Massive ovarian oedema

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

It characteristically presents in young women ~ 6 to 33 years (mean age ~21 years 4).

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

  • Meig syndrome
  • precocious puberty in infants due to MOO has been described in the literature 4 

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. As MOO is caused by chronic or intermittent torsion, imaging appearances will have some overlap with those of ovarian torsion

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

MRI may also demonstrate an enlarged ovarian mass like lesion. Described signal characteristics include 4 :

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

Management options include oophoropexy and occasionally oophorectomy is also considered.

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

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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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