Massive ovarian edema

[cellhc]

Presentation

Intermittent pelvic pain with dysmenorrhea

Patient Data
AGE: 20 years
GENDER: Female

MRI

Axial T2


Sagittal T2


Coronal T2


Axial T1


Axial T1 fat sat


Axial DWI


Axial ADC


Axial T1 C+ fat sat

Right ovary is increased in size (82x47x70 mm), its parenchyma shows edematous signs; hypointense in T1, hyperintense in T2 and discreetly hyperintense in diffusion, with weak and progressive enhancement. Multiple small follicles arranged mainly in the peripheral cortex, a peripheral enhancement of the ovary and follicles, with a peripheral cystic formation measuring 38x27 mm, oval, with heterogeneous fluid signal; hypointense in T1, very hyperintense in T2, without hypersignal in diffusion; thin and regular wall slightly enhanced. No sign of ovarian torsion is observed.

Mild free fluid is seen in the pelvis.

The left ovary is mildly enlarged in size containing multiple small follicles, but no masses or edema.

No ovarian masses or large cysts. No pelvic masses or enlarged lymph nodes.

Case Discussion
The ovary has become normal on the follow-up ultrasound after 2 months.

It's a rare condition presenting itself with enlargement of the ovary due to gross diffuse stromal edema.

References
Aiko Gobara, Takeshi Yoshizako, Rika Yoshida, Naruhito Okada, Ken Makihara, Hajime Kitagaki. Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management. (2016) SpringerPlus. 5 (1): 1. doi:10.1186/s40064-016-3123-3 .
Hisham Dahmoush, Sudha A. Anupindi, Bruce R. Pawel, Nancy A. Chauvin. Multimodality imaging findings of massive ovarian edema in children. (2017) Pediatric Radiology. 47 (5): 576. doi:10.1007/s00247-017-3782-4
V. Sailer, S. Huss, E. Wardelmann, A.M. Müller. Massives Ovarialödem bei einem 13-jährigen Mädchen. (2013) Der Pathologe. 34 (6): 563. doi:10.1007/s00292-013-1762-5