Laparoscopic conservative surgery for bilateral massive ovarian edema presenting with hemoperitoneum

Massive ovarian edema is a rare, non-neoplastic tumour-like mass. Massive ovarian edema mostly affects young women of reproductive age, who face a fertility-threatening diagnosis and treatment. We report a case of bilateral massive ovarian edema in a 36-year-old woman presenting with abdominal pain, an abdominal mass and hemoperitoneum. This is the first report of massive ovarian edema accompanied by hemoperitoneum. Ultrasonography showed enlarged multicystic right and left ovaries measuring 158 x 75 mm and 87 x 85 mm, respectively. MRI demonstrated multiple large peripherally located follicles, stromal edema evident by markedly increased T2 signal intensity and weak gadolinium enhancement, and torsion of the left ovary. MRI was useful in the preoperative diagnosis of massive ovarian edema. The patient underwent laparoscopic conservative surgery. Although the left ovary appeared dark purple due to torsion of 540 degrees during the surgery, both ovaries presented a normal appearance on MRI three months after surgery. Minimally invasive surgical treatment is a preferable option for women suspected to have massive ovarian edema.