# Massive ovarian edema with fallopian tube torsion treated with transumbilical laparoendoscopic single-site surgery: a case report

## TL;DR

A 14-year-old girl with a rare ovarian condition was successfully treated with a minimally invasive surgical technique that preserved her fertility.

## Contribution

This case report demonstrates the use of TU-LESS for diagnosing and treating massive ovarian edema with fallopian tube torsion while preserving fertility.

## Key findings

- Transumbilical laparoendoscopic single-site surgery diagnosed and treated massive ovarian edema with torsion.
- Frozen section analysis confirmed the benign nature of the ovarian mass, allowing for fertility-sparing surgery.
- The affected ovary was suspended to prevent future torsion events.

## Abstract

Massive ovarian edema (MOE) is a rare benign condition that can occur at any age, and mainly affects women of childbearing age and prepubertal girls. Patients with MOE do not have specific signs and symptoms, and imaging may show cystic or solid masses. Therefore, it is often unclear preoperatively whether the mass is a benign or malignant ovarian tumor. This increases the possibility of salpingo-oophorectomy due to suspicion of malignancy which, in turn, affects the fertility of young women and alters their sex hormone levels. We report the case of a 14-year-old girl with three complete turns of torsion of both the right fallopian tube and right ovary, and enlargement of the right ovary without necrosis. We performed transumbilical laparoendoscopic single-site surgery (TU-LESS) for diagnosis and treatment. During surgery, an ovarian cyst was removed and sent for frozen section, revealing MOE. Fertility-sparing surgery was therefore performed and the affected ovary was suspended to prevent further torsion.