• Yeping He, Xiaofang Yan, and Jianfeng Guo.
• Department of Ultrasound, Yixing People's Hospital, Wuxi, Jiangsu, China.
• Medicine (Baltimore). 2024 Sep 13; 103 (37): e39716e39716.

RationaleAn accessory ovary complicated by cystic teratoma and torsion is extremely rare and requires prompt diagnosis and surgical treatment. However, evidence for effective preoperative imaging diagnosis has barely been reported. Our study presented a case in which preoperative ultrasound reasonably suspected ovarian tumor torsion and an accessory ovary, and laparoscopic surgery was strategically performed.Patient ConcernsAn 18-year-old girl had persistent pain in the lower right abdomen for over 7 hours accompanied by nausea and vomiting, and she had a 14.1 × 10.1 × 9.0 cm hypo-echoic cystic lesion containing a 6.4 × 4.9 × 3.0 cm solid component accompanied by the whirlpool sign on the right side of the pelvis. Additionally, a hyper-echoic ovary with a size of 2.5 × 1.4 cm and a normal ovary appearance of 2.4 × 0.8 cm were detected on the right side of the adnexal area by ultrasound.DiagnosisThe cystic lesion was a large accessory ovarian cystic teratoma, complicated by torsion. The hyperechoic ovary appears as accessory ovarian stromal edema and the normal ovary appearance is eutopic.InterventionsSingle-port laparoscopic resection of the ovarian lesion, release of the ovarian torsion, and oophoroplasty were performed.OutcomesPostoperative recovery was unremarkable. Antral follicles were detected in both eutopic and accessory ovaries by ultrasound 20 days and 4 months after surgery. In addition, during the second postoperative ultrasound follow-up, the accessory ovary showed no difference in echo compared to the normal ovary, except for a slightly larger volume.LessonsClinical manifestations of accessory ovarian tumors combined with torsion are similar to those of eutopic ovarian torsion, and timely surgery is required.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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