Skip to main content

Complications of Adnexal Masses

  • Chapter
  • First Online:
Gynecological Imaging
  • 3218 Accesses

Abstract

Ovarian masses are usually asymptomatic and may grow to significant size before they can be palpated and give rise to symptoms. Intracystic hemorrhage, rupture or leakage, and torsion are the most frequent complications; infection, necrosis, fistula, and hernia are rare.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abolmakarem H, Tharmaratnum S, Thilaganathan B (2001) Fetal anemia as a consequence of hemorrhage into an ovarian cyst. Ultrasound Obstet Gynecol 17(6):527–528

    Article  PubMed  CAS  Google Scholar 

  2. Adamsbaum C, Metsdagh P, Andre C, Rocourt N, Robert Y (2000) Cystic ovarian pathology excepting genital activity. J Radiol 81(12 Suppl):1789–1797

    PubMed  CAS  Google Scholar 

  3. Kirkinen P, Jouppila P (1985) Perinatal aspects of pregnancy complicated by fetal ovarian cyst. J Perinat Med 13(5):245–251

    Article  PubMed  CAS  Google Scholar 

  4. Suita S, Handa N, Nakano H (1992) Antenatally detected ovarian cysts – a therapeutic dilemma. Early Hum Dev 29(1–3):363–367

    Article  PubMed  CAS  Google Scholar 

  5. Hann LE, Lui DM, Shi W, Bach AM, Selland DL, Castiel M (2000) Adnexal masses in women with breast cancer: US findings with clinical and histopathologic correlation. Radiology 216(1):242–247

    PubMed  CAS  Google Scholar 

  6. Lee KR, Young RH (2003) The distinction between primary and metastatic mucinous carcinomas of the ovary: gross and histologic findings in 50 cases. Am J Surg Pathol 27(3):281–292

    Article  PubMed  Google Scholar 

  7. Hayes MC, Scully RE (1987) Ovarian steroid cell tumors (not otherwise specified). A clinicopathological analysis of 63 cases. Am J Surg Pathol 11(11):835–845

    Article  PubMed  CAS  Google Scholar 

  8. Jaworski RC, Boadle R, Greg J, Cocks P (2001) Peritoneal “melanosis” associated with a ruptured ovarian dermoid cyst: report of a case with electron-probe energy dispersive X-ray analysis. Int J Gynecol Pathol 20(4):386–389

    Article  PubMed  CAS  Google Scholar 

  9. Muller AM, Sondgen D, Strunz R, Muller KM (2002) Gliomatosis peritonei: a report of two cases and review of the literature. Eur J Obstet Gynecol Reprod Biol 100(2):213–222

    Article  PubMed  Google Scholar 

  10. Levy AD, Shaw JC, Sobin LH (2009) Secondary tumors and tumorlike lesions of the peritoneal cavity: imaging features with pathologic correlation. Radio­graphics 29(2):347–373

    Article  PubMed  Google Scholar 

  11. Bider D, Ben-Rafael Z, Goldenberg M, Shalev J, Mashiach S (1989) Pregnancy outcome after unwinding of twisted ischaemic-haemorrhagic adnexa. Br J Obstet Gynaecol 96(4):428–430

    Article  PubMed  CAS  Google Scholar 

  12. Shalev J, Goldenberg M, Oelsner G, Ben-Rafael Z, Bider D, Blankstein J, Mashiach S (1989) Treatment of twisted ischemic adnexa by simple detorsion. N Engl J Med 321(8):546

    PubMed  CAS  Google Scholar 

  13. Aziz D, Davis V, Allen L, Langer JC (2004) Ovarian torsion in children: is oophorectomy necessary? J Pediatr Surg 39(5):750–753

    Article  PubMed  Google Scholar 

  14. Abes M, Sarihan H (2004) Oophoropexy in children with ovarian torsion. Eur J Pediatr Surg 14(3):168–171

    Article  PubMed  CAS  Google Scholar 

  15. Ghossain MA, Hachem K, Aoun NJ, Haddad-Zebouni S, Mansour F, Suidan JS, Abboud J (2006) Spontaneous detorsion of the ovary: can it be diagnosed by MRI? J Magn Reson Imaging 24(4):880–885

    Article  PubMed  Google Scholar 

  16. Ghossain MA, Hachem K, Buy JN, Hourany-Rizk RG, Aoun NJ, ­Haddad-Zebouni S, Mansour F, Attieh E, Abboud J (2004) Adnexal torsion: magnetic resonance findings in the viable adnexa with emphasis on stromal ovarian appearance. J Magn Reson Imaging 20(3):451–462

    Article  PubMed  Google Scholar 

  17. Hall BP, Printz DA, Roth J (1993) Massive ovarian edema: ultrasound and MR characteristics. J Comput Assist Tomogr 17(3):477–479

    Article  PubMed  CAS  Google Scholar 

  18. Umesaki N, Tanaka T, Miyama M, Nishimura S, Kawamura N, Ogita S (2000) Successful preoperative diagnosis of massive ovarian edema aided by comparative imaging study using magnetic resonance and ultrasound. Eur J Obstet Gynecol Reprod Biol 89(1):97–99

    Article  PubMed  CAS  Google Scholar 

  19. Ghossain MA, Buy JN, Bazot M, Haddad S, Guinet C, Malbec L, Hugol D, Truc JB, Poitout P, Vadrot D (1994) CT in adnexal torsion with emphasis on tubal findings: correlation with US. J Comput Assist Tomogr 18(4):619–625

    Article  PubMed  CAS  Google Scholar 

  20. Kim YH, Cho KS, Ha HK, Byun JY, Auh YH, Rhim HC, Shim JC, Cha SJ, Hur G (1999) CT features of torsion of benign cystic teratoma of the ovary. J Comput Assist Tomogr 23(6):923–928

    Article  PubMed  CAS  Google Scholar 

  21. Shalev J, Mashiach R, Bar-Hava I, Girtler O, Bar J, Dicker D, Meizner I (2001) Subtorsion of the ovary: sonographic features and clinical management. J Ultrasound Med 20(8):849–854; quiz 856

    PubMed  CAS  Google Scholar 

  22. Kupesic S, Plavsic BM (2010) Adnexal torsion: color Doppler and three-dimensional ultrasound. Abdom Imaging 35(5):602–606

    Article  PubMed  Google Scholar 

  23. Jain KA (1995) Magnetic resonance imaging findings in ovarian torsion. Magn Reson Imaging 13(1):111–113

    Article  PubMed  CAS  Google Scholar 

  24. Bader T, Ranner G, Haberlik A (1996) Torsion of a normal adnexa in a premenarcheal girl: MRI findings. Eur Radiol 6(5):704–706

    Article  PubMed  CAS  Google Scholar 

  25. Kawahara Y, Fukuda T, Futagawa S, Sakamoto I, Takao M, Kinoshita Y, Hayashi K (1996) Intravascular gas within an ovarian tumor: a CT sign of ­ovarian torsion. J Comput Assist Tomogr 20(1):154–156

    Article  PubMed  CAS  Google Scholar 

  26. Ghossain MA, Buy JN, Sciot C, Jacob D, Hugol D, Vadrot D (1997) CT findings before and after adnexal torsion: rotation of a focal solid element of a cystic adjunctive sign in diagnosis. AJR Am J Roentgenol 169(5):1343–1346

    Article  PubMed  CAS  Google Scholar 

  27. Kimura I, Togashi K, Kawakami S, Takakura K, Mori T, Konishi J (1994) Ovarian torsion: CT and MR imaging appearances. Radiology 190(2):337–341

    PubMed  CAS  Google Scholar 

  28. Warnock NG, Brown BP, Barloon TJ, Hemann LS (1994) Spontaneous ­detorsion of the ovary demonstrated by ultrasonography. J Ultrasound Med 13(1):57–59

    PubMed  CAS  Google Scholar 

  29. Guerriero S, Ajossa S, Caffiero A, Mais V (1995) Relationship between abnormally high levels of plasma CA 125 and resolution of acute pelvic pain in two women with endometrioma. Gynecol Obstet Invest 40(1):61–63

    Article  PubMed  CAS  Google Scholar 

  30. Scully RE, Young RH, Clement PB (1998) Tumor-like lesions. In: Rosai J, Sobin LH (eds) Tumors of the ovary, maldeveloped gonads, fallopian tube, and broad ligament, vol 23. Armed Forces Institute of Pathology, Washington, pp 409–450

    Google Scholar 

  31. Clement PB (2002) Nonneoplastic lesions of the ovary. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 5th edn. Springer, New-York, pp 675–727

    Google Scholar 

  32. Kramer LA, Lalani T, Kawashima A (1997) Massive edema of the ovary: high resolution MR findings using a phased-array pelvic coil. J Magn Reson Imaging 7(4):758–760

    Article  PubMed  CAS  Google Scholar 

  33. Haque TL, Togashi K, Kobayashi H, Fujii S, Konishi J (2000) Adnexal torsion: MR imaging findings of viable ovary. Eur Radiol 10(12):1954–1957

    Article  PubMed  CAS  Google Scholar 

  34. Young RH, Scully RE (1984) Fibromatosis and massive edema of the ovary, possibly related entities: a report of 14 cases of fibromatosis and 11 cases of massive edema. Int J Gynecol Pathol 3(2):153–178

    Article  PubMed  CAS  Google Scholar 

  35. Russell P, Farnsworth A (1997) Massive edema and fibromatosis. In: Russell P, Farnsworth A et al (eds) Surgical pathology of the ovaries. Churchill Livingstone, New York, pp 147–154

    Google Scholar 

  36. Kilickesmez O, Tasdelen N, Yetimoglu B, Kayhan A, Cihangiroglu M, Gurmen N (2009) Diffusion-weighted imaging of adnexal torsion. Emerg Radiol 16(5):399–401

    Article  PubMed  Google Scholar 

  37. Fujii S, Kaneda S, Kakite S, Kanasaki Y, Matsusue E, Harada T, Kaminou T, Ogawa T (2011) Diffusion-weighted imaging findings of adnexal torsion: initial results. Eur J Radiol 77(2):330–334

    Article  PubMed  Google Scholar 

  38. Zarain Garcia F (1974) Cystic teratoma of the ovary associated with abscess and vaginal fistula. Ginecol Obstet Mex 36(213):49–53

    Google Scholar 

  39. Reina J, Borrell N (1991) Infection of a neoplastic ovarian cyst caused by Salmonella enterica subspecies enterica, serotype Enteritidis. Enferm Infecc Microbiol Clin 9(3):185–186

    PubMed  CAS  Google Scholar 

  40. Hsueh PR, Hwang CC, Yen KP, Lin M, Young C (1992) Abscess formation complicated in ovarian mucinous cystadenoma: a case report. Kansenshogaku Zasshi 66(3):416–420

    PubMed  CAS  Google Scholar 

  41. Wan YL, Chen WJ, Chien CC, Lee TY, Tsai CC (1993) Ovarian dermoid cyst associated with tuberculosis, cystadenoma and torsion. J Formos Med Assoc 92(9):851–853

    PubMed  CAS  Google Scholar 

  42. Yoshida M, Katsuragawa H, Miyamoto U, Ohnishi S, Katsura Y (1993) Estrogen-producing ovarian adenocarcinoma with large abscess formation. Gynecol Obstet Invest 35(4):245–248

    Article  PubMed  CAS  Google Scholar 

  43. Burgmans JP, van Erp EJ, Brimicombe RW, Kazzaz BA (1997) Salmonella enteritidis in an endometriotic ovarian cyst. Eur J Obstet Gynecol Reprod Biol 72(2):207–211

    Article  PubMed  CAS  Google Scholar 

  44. Liu Z, Lang J, Huang R, Li B, Zhang L (1998) Secondary infection of the ­ovarian endometriotic cysts. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 20(1):49–53

    PubMed  CAS  Google Scholar 

  45. Matsubayashi T, Hamajima T, Asano K, Mizukami A, Seguchi M, Kohno C, Inukai K, Tobayama S (2001) Salmonella infection of an ovarian dermoid cyst. Pediatr Int 43(2):164–165

    Article  PubMed  CAS  Google Scholar 

  46. Le Bouedec G, Raynaud F, Glowaczower E, Quibant A, Dauplat J (1993) Ovarian abscess. A case of a dermoid cyst with a secondary infection. Rev Fr Gynecol Obstet 88(1):23–26

    PubMed  Google Scholar 

  47. Hiller N, Zagal I, Hadas-Halpern I (2000) Echinococcal ovarian cyst. A case report. J Reprod Med 45(3):224–226

    PubMed  CAS  Google Scholar 

  48. Konar K, Ghosh S, Konar S, Bhattacharya S, Sarkar S (2001) Bilateral ovarian hydatid disease – an unusual case. Indian J Pathol Microbiol 44(4):495–496

    PubMed  CAS  Google Scholar 

  49. El Fortia M, Elhajaji E, Elmadani B, Khalil M, Eldergash O, Elhamroush H (2006) Are they spherules of ovarian cystic teratoma or daughter cysts of echinococcosis? Ultraschall Med 27(6):582–584

    Article  PubMed  Google Scholar 

  50. Gurel H, Gurel SA (2008) Ovarian cystic teratoma with a pathognomonic appearance of multiple floating balls: a case report and investigation of common characteristics of the cases in the literature. Fertil Steril 90(5):2008.e17–2009.e17

    Article  Google Scholar 

  51. Floberg J, Backdahl M, Silfersward C, Thomassen PA (1984) Postpartum ­perforation of the colon due to endometriosis. Acta Obstet Gynecol Scand 63(2):183–184

    Article  PubMed  CAS  Google Scholar 

  52. Shiels WE, Dueno F, Hernandez E (1986) Ovarian dermoid cyst complicated by an entero-ovarian fistula. Radiology 160(2):443–444

    PubMed  CAS  Google Scholar 

  53. Allimant P, Bietiger M, Attipou L, Rosburger C, Babini E, Zeyer B, Dalcher G (1990) Sigmoid perforation in an ovarian cyst. J Chir (Paris) 127(11):559–560

    CAS  Google Scholar 

  54. Skipper D, Moran B, Dormandy JA, Heald RJ (1995) Two cases of colo-­ovarian cyst fistula. Int J Colorectal Dis 10(2):70–72

    Article  PubMed  CAS  Google Scholar 

  55. Landmann DD, Lewis RW (1988) Benign cystic ovarian teratoma with colorectal involvement. Report of a case and review of the literature. Dis Colon Rectum 31(10):808–813

    Article  PubMed  CAS  Google Scholar 

  56. Chamberlain RS, Kaufman HL, Danforth DN (1998) Enterocutaneous fistula in cancer patients: etiology, management, outcome, and impact on further treatment. Am Surg 64(12):1204–1211

    PubMed  CAS  Google Scholar 

  57. Takai N, Utsunomiya H, Kawano Y, Nasu K, Narahara H, Miyakawa I (2002) Complete response to radiation therapy in a patient with chemotherapy-resistant ovarian clear cell adenocarcinoma. Arch Gynecol Obstet 267(2):98–100

    Article  PubMed  CAS  Google Scholar 

  58. Milczek T, Emerich J, Klasa-Mazurkiewicz D (2003) Surgical complications connected with intraperitoneal chemotherapy in ovarian cancer. Ginekol Pol 74(9):817–823

    PubMed  Google Scholar 

  59. Nicholson CP, Donohue JH, Thompson GB, Lewis JE (1992) A study of metastatic cancer found during inguinal hernia repair. Cancer 69(12):3008–3011

    Article  PubMed  CAS  Google Scholar 

  60. van Heesewijk HP, Smit FW, Heitbrink MA, Kok FP (1990) Herniation of an ovarian cyst through the inguinal canal: diagnosis with CT. AJR Am J Roentgenol 154(1):202–203

    Article  PubMed  Google Scholar 

  61. Prasad KR, Aruna C, Saheb DA (1993) Primary leiomyoma of ovary. Indian J Med Sci 47(2):39–41

    PubMed  CAS  Google Scholar 

  62. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Kawakami T, Ohno Y, Kuwano H (2003) Malignant mixed Mullerian tumor of the ovary growing into an inguinal hernia sac: report of a case. Surg Today 33(10):797–800

    Article  PubMed  Google Scholar 

  63. Millar RC, Geelhoed GW, Ketcham AS (1975) Ovarian cancer presenting as umbilical hernia. J Surg Oncol 7(6):493–496

    Article  PubMed  CAS  Google Scholar 

  64. Wolfson N, Graves K, Pastorek JG 2nd, Suleman M (1991) Benign cystic ­teratoma manifested as an umbilical hernia. South Med J 84(3):405

    Article  PubMed  CAS  Google Scholar 

  65. Slizovskii GV, Sigailo ZS (1990) Ovarian polycystosis in a strangulated inguinal hernia in a newborn infant. Vestn Khir Im I I Grek 145(11):99–100

    PubMed  CAS  Google Scholar 

  66. Poenaru D, Jacobs DA, Kamal I (1999) Unusual findings in the inguinal canal: a report of four cases. Pediatr Surg Int 15(7):515–516

    Article  PubMed  CAS  Google Scholar 

  67. Demir H, Scoccia B (2010) Internal herniation of adnexa through a defect of the broad ligament: case report and literature review. J Minim Invasive Gynecol 17(1):110–112

    Article  PubMed  Google Scholar 

  68. Huang CS, Luo CC, Chao HC, Chu SM, Yu YJ, Yen JB (2003) The presentation of asymptomatic palpable movable mass in female inguinal hernia. Eur J Pediatr 162(7–8):493–495

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Buy, J.N., Ghossain, M. (2013). Complications of Adnexal Masses . In: Gynecological Imaging. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31012-6_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-31012-6_32

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-31011-9

  • Online ISBN: 978-3-642-31012-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics