{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T15:10:39Z","timestamp":1778685039092,"version":"3.51.4"},"reference-count":14,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,4,25]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Massive ovarian oedema (MOE) is a rare benign condition that can mimic ovarian neoplasms and lead to unnecessary oophorectomy. It is typically caused by impaired venous and lymphatic drainage secondary to partial or intermittent ovarian torsion, with preserved arterial inflow resulting in stromal oedema and maintained follicular viability. We report a woman in her late 20s presenting with intermittent mild lower abdominal pain and infertility. Ultrasound imaging suggested a solid ovarian mass; however, MRI demonstrated features consistent with a torsion\u2013detorsion sequence, including heterogeneous stroma and peripherally displaced follicles. Laparoscopy confirmed adnexal torsion with a markedly enlarged but viable ovary. Detorsion and controlled stromal decompression were performed, followed by ligament-based ovariopexy using the Hot-Dog-in-a-Bun technique to reduce the risk of recurrence while preserving vascular integrity. Follow-up demonstrated complete resolution of ovarian enlargement and restoration of normal morphology. This case highlights the importance of recognising MOE and supports conservative laparoscopic management to avoid unnecessary ovarian loss in reproductive-age women.<\/jats:p>","DOI":"10.1136\/bcr-2025-271835","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:20:19Z","timestamp":1778682019000},"page":"e271835","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ovarian torsion presenting as massive oedema: diagnostic challenges and fertility-preserving management"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5635-0332","authenticated-orcid":false,"given":"Ruthvika","family":"Kundoor","sequence":"first","affiliation":[{"name":"Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monna","family":"Pandurangi","sequence":"additional","affiliation":[{"name":"Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radha","family":"Vembu","sequence":"additional","affiliation":[{"name":"Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swetha","family":"Mayilvahanan","sequence":"additional","affiliation":[{"name":"Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"2026051307201325000_19.5.e271835.1","first-page":"564","article-title":"Massive edema of the ovary simulating fibroma","volume":"34","author":"Kalstone","year":"1969","journal-title":"Obstet Gynecol"},{"key":"2026051307201325000_19.5.e271835.2","article-title":"A clinical update on massive ovarian oedema - a pseudotumour?","volume":"7","author":"Praveen","year":"2013","journal-title":"Ecancermedicalscience"},{"key":"2026051307201325000_19.5.e271835.3","doi-asserted-by":"crossref","DOI":"10.1186\/s13000-016-0469-3","article-title":"Massive ovarian oedema: a misleading clinical entity","volume":"11","author":"Machairiotis","year":"2016","journal-title":"Diagn Pathol"},{"key":"2026051307201325000_19.5.e271835.4","first-page":"172","article-title":"J Family Med Prim Care.","volume":"Jan- Mar","author":"Varma","year":"2016","journal-title":"Massive ovarian edema: A case report presenting as a diagnostic dilemma"},{"key":"2026051307201325000_19.5.e271835.5","first-page":"676043","article-title":"Massive ovarian edema with para-ovarian cyst torsion treated with laparoscopic surgery: a case report","volume":"11","author":"Fukuda","year":"2021","journal-title":"Front Oncol"},{"key":"2026051307201325000_19.5.e271835.6","first-page":"414","article-title":"Whirlpool sign\u201d on colour Doppler: a unique pathognomonic sign of ovarian torsion","volume":"23","author":"Vijayaraghavan","year":"2004","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2026051307201325000_19.5.e271835.7","first-page":"972","article-title":"Massive ovarian oedema: literature review and case presentation","volume":"14","author":"Daboubi","year":"2008","journal-title":"East Mediterr Health J"},{"key":"2026051307201325000_19.5.e271835.8","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200609000-00006"},{"key":"2026051307201325000_19.5.e271835.9","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1016\/j.jpedsurg.2017.10.053","article-title":"Ovarian torsion in pediatric and adolescent patients: A systematic review","volume":"53","author":"Dasgupta","year":"2018","journal-title":"J Pediatr Surg"},{"key":"2026051307201325000_19.5.e271835.10","doi-asserted-by":"crossref","unstructured":"Saito S , Yamamoto M , Iwaizumi S , et al . Laparoscopic surgery for massive ovarian edema during pregnancy: A case report. Case Rep Womens Health 2021;PMCID. doi:10.1016\/j.crwh.2021.e00318","DOI":"10.1016\/j.crwh.2021.e00318"},{"key":"2026051307201325000_19.5.e271835.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.01.034"},{"key":"2026051307201325000_19.5.e271835.12","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.18203\/2320-1770.ijrcog20191975","article-title":"Hotdog in bun: a recent technique for oophoropexy","volume":"8","author":"Shah","year":"2019","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"2026051307201325000_19.5.e271835.13","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1007\/s00404-025-08128-x","article-title":"Comparative outcomes of oophoropexy techniques in preventing recurrent adnexal torsion","volume":"PMCID","author":"Yagur","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"2026051307201325000_19.5.e271835.14","doi-asserted-by":"crossref","DOI":"10.1186\/s40064-016-3123-3","article-title":"Magnetic resonance imaging features of massive ovarian edema in pregnancy: utility for decisions in expectant management","volume":"PMCID","author":"Gobara","year":"2016","journal-title":"Springerplus"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:20:24Z","timestamp":1778682024000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,13]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bcr-2025-271835"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271835","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}