Supernumerary ovary: A rare gynaecological entity unveiled incidentally-insights from a case report

A supernumerary ovary is an exceptionally rare congenital gynaecological anomaly characterised by the presence of ovarian tissue separate from the normal adnexa and lacking anatomical continuity. Owing to its rarity and nonspecific clinical presentation, it is often detected incidentally during surgery. We report the case of a 17-year-old unmarried adolescent who presented with an acute onset of lower abdominal pain and vomiting. She was obese and had severe abdominal tenderness. A quick workup of primary investigations was ordered. Ultrasonography was suggestive of right ovarian torsion. An emergency exploratory laparotomy revealed a necrotic right ovary with two turns of torsion, along with an associated paraovarian cyst, necessitating right oophorectomy and paraovarian cystectomy. The left ovary had evidence of endometriosis, which was managed by drainage and cystectomy. During peritoneal toileting, an additional ovarian tissue was incidentally identified in an ectopic location adherent to the greater omentum, appendix, and epiploica of the large bowel, consistent with a supernumerary ovary. This case emphasises the importance of recognising rare ovarian anomalies to ensure appropriate surgical management and preservation of future reproductive potential.