Ovarian Fibrothecoma: A Rare Cause of Ovarian Torsion in Postmenopausal Woman

Öz

Ovarian torsion is a common gynecological surgical emergency. It is usually associated with a cyst or a tumor, which is typically benign. The most common cause of ovarian torsion is mature cystic teratoma. We herein present an unusual case of torsion in the ovarian fibrothecoma. We report a case of ovarian torsion in a 47-year-old postmenopausal woman who came to the emergency department with acute abdominal pain. In this case report, we highlight Doppler ultrasonography and the magnetic resonance imaging features of ovarian torsion. She underwent an urgent surgery due to a torsion indicated. Total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed. The final pathologic diagnosis revealed torsion of left ovarian fibrothecoma. Ovarian fibrothecoma are usually asymptomatic. They can become symptomatic when they are torsed.

Key Words: Magnetic Resonance Imaging, Ovarian Fibrothecoma, Ovarian Torsion

 

Anahtar Kelimeler

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Ovarian Fibrotekoma: Postmenopozal Kadinda Over Torsiyonun Nadir Bir Nedeni

Öz

Over torsiyonu acil cerrahi müdahele gerektiren bir jinekolojik patolojidir. Genellikle benign over tümörleri ya da kistleri ile ilişkilidir. Over torsiyonunun en sık nedeni matür kistik teratomlardır. Biz burada overde fibrotekoması bulunan, akut karın ağrısı şikayeti ile acil servise başvuran ve over torsiyonu izlenen 47 yaşında postmenopozal dönemde olan nadir görülen bir vakayı sunduk. Bu vakada over torsiyonunun doppler ultrasonografi ve manyetik rezonans görüntüleme özelliklerini vurguladık. Hastamız over torsiyonuna bağlı olarak acil cerrahiye alındı. Total abdominal histerektomi ve biateral salpingooferektomi uygulandı. Patoloji sonucu fibrotekoma bulunan sol overde torsiyon olarak geldi.  Ovarien fibrotekomalar genellikle asemptomatiktirler. Torsiyone oldukları zaman bulgu verebilirler.  

Anahtar kelimeler: Manyetik Rezonans Görüntüleme, Ovarian Fibrotekoma, Over Torsiyonu

Anahtar Kelimeler

• Manyetik Rezonans Görüntüleme

Kaynakça

1. Andersson S, Mints M. Thermal balloon ablation for the treatment of menorrhagia in an outpatient setting. Acta Obstet Gynecol Scand 2007;86:480-483.
2. Gargano G, De Lena M, Zito F, Fanizza G, Mattioli V, Schit- tulli F. Ovarian fibroma: our experience of 34 cases. Eur J Gynecol Oncol 2003;24:429-432.
3. Chechia A, Attia L, Temime RB, Makhlouf T, Koubaa A. Incidence, clinical analysis, and management of ovarian fibromas and fibrothecomas. Am J Obstet Gynecol 2008;199:473:1-4.
4. Paladini D, Testa A, Van Holsbeke C, Mancarı R, Timmerman D , Valentin L. Imaging in gynecological disease: clinical and ultrasound characteristics in fibroma and fibrothecoma of the ovary. Ultrasound Obstet Gynecol 2009;34:188-195.
5. Sivanesaratnam V, Dutta R, Jayalakshmi P. Ovarian fibroma clinical and histopathological characteristics. Int J Gynecol Obstet 1990;33:243-247.
6. Shahla Y, Abolhasan A, Majid S, Zinatossadat B, Mohammad A, Faranak L, Mehdi M Meigs' syndrome with elevated serum CA125 in a case of ovarian fibroma /thecoma Caspian J Intern Med 2014;5(1):43–45.
7. Son CE, Choi JS, Lee JH, Jeon SW, Hong JH, Bae JW Laparoscopic surgical management and clinical characteristics of ovarian fibromas. JSLS 2011;15:16-20.
8. Leung SW, Yuen PM. Ovarian fibroma: a review on the clinical characteristics, diagnostic difficulties, and management options of 23 cases. Gynecol Obstet Invest 2006; 62:1-6.

9. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol 1985; 152:456-461.
10. Lin CK, Chu TW, Yu MH. Painless ovarian torsion mimicking a uterine myoma. Taiwan J Obstet Gynecol 2006;45(4):340-2.
11. Valsky DV, Esh-Broder E, Cohen SM, Lipschuetz M, Yagel S. Added value of the gray-scale whirlpool sign in the diagnosis of adnexal torsion. Ultrasound Obstet Gynecol 2010;36: 630-634.
12. Argenta PA, Yeagley TJ, Ott G, Sondheimer SJ. Torsion of the uterine adnexa: pathologic correlations and current management trends. Journal of Reproductive Medicine 2000;45:831–836.