Massive ovarian edema

Case contributed by Ammar Haouimi
Diagnosis probable

Presentation

Intermittent right lower abdominal pain.

Patient Data

Age: 17 years
Gender: Female
mri

The right ovary is enlarged measuring (8.5 x 7 x 5.5 cm) of low signal on T1, high signal on T2 with multiple follicles arranged mainly in the peripheral cortex. The post contrast sequences demonstrate a peripheral enhancement of the ovary and follicles. No evidence of twisted ovarian pedicle or whirlpool appearance is seen.

Normal appearance of the left ovary containing small follicles.

Normal size and shape of the uterus.

Case Discussion

Massive ovarian edema (MOO) is a very rare disease, usually unilateral, and in approximately two-thirds of cases involve the right side. Most patients present with intermittent pelvic pain of several months duration. The most probable cause is thought to be recurrent partial torsion of the mesovarium, with obstruction to the venous and lymphatic returns.

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