Torsion of Ovarian Dysgerminoma in a Child: Role of Computed Tomography

Abstract

Dysgerminomas are malignant germ cell tumors of the ovary that most commonly occur in the adolescent population. Ovarian dysgerminoma presenting with complications like torsion is a rare entity in the pediatric age group. Cross-sectional imaging plays a crucial role in diagnosis, tumor staging before surgical resection, and for planning adjuvant chemotherapy. We report a case of a nine-year-old female who presented to the emergency room (ER) with abdominal distention and abdominal pain. Computed tomography scan revealed a large right-sided pelvic mass with areas of low attenuation, speckled calcification, peritumoral free fluid, and a twisted vascular pedicle that was likely originating from the left adnexa. The right ovary was normal in appearance. Suspicion of a left-sided ovarian tumor with torsion was raised, which was later confirmed on surgery and histopathology of the resected specimen.

Imaging appearance of ovarian dysgerminoma: A report of two cases

“…The ipsilateral ovarian arteries may expand if there is an ovarian mass. Consequently, the “ovarian vascular pedicle sign” that Lee et al describe is also a useful sign to determine the exact site of origin of the mass, especially in cases of ambiguous locations due to the large size of the mass or when complications like torsion arise [ 5 ].…”

2 cases dysgerminoma with micrometastasis in lymph nodes

“…Most of the times dysgerminoma grow slowly, but rarely needs emergency surgery by torsion, 21 Torsion of ovarian tumors mostly occurred in the reproductive age group, more commonly on the right side, and only approximately 8% of masses were malignant. 22 The incidence of micrometastasis in dysgerminoma is not specify.…”

2 cases dysgerminoma with micrometastasis in lymph nodes

“…Most of the times dysgerminoma grow slowly, but rarely needs emergency surgery by torsión [21]. Torsion of ovarian tumors mostly occurred in the reproductive age group, more commonly on the right side, and only approximately 8% of masses were malignant [22].…”