Bilateral endometrioma of ovary in a 25-year-old woman with unilateral autoamputation and contralateral torsion of ovary: A case report

OBJECTIVE: We report a unique case of bilateral ovarian endometrioma in a young woman with suspected torsion. To the best of our knowledge, no previous cases of unilateral torsion with contralateral autoamputation of an ovarian endometrioma have been reported. This case underscores the importance of laparoscopic management and its potential benefits for preserving fertility. CASE REPORT: A 25-year-old woman with no history of acute abdominal pain was initially diagnosed with bilateral ovarian endometrioma and torsion. During emergent laparoscopic surgery, an autoamputation of the left ovarian endometrioma with reimplantation into the great omentum was discovered incidentally after adhesiolysis. The amputated tumor had blood supply from the left lower quadrant of the great omentum, and concurrent torsion of the right ovarian endometrioma was noted. A cutting notch was identified over the left infundibulopelvic ligament, despite the absence of prior surgical history. This finding supported the diagnosis of autoamputation of the left adnexa due to a previous asymptomatic torsion of the ovarian endometrioma. All masses were removed laparoscopically. CONCLUSION: Clinicians should consider spontaneous autoamputation of the adnexa as a potential condition in women presenting with adnexal masses even in the absence of prior abdominal pain. Before undertaking destructive procedures such as adnexectomy or enucleation, a thorough evaluation of the bilateral ovaries should be performed to preserve future fertility.