Risk analysis of torsion and malignancy for adnexal masses during pregnancy

Acute abdomen in early pregnancy caused by torsion of bilateral huge multiloculated ovarian cysts

“…7 In 2009, Yen et al analysed 214 pregnancies with adnexal masses greater than or equal to 4 cm. 8 Torsion was encountered in 14.84% of patients. Adnexal masses with sizes between 6 cm and 8 cm had a significantly high risk of torsion compared with other sizes.…”

Differential diagnosis of bilateral ovarian masses during pregnancy, and their hormonal effect

“…8 Although other malignant features, such as papillary projections larger than 3mm, complex masses, and extratumoral fluid, were not observed in the present case, along with the fact that mass diameters more than 10 cm at the initial diagnosis has a higher risk of malignancy, more detailed evaluation with MRI could be of an acceptable option. 8,9 In MRI, HL may appear as high-intensity cystic masses with intermediate-to-high intensity edematous thickened septal walls on T2-weighted images; septations may have low signal intensity on T1-weighted images, and low signal intensity on diffusion-weighted images. The ADC values may be decreased in some ovarian cancers, whereas unchanged values would likely indicate HL.…”

“…1,9 Although rare, torsion can occur even in the third trimester or when the mass size exceeds 10 cm. 11 In the current case, the patient was referred to our hospital at the gestational age of 30th week, which partly made it difficult to proceed to surgery but also enabled careful evaluation and observation.…”

Ovarian mass in pregnancy: a case report

“…If the cyst has picture as that of simple cyst, than it can be followed up by serial ultrasonography. However it is to be kept in mind that even these cysts may necessitate emergency laparotomy and exploration if complications like torsion, rupture or necrosis arise as seen in as many as 50% cases 13 .These days due to advent of modern techniques such as MRI, trans vaginal colour Doppler, high resolution ultrasound, conservative management has become quite easy.…”

“…Emergency laparotomy is taken up whenever complications arise such as torsion, rupture, hemorrhage, necrosis or features of malignancy, whatever may be the period of gestation. 13 In the past untwisting of the pedicle was avoided due to fear of embolisation of toxic materials to the peripheral circulation, but these days, there are sufficient evidences that by untwisting of pedicle during surgery and thereby reestablishment of circulation leads to viable ovarian tissue, that too without any systemic complications. 3 …”