Massive ovarian oedema

Massive ovarian oedema (MOO) is a very rare disease characterized by a tumour-like enlargement of the ovary. 

It characteristically presents in young women ~ 6 to 33 years (mean age ~21 years 5).

Most patients present with intermittent pelvic pain of several months duration +/- an adnexal mass. Abnormal uterine bleeding, elevated androgens and abdominal distension can be occasionally seen

The most probable cause is thought to be recurrent partial torsion of the mesovarium, with obstruction to the venous and lymphatic returns; on the other hand, the basic process may be stromal hyperplasia or hyperthecosis, while the oedema is a secondary phenomenon, probably due to torsion of an abnormal, already enlarged organ.

Associations
  • Meig syndrome
  • precocious puberty in infants due to MOO has been described in the literature 5 
Location - laterality

It is almost always unilateral and in ~ 2/3rd of cases involve the right side

The imaging features correspond to the degree of torsion and oedema.

Ultrasound

May appear like a hypoechoeic, hypovascular solid ovarian mass like lesion; there is presence of central increased ovarian stroma and there are multiple follicles arranged in the peripheral cortex.

Pelvic MRI

MRI may also demonstrate an enlarged ovarian mass like lesion.

Described signal characteristics include 5

  • T1: hypointense
  • T2: hyperintense
  • T1 C+ (Gd): may show enhancement 

The term massive ovarian oedema was first described by Kalstone in 1969.

Management options include oophoropexy and occasionally oophorectomy is also considered.

See also
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Article Information

rID: 15396
System: Gynaecology
Tag: cases
Synonyms or Alternate Spellings:
  • Massive ovarian oedema (MOO)
  • Massive ovarian edema
  • Massive edema of the ovary
  • Massive ovarian edema (MOE)

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