Partial autoamputation of an ovary following adnexal torsion with preserved ovarian function in a reproductive-age woman: a case report and literature review.

BACKGROUND: Ovarian autoamputation is a rare consequence of adnexal torsion. Preoperative diagnosis is challenging, and ovarian and tubal function on the affected side is rarely preserved once autoamputation has occurred.

CASE: A 29-year-old woman with a known benign-appearing left ovarian tumor presented with acute lower abdominal pain. Imaging studies suggested torsion of the ovarian tumor pedicle, and emergency laparoscopic surgery was performed. Intraoperatively, a necrotic, fist-sized mass consistent with an autoamputated ovarian tumor was identified in the pouch of Douglas, while the remaining ovary and fallopian tube were preserved. Histopathological examination revealed hemorrhagic infarction and necrosis of the tumor, with residual ovarian stroma containing follicles. Postoperative follow-up demonstrated normal follicular development and resumption of ovulatory function, confirming preserved ovarian function on the affected side.

CONCLUSION: Unlike previous reports of ovarian autoamputation, this rare case of partial ovarian autoamputation suggests that spontaneous detachment of necrotic tissue does not inevitably result in the complete loss of ipsilateral ovarian function. However, in reproductive-age women, early surgical intervention should be strongly considered when adnexal torsion is suspected, even in the absence of definitive imaging findings, to maximize the potential for preserving ovarian function.