Torsion of Serous Cystadenoma - A Rare Entity

Dr. Pooja G, Dr. Aparna Nair

Abstract: Aim and Background: Ovarian torsion is a surgical emergency, accounting for 2.7 % of acute gynaecological complaints. Torsion is a complication of ovarian tumors, with an incidence 6.9 % of all ovarian tumors, with an average patient age of 29.8, that occurs more commonly in pregnant than non pregnant women with ovarian tumors. Benign ovarian neoplasms are 12.9 times more likely to undergo torsion-possibly related to the tendency of malignancies to adhere to local structures (1). Case Description: A 44 year old P2L2 with complaints of sudden onset of pain abdomen since 30 minutes, multiple episodes of vomiting and with one syncopal attack. On examination vitals were stable. PA-Abdominal mass corresponding to 30-32 weeks of gravid uterus, cystic in nature, all borders felt, guarding+, rigidity+, tenderness + PS- Cervix, Vagina healthy. PV- Uterine size couldn?t be made out, cystic mass corresponding to 30-32 weeks size of a gravid uterus felt in b/l and posterior fornices, tenderness. MRI scan- Right adnexal cyst measuring 24*20*12 cm suggestive of Right simple ovarian cyst. Patient underwent Emergency Exploratory Laparotomy and Right ovarian cyst of 20*25 cm with 1 torsion noted, 2 litres of haemorrhage fluid drained. Left ovary and uterus were normal. Patient underwent Right salphingooophorectomy. Frozen section of the cyst was negative for malignancy. Conclusion: Torsion of a large benign ovarian cyst is very rare. The key to effective management is an accurate diagnosis and consideration of the age of the patient. An attempt to save the Ovarian tissue in young females should be made. However, oophorectomy is the surgery of choice in older females whose family is completed. Clinical Significance: Ovarian torsion occurs more commonly in benign lesions of 4-8cm (2). However, torsion in such huge cyst of 24*20*12 cm is highly unlikely which makes this case a rare entity.

Keywords: Ovarian Torsion, Surgical Emergency, Benign Ovarian neoplasms, Abdominal mass, Exploratory laparotomy, Salphingo oopharectomy

How to Cite?: Dr. Pooja G, Dr. Aparna Nair, "Torsion of Serous Cystadenoma - A Rare Entity", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 269-270, https://www.ijsr.net/getabstract.php?paperid=SR26203205846, DOI: https://dx.doi.org/10.21275/SR26203205846