Torsion’s Tug: Unmasking Ovarian Torsion In A Borderline Tumor
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A 32-year-old woman, para 2 living 2, with a history of two previous cesarean sections and sterilization, presented with acute lower abdominal pain and backache. Imaging revealed a large right ovarian cyst with features suggestive of a borderline tumor, and tumor markers showed elevated CA-125 levels. Intraoperatively, the cyst was found to be twisted, indicating ovarian torsion, a rare complication in borderline ovarian tumors (BOTs). Frozen section analysis suggested a borderline serous cystadenoma, which was confirmed on histopathology as FIGO stage IB. The patient underwent staging laparotomy, right oophorectomy, total abdominal hysterectomy, and omentectomy, with an uneventful postoperative recovery. This case highlights the diagnostic challenges of BOTs, particularly in the context of rare complications like torsion, and underscores the importance of a multidisciplinary approach involving imaging, tumor markers, and histopathological evaluation. Early diagnosis and timely surgical intervention are crucial, especially in young women, to preserve fertility and ensure favorable outcomes. Long-term follow-up is essential to monitor for late recurrences, given the potential for late recurrence in BOTs.
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