Isolated Tubal Torsion With Endometriosis

Abstract

A 34-year-old woman, gravida 1, para 1, consulted our department because of secondary infertility of 1-year duration. On transvaginal ultrasound, a unilocular hypoechoic cystic mass was observed in the left adnexa measuring 6.70 ! 5.56 cm, suggestive of a paratubal cyst (Fig. 1). She menstruated regularly with dysmenorrhea at a numeric rating scale of 5. She delivered her child vaginally with no other previous operations and pelvic inflammatory disease. Laboratory examination showed her cancer antigen-125 level at 29.6 U/mL. On laparoscopy, there was torsion of the left fallopian tube, twisting around itself 4 times, with its distal end engorged (Fig. 2) containing chocolatelike fluid and adhered to the peritoneum and cul-de-sac. The uterus, right adnexa, and left ovary were grossly normal. Adhesiolysis and left partial salpingectomy were performed. Histopathologic findings revealed tubal endometrioma with hemosiderinladen macrophages, fibrosis, and chronic inflammation.