Torção do Ovário Simulando um Tumor Maligno do Ovário

Abstract

Ovarian torsion is a rare surgical emergency, and its diagnosis is often challenging due to the nonspecific or intermittent nature of symptoms. Radiological evaluation is almost always necessary to reach the diagnosis, and to exclude other more common causes of acute pelvic and lower abdominal pain.

Although pelvic ultrasound is usually the first-line examination, ovarian torsion may be first detected on cross-sectional imaging (CT or MRI) due to the growing use of these techniques, especially the use of CT in the emergency department.

There are some specific imaging findings, such us the whirlpool sign (of the twisted ovarian vascular pedicle) associated with an ipsilateral adnexal mass or ovarian enlargement, however, clinical presentation and imaging findings may both be unspecific, in which case, the correct diagnosis may only arise from a high level of clinical suspicion and comprehension of the pathophysiology that underlies the different chronological stages of ovarian torsion.