title: A case of uterine torsion concurrent with a ruptured ovarian endometrial cyst.
abstract: The patient was a 54-year-old female presented with severe abdominal swelling and intermittent pain. On emergent CT, massive ascites with thickened peritoneum and intra-pelvic cystic mass approximately 20 cm in diameter were observed. The cyst wall showed redundant irregular shape. The uterus was enlarged with intramural mass located at its right anterior fundus. MRI showed this pelvic cyst as high intensity on T1-weighted images, so that it was suspected as an endometrial cyst. The operation revealed the rupture of endometrial cyst and the uterine torsion of 180° around the long axis. Retrospectively, the X-shaped configuration of the upper vagina was observed on MRI and both the adnexa, including right ovarian cyst, were connected to the opposite side ovarian vein. Torsion of a non-gravid uterus is rare. In this case, the uterine torsion seemed to be caused by enlarged uterine body and ruptured endometrial cyst. Radiologists should be aware of this potential complication of huge ovarian mass and enlarged uterus and its appearance.
authors.affiliation: Department of Radiology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan. hachan0213@yahoo.co.jp.
authors.forename: Aya
authors.initials: A
authors.lastname: Hashimoto
authors.affiliation: Department of Radiology, IVR Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Takahama
authors.affiliation: Department of Gynecology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Harada
authors.affiliation: Department of Radiology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan.
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Department of Radiology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Anai
authors.affiliation: Department of Radiology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Fukusumi
authors.affiliation: Department of Pathology, Nara City Hospital, 1-50-1 Higashikidera-cho, Nara, Nara, 630-8305, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Imai
authors.affiliation: Department of Radiology, IVR Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010048:Ovarian Cysts; D012421:Rupture; D014591:Uterine Diseases
keywords: Degenerated leiomyoma; Ruptured endometrial cyst; Uterine torsion