The phantom tumor: Radiological clues to massive ovarian edema

Introduction and importance: Massive ovarian edema is a non-neoplastic condition characterized by massively enlarged ovaries due to the torse-detorsion phenomenon of the ovarian pedicles, resulting in the interruption of venous and lymphatic drainage. The presentation is nonspecific and requires a multidisciplinary approach to determine the final diagnosis and management. Case Presentation: A 22-year-old nulliparous female with a 30-day regular cycle and normal blood flow presented with right abdominal pain and vomiting. After further examination and imaging, it was found that a massively enlarged right ovary was present along with torsion of the ovarian pedicle, which requires early interpretation and surgical intervention. Clinical Discussion: Massive ovarian edema is a rare condition characterised by fluid accumulation in the ovarian stroma, often due tom ovarian torsion. It presents with abdominal pain and nausea, which can mimic other ovarian conditions. In this case, a 22year old female with right sided pain and vomiting was diagnosed via ultrasound and MRI, revealing a massively enlarged ovary with torsion. Surgery, including detorsion and salpingo-oophorectomy, was performed, and histopathology confirmed a benign cystic lesion. Early diagnosis with imaging and timely intervention are crucial for preventing complications like ovarian necrosis. Conclusion: Massive ovarian edema is a rare, multi-disease-mimicking entity that requires early detection and intervention to reduce morbidity and mortality in young females. Imaging plays a crucial role in the diagnosis of massive edema from ovarian neoplasms or torsion. MRI is the investigation of choice because it has excellent soft tissue resolution, making it stand out in the diagnosis of the condition.