Presentation
Right upper quadrant pain for 3 days.
Patient Data
There is an oval, enhancing soft tissue mass containing multiple cysts in the right upper quadrant. The mass abuts the inferior aspect of hepatic segment 6; it does not arise from either the liver or the right kidney. The artery and vein to the mass appear to arise from the aorta and inferior vena cava, respectively.
The uterus is surgically absent. In the right pelvis, no right ovary is identified. A left ovary is present with multiple follicles.
There is an oval soft tissue mass containing multiple cysts in the right upper quadrant. The cysts are T1-weighted hypointense and T2-weighted hyperintense. On the axial series, one of the cysts appears partially collapsed and its walls are hyperenhancing.
On the coronal series, the uterus is surgically absent and a left ovary is present.
Case Discussion
The case is most suggestive of an acquired ectopic ovary. The ovary is noted to be on a long vascular pedicle and is therefore potentially at increased risk for ovarian torsion.
Three months prior to this presentation, the patient underwent a hysterectomy. Normal ovaries were identified intraoperatively. This case may represent a right ovary that became mobile following hysterectomy, suggestive of an iatrogenic "wandering ovary".
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