Tragically, massive ovarian oedema mimics malignancy.

An 11-year old girl, who had undergone left oophorec­ tomy 2 years previously, was admitted to hospital with abdominal pain and fever of 2 days' duration. She had attained menarche 3 months previously. An abdominal mass with ascites detected on examination corresponded to a massive haemorrhagic right ovarian mass at surgery. Abdominal hysterectomy, right salpingo-oophorectomy and omentectomy were performed in keeping with the clini­ cal impression of malignancy. The specimen comprised a haemorrhagic ovarian mass 150 x 55 x 60 mm (Figure 1), oedematous fallopian tube, normal uterus and omentum. Histology was of massive ovarian oedema (MOO), with diffuse stromal haemorrhage, oedema, congestion, focal infarction and an occasional normal follicular derivative (Figure 2). Review of the left ovarian lesion confirmed a haemorrhagic cyst 75 x 50 x 30 mm, consisting of haemorrhagic congested ovarian tissue.