Case of the Week #530

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Dr. P. Turnova, Dr. K. Biringer, Dr. N. Visnovcova, Dr. M. Zibolen

January 21st, 2021 - February 11th, 2021

Dr. P. Turnova; Dr. K. Biringer - Department of Obstetrics and Gynecology, Martin University Hospital , Slovakia

Dr. N. Visnovcova - Department of Pediatric Surgery, Martin University Hospital , Slovakia

Dr. M. Zibolen - Department of Neonatology, Martin University Hospital, Slovakia

Email: petraturnova@hotmail.com

A 31-year-old G2P1 was referred to our department at 37 weeks of her pregnancy due to a cystic abdominal mass. Her previous ultrasonographic examinations at 12 , 20 and 30 weeks were reported to be normal, and the course of the pregnancy was uneventful. What is the diagnosis?

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Image 1: 2D scan of the fetal abdomen, 37 weeks of pregnancy
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Image 2: 2D scan of the fetal abdomen, 37 weeks of pregnancy
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Image 3: 2D scan of the fetal abdomen, 37 weeks of pregnancy
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Answer

Our ultrasound examination revealed a heterogeneus mass located in the left side of the pelvis and abdomen suggestive of ovarian cyst hemorrhage and torsion. The fetus had no tachycardia and MCA PSV was normal. The baby was born at 38 weeks of pregnancy. The surgery was performed at 5 days and the diagnosis of ovarian cyst torsion was confirmed.

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Image 4: postnatal surgery showing a brown cystic mass with twisted peduncle and peri-cystic adhesions. The left ovary and the tube were necrotic and were removed.
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Image 5: postnatal surgery showing a brown cystic mass with twisted peduncle and peri-cystic adhesions. The left ovary and the tube were necrotic and were removed.

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