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Massive Ovarian Edema and Fibromatosis
Akram M. Shaaban, MBBCh
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Massive ovarian edema (MOE)
            • Ovarian fibromatosis (OF)
          • Definitions

            • Massive ovarian edema: Tumor-like ovarian enlargement secondary to edema
            • Ovarian fibromatosis: Tumor-like ovarian enlargement due to fibromatous growth of ovarian stroma
            • It appears that both conditions are related to partial or intermittent torsion, leading to venous and lymphatic obstruction with subsequent ovarian enlargement
              • Chronic torsion may primarily lead to fibromatosis or massive edema (not clear which is 1st)

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Beurdeley M et al: Ovarian fibromatosis and sotos syndrome with a new genetic mutation. J Pediatr Adolesc Gynecol. 26(2):e39-41, 2013
                                      2. George V et al: Chronic fibrosing conditions in abdominal imaging. Radiographics. 33(4):1053-80, 2013
                                      3. Guzel AB et al: Unusual adnexal masses in adolescents and young women: massive ovarian oedema. J Obstet Gynaecol. 33(6):635-6, 2013
                                      4. Praveen R et al: A clinical update on massive ovarian oedema - a pseudotumour? Ecancermedicalscience. 7:318, 2013
                                      5. Coakley FV et al: Magnetic resonance imaging of massive ovarian edema in pregnancy. J Comput Assist Tomogr. 34(6):865-7, 2010
                                      6. Diamantopoulou S et al: Serous cystadenoma with massive ovarian edema. A case report and review of the literature. Clin Exp Obstet Gynecol. 36(1):58-61, 2009
                                      7. Peters FH et al: Massive ovarian edema and contralateral mature cystic teratoma: asymptomatic presentation in a premenarchal female. J Pediatr Adolesc Gynecol. 22(5):e118-20, 2009
                                      8. Telischak NA et al: MRI of adnexal masses in pregnancy. AJR Am J Roentgenol. 191(2):364-70, 2008
                                      9. Cepni I et al: Massive edema of the ovary diagnosed with laparoscopic biopsy and frozen section. J Postgrad Med. 51(4):336-7, 2005
                                      10. Geist RR et al: Massive edema of the ovary: a case report and review of the pertinent literature. J Pediatr Adolesc Gynecol. 18(4):281-4, 2005
                                      11. Natarajan A et al: Precocious puberty secondary to massive ovarian oedema in a 6-month-old girl. Eur J Endocrinol. 150(2):119-23, 2004
                                      12. Spurrell EL et al: A case of ovarian fibromatosis and massive ovarian oedema associated with intra-abdominal fibromatosis, sclerosing peritonitis and Meig's syndrome. Sarcoma. 8(4):113-21, 2004
                                      13. Bazot M et al: Massive ovarian edema revealing gastric carcinoma: a case report. Gynecol Oncol. 91(3):648-50, 2003
                                      14. Kocak M et al: Laparoscopic conservation of the ovaries in cases with massive ovarian oedema. Gynecol Obstet Invest. 53(2):129-32, 2002
                                      15. Guvenal T et al: Unilateral massive ovarian edema in a woman with polycystic ovaries. Eur J Obstet Gynecol Reprod Biol. 99(1):129-30, 2001
                                      16. Dolgin SE et al: Maximizing ovarian salvage when treating idiopathic adnexal torsion. J Pediatr Surg. 35(4):624-6, 2000
                                      17. Sakaki M et al: Ovarian fibrothecoma with massive edema. J Med Invest. 47(3-4):148-51, 2000
                                      18. Umesaki N et al: Successful preoperative diagnosis of massive ovarian edema aided by comparative imaging study using magnetic resonance and ultrasound. Eur J Obstet Gynecol Reprod Biol. 89(1):97-9, 2000
                                      19. Roberts CL et al: Bilateral massive ovarian edema: a case report. Ultrasound Obstet Gynecol. 11(1):65-7, 1998
                                      20. Hameed A et al: Ovarian mucinous cystadenoma associated with mural leiomyomatous nodule and massive ovarian edema. Gynecol Oncol. 67(2):226-9, 1997
                                      21. Kramer LA et al: Massive edema of the ovary: high resolution MR findings using a phased-array pelvic coil. J Magn Reson Imaging. 7(4):758-60, 1997
                                      22. Hall BP et al: Massive ovarian edema: ultrasound and MR characteristics. J Comput Assist Tomogr. 17(3):477-9, 1993
                                      23. Hubbell GP et al: Conservative management of bilateral massive edema of the ovary. A case report. J Reprod Med. 38(1):61-4, 1993
                                      24. Sageshima M et al: Massive ovarian edema associated with polycystic ovary. Acta Pathol Jpn. 40(1):73-8, 1990
                                      25. Thorp JM Jr et al: Ovarian suspension in massive ovarian edema. Obstet Gynecol. 76(5 Pt 2):912-4, 1990
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Massive ovarian edema (MOE)
                                                • Ovarian fibromatosis (OF)
                                              • Definitions

                                                • Massive ovarian edema: Tumor-like ovarian enlargement secondary to edema
                                                • Ovarian fibromatosis: Tumor-like ovarian enlargement due to fibromatous growth of ovarian stroma
                                                • It appears that both conditions are related to partial or intermittent torsion, leading to venous and lymphatic obstruction with subsequent ovarian enlargement
                                                  • Chronic torsion may primarily lead to fibromatosis or massive edema (not clear which is 1st)

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Beurdeley M et al: Ovarian fibromatosis and sotos syndrome with a new genetic mutation. J Pediatr Adolesc Gynecol. 26(2):e39-41, 2013
                                                                          2. George V et al: Chronic fibrosing conditions in abdominal imaging. Radiographics. 33(4):1053-80, 2013
                                                                          3. Guzel AB et al: Unusual adnexal masses in adolescents and young women: massive ovarian oedema. J Obstet Gynaecol. 33(6):635-6, 2013
                                                                          4. Praveen R et al: A clinical update on massive ovarian oedema - a pseudotumour? Ecancermedicalscience. 7:318, 2013
                                                                          5. Coakley FV et al: Magnetic resonance imaging of massive ovarian edema in pregnancy. J Comput Assist Tomogr. 34(6):865-7, 2010
                                                                          6. Diamantopoulou S et al: Serous cystadenoma with massive ovarian edema. A case report and review of the literature. Clin Exp Obstet Gynecol. 36(1):58-61, 2009
                                                                          7. Peters FH et al: Massive ovarian edema and contralateral mature cystic teratoma: asymptomatic presentation in a premenarchal female. J Pediatr Adolesc Gynecol. 22(5):e118-20, 2009
                                                                          8. Telischak NA et al: MRI of adnexal masses in pregnancy. AJR Am J Roentgenol. 191(2):364-70, 2008
                                                                          9. Cepni I et al: Massive edema of the ovary diagnosed with laparoscopic biopsy and frozen section. J Postgrad Med. 51(4):336-7, 2005
                                                                          10. Geist RR et al: Massive edema of the ovary: a case report and review of the pertinent literature. J Pediatr Adolesc Gynecol. 18(4):281-4, 2005
                                                                          11. Natarajan A et al: Precocious puberty secondary to massive ovarian oedema in a 6-month-old girl. Eur J Endocrinol. 150(2):119-23, 2004
                                                                          12. Spurrell EL et al: A case of ovarian fibromatosis and massive ovarian oedema associated with intra-abdominal fibromatosis, sclerosing peritonitis and Meig's syndrome. Sarcoma. 8(4):113-21, 2004
                                                                          13. Bazot M et al: Massive ovarian edema revealing gastric carcinoma: a case report. Gynecol Oncol. 91(3):648-50, 2003
                                                                          14. Kocak M et al: Laparoscopic conservation of the ovaries in cases with massive ovarian oedema. Gynecol Obstet Invest. 53(2):129-32, 2002
                                                                          15. Guvenal T et al: Unilateral massive ovarian edema in a woman with polycystic ovaries. Eur J Obstet Gynecol Reprod Biol. 99(1):129-30, 2001
                                                                          16. Dolgin SE et al: Maximizing ovarian salvage when treating idiopathic adnexal torsion. J Pediatr Surg. 35(4):624-6, 2000
                                                                          17. Sakaki M et al: Ovarian fibrothecoma with massive edema. J Med Invest. 47(3-4):148-51, 2000
                                                                          18. Umesaki N et al: Successful preoperative diagnosis of massive ovarian edema aided by comparative imaging study using magnetic resonance and ultrasound. Eur J Obstet Gynecol Reprod Biol. 89(1):97-9, 2000
                                                                          19. Roberts CL et al: Bilateral massive ovarian edema: a case report. Ultrasound Obstet Gynecol. 11(1):65-7, 1998
                                                                          20. Hameed A et al: Ovarian mucinous cystadenoma associated with mural leiomyomatous nodule and massive ovarian edema. Gynecol Oncol. 67(2):226-9, 1997
                                                                          21. Kramer LA et al: Massive edema of the ovary: high resolution MR findings using a phased-array pelvic coil. J Magn Reson Imaging. 7(4):758-60, 1997
                                                                          22. Hall BP et al: Massive ovarian edema: ultrasound and MR characteristics. J Comput Assist Tomogr. 17(3):477-9, 1993
                                                                          23. Hubbell GP et al: Conservative management of bilateral massive edema of the ovary. A case report. J Reprod Med. 38(1):61-4, 1993
                                                                          24. Sageshima M et al: Massive ovarian edema associated with polycystic ovary. Acta Pathol Jpn. 40(1):73-8, 1990
                                                                          25. Thorp JM Jr et al: Ovarian suspension in massive ovarian edema. Obstet Gynecol. 76(5 Pt 2):912-4, 1990