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Postmenopausal adnexal torsion: rare case report
Ibrahim A Abdelazim1,2, Mohannad AbuFaza2, Yerbol Bekmukhambetov3
1Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
Przeglad Menopauzalny = Menopause Review
|July 24, 2020
Summary
Adnexal torsion, though rare in postmenopausal women, can occur at any age. Ovarian cysts increase the risk of this condition, necessitating prompt diagnosis and treatment.
Area of Science:
- Gynecology
- Reproductive Medicine
- Surgical Oncology
Background:
- Adnexal torsion is most common in reproductive-aged women.
- It is characterized by the twisting of the ovary and/or fallopian tube, compromising blood supply.
- Ovarian masses and cysts are known risk factors.
Observation:
- A 49-year-old postmenopausal woman presented with abdominal pain and a palpable pelvi-abdominal mass.
- Ultrasound and MRI revealed a large right adnexal cyst (15x12 cm) with a 'stained glass appearance', suggestive of mucinous cystadenoma.
- Exploratory laparotomy confirmed adnexal torsion of the right ovary and cyst.
Findings:
- Histological examination confirmed the diagnosis of mucinous cystadenoma.
- The patient underwent successful adnexectomy.
- This case highlights a rare instance of adnexal torsion in a postmenopausal woman.
Implications:
- Adnexal torsion should be considered in postmenopausal women presenting with abdominal pain and ovarian masses.
- The presence of ovarian cysts or masses is a significant risk factor for torsion, regardless of age.
- Early recognition and surgical intervention are crucial for managing adnexal torsion to preserve ovarian viability when possible and prevent complications.
