Ovarian Fibroma Torsion（卵巢纖維瘤扭轉）

A 57-year-old postmenopausal woman presented to the emergency department with severe abdominal pain and hypovolemic shock. On examination, the abdomen was distended with rebound tenderness in the suprapubic and left lower quadrant areas. A computed tomographic scan of the abdomen and pelvis revealed a 26-cm complex tumor in the left peritoneal space, swirl appearance of the left adnexa and broad ligament (Panel A, arrow), and ascites. Emergent laparotomy disclosed a large left ovarian solid tumor with a dilated, congested, and twisted left fallopian tube (Panel B). A left salpingo-oophorectomy was performed. Histopathological examination revealed an ovarian fibroma with hemorrhagic necrosis and with no evidence of malignancy. The patient recovered uneventfully postoperatively. To our knowledge, this woman presents the largest fibroma torsion in the current literature.
一名57歲停經後婦女因嚴重腹痛和低血量性休克而被送到急診。 身體檢查時發現腹部腫脹且在恥骨上與左下腹部有反彈性觸痛。 全腹部電腦斷層掃描顯示左腹膜腔內有一個26公分的複雜性腫瘤、左側子宮附屬器和寬韌帶呈漩渦狀（圖A，箭頭）、和腹水。 緊急剖腹術發現一個大的左卵巢實體腫瘤、以及左輸卵管充血扭轉（圖B），於是進行了左側輸卵管卵巢切除手術。 組織病理學檢查顯示卵巢纖維瘤伴隨出血壞死，無惡性證據。 病人術後恢復良好。 此案例為當前文獻中最大的卵巢纖維瘤扭轉報告。