Torsion Giant ovarian cysts in a postmenopausal woman with cervical cancer.

Abstract

Ovarian torsion is a rare gynecological emergency, particularly in postmenopausal women, and is associated with significant morbidity if not promptly managed. The occurrence of torsion in giant ovarian cysts (>20 cm) is exceptionally uncommon, posing diagnostic and therapeutic challenges. A 67-year-old postmenopausal woman with stage IIIB cervical cancer presented with worsening abdominal pain and vaginal bleeding over three months. During surgery, a 30 cm giant right ovarian cyst with torsion and a smaller left dermoid cyst were identified. The patient underwent bilateral salpingo-oophorectomy, and histopathological findings confirmed a right benign serous cystadenoma with mature teratoma and struma ovary and left serous cystadenoma and dermoid cyst. Postoperatively, she received chemoradiation for cervical cancer and remained asymptomatic at one-year follow-up. This case emphasizes the need for prompt diagnosis and management of ovarian torsion in postmenopausal women, especially in complex clinical scenarios involving coexisting conditions such as cervical cancer.