Laparoscopy ıs a defınıtıve dıagnostıc method for auto-amputated ovary ın ınfants

A Case of Spontaneous Autoamputation of Ovary in a 46-Year-Old Woman: An Uncommon Presentation (Painless Ovarian Torsion) with Unique Diagnostic and Therapeutic Challenges

This article presents a case of spontaneous autoamputation of ovary in a 46-year-old nulligravid woman with a history of rheumatoid arthritis and hypertension, who presented with secondary amenorrhea and white vaginal discharge. Despite an initial diagnosis of dermoid cyst based on ultrasound findings, subsequent laparoscopic surgery revealed a necrotized oval-shaped mass in the cul-de-sac, which was identified as the right ovary that had undergone torsion and autoamputation. This case highlights the diagnostic and therapeutic challenges associated with this uncommon presentation, which may be easily misdiagnosed. Clinicians should consider spontaneous autoamputation of ovary as a potential differential diagnosis in women presenting with adnexal masses, even if there is no prior history of abdominal pain.

Preservation of ovarian tissue embedded in omentum following torsion and auto-amputation of the left ovary and fallopian tube in a 14-year-old girl: A case report

INTRODUCTION

Autoamputation of the ovary and fallopian tube is a scarce phenomenon particularly in adolescents but could adversely affect fertility by causing ovarian damage and loss of tubal function.

CASE PRESENTATION

A case of autoamputation of the left adnexa as a result of chronic torsion in the setting of an ovarian dermoid cyst in an adolescent girl is presented. The patient had also a large dermoid cyst in the contralateral ovary which was in danger of another torsion and loss of ovarian reserve and tube. Her left fallopian tube was absent and left ovary was embedded in the omentum. She was successfully managed through laparoscopic surgery. Bilateral cystectomy was performed and the ectopic ovarian tissue was saved.

CLINICAL DISCUSSION

Chronic torsion sometimes results in ectopic displacement of the affected ovary. While some patients may be asymptomatic, many of these cases express episodes of acute or chronic abdominopelvic pain. Hence, a prolonged pain or discomfort, even of low intensity, should not be overlooked particularly in younger patients with bilateral ovarian cysts.

CONCLUSION

Ovarian dermoid cysts in adolescents could possibly undergo chronic torsion resulting in autoamputation of the adnexa and ectopic displacement of the ovary. With prompt diagnosis and intervention, ovarian tissue and fertility could be preserved.