Unilateral ovarian autoamputation in a 5-year-old: An unusual pediatric presentation of adnexal torsion

Abstract

In a pediatric patient with abdominal pain, should a diagnosis of an adnexal torsion be higher on the differential? We report a case of a 5-year-old evaluated in the ER for viral-like illness and abdominal pain that led to the discovery of a calcified mass in the left pelvis on a CT scan prior to surgery. Laparoscopic surgical exploration further revealed the absence of the right ovary and fallopian tube along with a free floating calcified gray mass adjacent to the left ovary. The pathology report identified a degenerative and dystrophic calcification with no ovarian stroma or viable neoplastic proliferation. However, based on the patient's history and presentation, we speculate the mass could be the patient's right ovary which necrosed over time due to chronic hypoxia advancing to autoamputation.

Keywords

• Adnexal torsion
• Dystrophic calcification
• Ovarian autoamputation
• Calcified mass