass in the abdomen, infertility, and in some cases irregular vaginal bleeding [2–7]. The masculinisation features are frequently seen in many adult cases, and rarely a small number of cases are known to present with precocious puberty [3, 8–10]. There are at least two types of massive ovarian oedema: primary, without concomitant pathology, and secondary, superimposed on already altered ovaries [11].…”

Section: Introductionmentioning

confidence: 99%

“…There are at least two types of massive ovarian oedema: primary, without concomitant pathology, and secondary, superimposed on already altered ovaries [11]. The most favoured hypothesis for the aetiology is the development of massive oedema as a result of the disturbed venous and lymphatic circulation following complete or partial torsion of the mesovary, but not the arterial blood flow [2–6, 8–10]. As a result, there is stromal cell luteinisation in the oedematous ovary, occurring as a response to torsion and subsequent ischaemia.…”

Section: Introductionmentioning

confidence: 99%

“…As a result, there is stromal cell luteinisation in the oedematous ovary, occurring as a response to torsion and subsequent ischaemia. The stromal cells have positive oestrogen progesterone receptors and may undergo stimulatory changes responsible for the hormonally related symptoms often found associated with massive ovarian oedema [3, 4, 8–10]. Derangement of a local paracrine factor, such as insulin-like growth factor, epidermal growth factor, or cytokines, was an alternate explanation proposed by Eden et al [9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

ecancermedicalscience

Ramar

Pallavi²,

Rajashekar³

et al.

View full text Add to dashboard Cite

Objective:Benign massive ovarian oedema is a rare clinical entity arising from the ovaries, and it poses a significant clinical challenge as it can be easily mistaken for neoplasm. Due to the lack of pathognomonic clinical features or characteristic hallmarks on non-invasive diagnostic modalities and the dependence on the final histopathology, the efforts of the surgeon have been deviated from performing fertility-sparing surgery on young women. The lack of standardised guidelines due to the rarity of this condition calls for a review of the literature to enable the clinician to formulate treatment guidelines.Methods and Material:A Medline search on the PubMed database for literature published in English from 1969 to 2011 was done using the keywords ‘massive ovarian oedema, massive ovarian oedema case report or case series, and pseudotumour of ovary’. A total of 177 women who had undergone a variety of treatments were retrieved. We also report the management options we used for four women presenting to us between August 2000 and October 2011, as well as a review of the literature.Result:A total of 177 cases of massive ovarian oedema were identified. Out of these cases 151 (85.3%) were primary massive ovarian oedema; secondary massive ovarian oedema was identified in 26 (14.7%) cases. A salpingo-oophorectomy was done in 145 (81.9%) cases, 12 (6.8%) cases had an abdominal hysterectomy with bilateral salpingo-oophorectomy. A total of 76 (42.9%) cases intraoperatively were found to have ovarian torsions, and one patient with primary massive ovarian oedema had ascites. Conservative treatment was carried out in 20 (11.3%) patients; 14 of these had a wedge biopsy with frozen section and with or without ovarian suspension, one patient had diagnostic laparotomy, and five cases had only ultrasonographic or magnetic resonance imaging monitoring and symptomatic treatment. The four cases treated at the regional cancer institute from 2000 to 2011 revealed that the first three cases had salpingo-oophorectomy and the fourth case received a successful conservative treatment.Conclusion:The majority of massive ovarian oedemas will respond to judicious use of intraoperative wedge resection and frozen section for the confirmation of diagnosis. The detorsion and transfixation of the ovary or partial debulking and drainage of fluid accumulated in the cyst may be more appropriate to preserve hormonal function and fertility in these young women.

show abstract

Massive ovarian oedema: An unusual abdominal mass in infancy

Moon¹,

Mears²,

Kitteringham³

et al. 2009

Pediatric Blood & Cancer

View full text Add to dashboard Cite

We describe a 13-month-old female who presented with vaginal bleeding, breast and pubic hair development and an abdominal mass. She underwent emergency laparotomy and left-sided salpingoophorectomy. Histological examination of the resected ovary revealed massive ovarian oedema, a rare non-neoplastic enlargement of the ovary. Consideration of this diagnosis in patients with an abdominal mass and endocrine disturbance may allow conservative surgery and preservation of fertility.

show abstract

Massive Edema of the Ovary: A Case Report and Review of the Pertinent Literature

Cited by 25 publications

References 7 publications

Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management

Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management

ecancermedicalscience

Massive ovarian oedema: An unusual abdominal mass in infancy

Contact Info

Product

Resources

About