Acute Abdomen Caused by Torsion of a Giant Parasitic Ovarian Leiomyoma: A Clinical Case Report

Ovarian torsion, also referred to as adnexal torsion, is a gynecological emergency that occurs when the ovary twists partially or completely around the ligaments that support it. This rotation can obstruct the ovarian blood vessels, reducing or cutting off the blood supply. Rapid recognition and management are essential, as prolonged interruption of blood flow can lead to ischemia, tissue necrosis, and potential loss of the ovary. We present a case of ovarian torsion in a 36-year-old woman who presented during her menstrual period with sudden-onset severe lower abdominal pain and clinical features consistent with an acute abdomen. Imaging revealed an adnexal mass with features suggestive of ovarian torsion. Emergency laparotomy identified a solid mass inseparable from the ovary. Salpingo-oophorectomy was performed. Gross and histopathological examination confirmed the diagnosis of an ovarian leiomyoma with torsion. Although ovarian leiomyomas are rare, they should be considered in the differential diagnosis of solid adnexal masses, especially in cases presenting with an acute abdomen. Preoperative differentiation from other ovarian tumors is challenging, and definitive diagnosis relies on histopathology. Prompt surgical intervention remains crucial to prevent complications related to torsion and ischemia.