Massive ovarian edema

Case contributed by Tamer O. Abdo
Diagnosis almost certain

Presentation

Intermittent pelvic pain

Patient Data

Age: 25 years
Gender: Female

Pelvis MRI with contrast

mri

The right ovary is significantly enlarged in size and edematous with multiple small peripherally arranged follicles. Corpus luteum measuring about 2 x 1.4 cm with enhancing wall is seen in the right ovary. The mentioned follicles showed enhancing wall. The vascular pedicle of the right ovary appears enhancing and patent with no signs of torsion in this study.

Mild free fluid is seen in the pelvis.

The left ovary is mildly enlarged in size containing multiple small follicles, but no masses or edema.

No ovarian masses or large cysts. No pelvic masses or enlarged lymph nodes. 

Arcuate uterus (normal variant). Othewise, the uterus appears normal in size, shape and signal intensity without evidence of focal lesion. The endometrium is well distinct appearing normal.

Case Discussion

Massive ovarian edema is a rare benign condition that predominantly affects childbearing women as well as preadolescent girls. It is thought to result from intermittent or partial torsion of the ovary compromising the venous and lymphatic drainage but with preserved arterial supply. The clinical features of massive ovarian edema are nonspecific and can simulate tumors, leading to unnecessary oophorectomy.

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