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Torsion of Ovary Mass (Composite View)
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Torsion of Ovary Mass (Composite View)

On the left is the bluish external surface of an ovary.
On the right is the cut surface which is extremely hemorrhagic.
Frequently cannot tell what the pathology of the mass is because of infarct and hemorrhage.
Arrows point to fallopian tubes.
(Description By:Melinda Sanders, M.D. )
(Image Contrib. by: Hartford Hospital )
Torsion
Etiology

Frequently associated with benign or occasionally malignant ovarian enlargement
Unusually mobile adnexa
Increasing incidence in patients undergoing ovulation induction
Pathogenesis

Ovary twists obstructing first venous return resulting in intense congestion
Eventually obstructs arterial inflow
May completely necrose underlying neoplasm rendering it non-diagnosable,
Epidemiology

Usually adults
Occasionally children
General Gross Description

Enlarged deep purple ovary
Firm unless completely necrotic
General Microscopic Description

Hemorrhagic often necrotic
Ovarian tissue may not be recognizable
Clinical Correlation

Patients generally present with an acute abdomen
Can salvage adnexa if recognized early.
References

Blaustein's Pathology of the Female Genital Tract, 4th ed. Kurman RJ (ed). New York: Springer-Verlag, 1994, pp. 631.
Child TJ, et. al Fertil Steril 67(3), 573-575 (1997)
Torsion
Synopsis by: Melinda Sanders M.D. (T87000M34210)[274]
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