Large Ovarian Fibroma With Torsion in a 17-Year-Old Patient: A Report of a Rare Case of Acute Surgical Abdomen

This study presents a rare case of emergency surgical management via exploratory laparotomy of a large torsed ovarian fibroma in a young female patient. A 17-year-old patient with no history of sexual activity and under chronic antipsychotic medication presented to the emergency department with signs of acute surgical abdomen and fever up to 37.9°C. Laboratory markers of inflammation were elevated. An emergency computed tomography scan revealed a large, solid echogenic pelvic mass of unclear origin. The clinical and laboratory findings, along with the imaging results, led to the decision to perform an emergency exploratory laparotomy. Intraoperatively, a large, solid ovarian mass in torsion, along with the ipsilateral fallopian tube, was identified. A right salpingo-oophorectomy was performed. Histological examination confirmed the diagnosis of a torsed ovarian fibroma. The immediate postoperative course was uneventful, and the patient was discharged on the fourth postoperative day. This article also includes a brief narrative review of the literature regarding ovarian fibromas with torsion, focusing on their rarity, diagnostic challenges, management, and prognosis.