Laparoscopic Detorsion of Twisted Ovary in a Nulliparous Woman with a Recurrent, Bilateral Mature Cystic Teratoma

摘要

Background: Ovarian mature cystic teratomas are common, benign, pelvic tumors easily detected by ultrasonography. These tumors are bilateral in 8% to 15%, and recurrent teratomas are uncommon and underdiagnosed. A benign dermoid cyst is the most common ovarian mass to develop torsion. Although uncommon, adnexal torsions are an important cause of gynecological emergencies. It was previously thought that untwisting the adnexa could result in an embolus from thrombosed veins but this has proved untrue. Currently, it is considered that laparoscopic conservative management by untwisting the ovary allows recovery of almost all cases, even when the ovaries seem nonviable. Case: This article presents a case of an ovarian torsion in a 23-year-old nulliparous woman referred to our emergency room because of acute right iliac fossa pain. Ultrasound showed a complex right adnexal mass 60 x 60 mm. Three years earlier she had undergone, in an urgent context, a left adnexectomy and a right cystectomy for bilateral teratoma and torsion of the left ovary. We decided on a conservative laparoscopic approach with adnexal detorsion.