Ovarian torsion in early pregnancy

Discussion:

Ultrasound features are consistent with left paraovarian cyst with acute left ovarian torsion and coexisting gravid uterus with normal early pregnancy of 8 weeks. Acute ovarian torsion is a gynecological emergency and should be excluded on ultrasound. Ovarian torsion during pregnancy is an uncommon complication with high fetal mortality if not immediately treated. It commonly occurs between the 6th and 14th weeks of pregnancy 1. It usually occurs due to enlarged corpus luteum cyst. 

In this case, the cyst arises near the left ovarian pedicle suggestive of paraovarian cyst. Paraovarian cysts account for ~10-20% of adnexal masses and can be complicated by rupture, torsion, or hemorrhage.  

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