Massive Ovarian Edema Successfully Treated Through Accurate Preoperative Diagnosis and Laparoscopic Conservative Surgery

Massive ovarian edema (MOE) is a rare benign condition that causes marked ovarian enlargement due to stromal fluid accumulation and can mimic an ovarian neoplasm. Accurate preoperative diagnosis is essential to avoid unnecessary oophorectomy, especially in young women. A 26-year-old nulligravid woman presented with right lower abdominal pain. Ultrasonography showed a markedly enlarged right ovary with peripheral follicles and mottled hypoechoic areas. MRI demonstrated an 85-mm enlarged ovary with high T2 signal intensity and multiple peripheral cysts, findings suggestive of MOE. Tumor markers were within normal limits. Based on characteristic imaging features and prior clinical experience, MOE was strongly suspected preoperatively. Laparoscopy revealed a markedly enlarged ovary with a 360-degree torsion. Following detorsion, the ovary decreased in size. A cortical incision revealed no tumorous lesion, and serous fluid leaked from the stroma. A wedge biopsy was performed, and histopathology confirmed MOE. The postoperative course was uneventful, and follow-up ultrasonography one month later showed complete return of the ovary to normal size. This case illustrates the diagnostic value of characteristic ultrasonographic and MRI findings of MOE and highlights the importance of clinical experience in avoiding unnecessary oophorectomy and achieving fertility-preserving management.