Spontaneous Autoamputation of Adnexa.

Abstract

Acquired ovarian torsion is an uncommon gynecologic emergency that afflicts women of reproductive age and requires correction by surgery. A rare complication of asymptomatic ovarian torsion can be necrosis and autoamputation of the adnexal structures. A 28-year-old nulliparous woman presented with irregular menses since puberty associated with dysmenorrhea, menorrhagia, and nausea, and that did not improve with trials of oral hormone therapy. Ultrasound and pelvic MRI revealed a large, tubular-cystic mass separated from the right ovary and tubo-ovarian junction. Intraoperative findings revealed filmy adhesions and fimbriae emanating from this cystic lesion, as well as dilation of the medial portion of the right fallopian tube. Histopathology reported dilated, cystic structures with focal tubal-type epithelial lining, and a dilated fallopian tube lumen, consistent with hydrosalpinx. Autoamputation of fallopian tube is a rare but serious complication of adnexal torsion that should be treated promptly via intraoperative detorsion.