Matsushita Hiroshi, Kurabayashi Takumi, Yanase Toru, Hashidate Hideki
Department of Obstetrics and Gynecology, Niigata City General Hospital, Chuo-ku, Niigata, Japan.
J Reprod Med. 2009 Nov-Dec;54(11-12):709-11.
Torsion of adnexa usually manifests with severe abdominal pain and is treated as an acute surgical emergency. Asymptomatic torsion, necrosis and amputation of an ovary, and sometimes with other adnexal structures as well, are extremely rare.
A 69-year-old Japanese woman presented to her practitioner complaining of dull lower abdominal pain. She was referred to us for presumed uterine tumor. Pelvic examination, ultrasonography and magnetic resonance imaging revealed a 7-cm, multicystic ovarian mass with solid component, and her serum CA125 and CA19-9 were elevated to 110.5 and 92 U/mL, respectively. Two months after the onset of abdominal pain, laparotomy was performed. In the cul-de-sac, the patient was found to have a mass with no ligamentous or direct connection with the pelvic organs. The right ovary seemed atrophic, with a rough surface. These findings were interpreted as an autoamputation of an ovarian cyst arising from the right ovary.
Physicians should bear in mind the possibility of an autoamputated ovarian cyst even if the preoperative radiograph shows no calcification.
附件扭转通常表现为严重腹痛，需作为急性外科急症进行治疗。无症状的附件扭转、卵巢坏死及切除，有时还伴有其他附件结构的情况极为罕见。
一名69岁日本女性因下腹部隐痛就诊于其医生处。她因疑似子宫肿瘤被转诊至我院。盆腔检查、超声检查及磁共振成像显示一个7厘米的多房性卵巢肿物，伴有实性成分，其血清CA125和CA19-9分别升高至110.5和92 U/mL。腹痛发作两个月后，进行了剖腹手术。在直肠子宫陷凹处，发现患者有一个肿物，与盆腔器官无韧带或直接连接。右侧卵巢似乎萎缩，表面粗糙。这些发现被解释为源自右侧卵巢的卵巢囊肿自行截断。
即使术前X线片未显示钙化，医生也应牢记卵巢囊肿自行截断的可能性。
