Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman: A case report
- Abstract
- Rationale: Adnexal torsion is 1 of the most common emergency gynecological disease. It is more often diagnosed in reproductive
age, but rarely in postmenopausal women. The clinical symptoms of adnexal torsion are nonspecific in postmenopausal women.
Epithelial ovarian tumors are common in adults, and the risk of malignancy increases with age, especially after menopause. So, it is
difficult to diagnose adnexal torsion precisely compared with reproductive women, and most cases of adnexal torsion with
postmenopausal women are diagnosed as a malignancy preoperatively. We report a case of ovarian torsion with mixed epithelial
tumor misdiagnosed as a malignancy in postmenopausal woman.
Patient concerns: A 65-year-old woman presented lower left abdominal pain, and there was slight abdominal distension, but no
tenderness or rebound tenderness on abdominal palpation.
Diagnoses: Radiologic assessments showed a huge multiseptated cystic mass with solid portion in the left ovary, and malignancy
was suspected. The test for serum tumor markers revealed normal levels of cancer antigen 125 (CA-125).
Interventions: The patient underwent a laparotomy and there was torsion of the left ovary. We conducted frozen biopsy of left
ovary for confirming malignancy before performing staging surgery.
Outcomes: The result of a frozen section biopsy confirmed a borderline Brenner tumor associated with a benign mucinous tumor.
Subsequently, total hysterectomy and right salpingo-oophorectomy were performed. The operation was completed without addition
procedures
Lessons: Ovarian torsion is benign in most cases and malignancy is rare. Although very rare, ovarian torsion can occur in
postmenopausal women, and it should be taken into consideration that the possibility of malignancy is low in postmenopausal
women with normal CA-125 levels. Instead of performing staging surgery, it appears to be appropriate to carry out surgery based on
the result of intraoperative frozen section biopsy so that we were able to avoid unnecessary surgical procedures.
- All Author(s)
- H. Jeon
; A. Ryu
; H. G. Seo
; S. H. Jang
- Issued Date
- 2017
- Type
- Article
- Keyword
- adnexal torsion in postmenopausal women; mixed ovarian tumor
- Publisher
- Lippincott Williams & Wilkins
- ISSN
- 0025-7974
; 1536-5964
- Citation Title
- Medicine
- Citation Volume
- 96
- Citation Number
- 40
- Citation Start Page
- e8207
- Citation End Page
- e8207
- Language(ISO)
- eng
- DOI
- 10.1097/md.0000000000008207
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2437
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