Stomach pain

The main complaint of a 35-year-old gravida 3 para 0 (abortion 2) lady who visited the obstetrics emergency department was stomach pain. The pain started a week earlier and worsened primarily in the right lower quadrant and the hypogastric region. The patient was reasonably unwell, but vital signs were stable, and an abdomen examination revealed hypogastric discomfort. An ultrasound revealed a normal left ovary measuring 20 by 36 mm and a right adnexal tumour measuring 34 by 87mm with a whirlpool indication on the infero-medial region (Figure 1). In the operating room, a mini-laparotomy incision was made. A three-rotation cyst with white colour and hard consistency was observed in the right ovary. The tumoral mass was removed and sent for a pathologic analysis after tumour detorsion. Sections showed extensive cell growth, pale cytoplasm, round to ovoid nuclei free of nuclear atypia, and no signs of mitosis (Figure 2).