- 期刊
Left Paratubal Cyst Torsion Mimicking Malignancy on Computed Tomography
摘要
Taking into account the importance of fertility preservation, an accurate diagnosis of the nature of a pelvic mass in girls is crucial to the determination of the extent and procedure of surgery. Although a detailed preoperative imaging evaluation is mandatory for assessing the nature and size of a pelvic lesion as well as its relationships with the surrounding organs, it can only offer a preliminary diagnosis that needs to be correlated with the clinical picture. Here we reported a 14-year-old girl presenting with a huge pelvic mass for which preoperative abdominal and pelvic computed tomography suggested ovarian malignancy with extension outside the pelvic cavity, ascites, and mesenteric lymph node involvement. Nevertheless, laparoscopic exploration revealed a picture of left paratubal cyst with torsion. Based on the clinical diagnosis, laparoscopic detorsion and left tubal cystectomy were performed with preservation of the uterus and the ovaries without lymph node dissection. Pathological analysis of the excised left adnexa later demonstrated pictures of hemorrhagic necrosis compatible with paratubal cyst torsion without evidence of malignancy. The patient, who recovered uneventfully and was discharged three days after operation, remained symptom-free without surgical complication on following up for one month. The findings of the present case suggested that, a sound clinical judgment, rather than imaging findings, is of utmost importance in determining the nature of a pelvic lesion that guides the subsequent procedure and the extent of surgery to avoid unnecessary exploration as well as to preserve fertility for benign lesions, especially in children and adolescents.