Isolated fallopian tube torsion: A rare diagnosis in a perimenopausal patient with adnexal mass and raised Ca 19-9: Endoscopic management and review

Abstract

Isolated torsion of the fallopian tube in perimenopausal women is very rare. A patient who presented with an adnexal mass with possible ovarian torsion and with a raised Ca 19-9 titer is reported. A 48-year-old perimenopausal woman had acute lower right abdominal pain accompanied by nausea and vomiting. Ultrasonographic studies revealed a multiloculated cystic mass in the right adnexum, and Ca 19-9 was raised. The symptoms worsened, and emergency laparoscopy and salpingoophorectomy were performed. Histology revealed isolated fallopian tube torsion with a benign ovarian cyst. Torsion of the fallopian tube, although rare, should always be considered as part of the differential diagnosis of any symptomatic pelvic mass, even in a perimenopausal woman. Characteristic ultrasonographic and CT findings have been reported, an early diagnosis can be made, and an endoscopic, less radical procedure will be the treatment of choice resulting in shorter hospitalization, increased patient satisfaction, and more cost benefits. © Springer-Verlag 2005.