Multidetector row CT scan of abdomen with pre- and post-
intravenous contrast, and with multiplanar reconstruction
(figure 1-4):

1. A homogeneous poor enhancing ovoid mass (arrow in figure 1-4),
about 6.0cm in greatest dimension, with multiple peripheral
cystic component (around 0.5cm) in right parasagittal region
of pelvis, possibly associated with adnexal torsion with
enlarged ovary and cortical follicles, but nature to be
determined.
2. Small fluid in pelvis.
3. No abnormal finding in remaining abdomen, including appendix.

1.5 Tesla MRI of pelvis with T2 weighted half-Fourier acquisition
single-shot turbo spin echo with fat suppression, T2 weighted echo
train spin echo with fat saturation, diffusion-weighted echo-planar
MR imaging, T1 weighted double inversion recovery echo train spin
echo, T2/T1 true fast imaging with steady-state precession gradient
echo with fat saturation, T1 weighted fast low angle shot gradient
echo with fat saturation, and with intravenous gadolinium-enhanced
images (figure 5):

1. A homogeneous poor enhancing iso-T1 and mild heterogeneous long
T2 ovoid mass, about 6.0cm in greatest dimension, with multiple
peripheral long T1 and T2 cystic component (around 0.5cm) in
right parasagittal region of pelvis, possibly associated with
left adnexal torsion with enlarged left ovary and multiple
cortical follicles.
2. No detectable fat content within above structure.
But occult neoplasm still can not be excluded from this
examination.
3. Small fluid in pelvis.
4. Small cysts in right ovary (arrow in figure 5).

Photo:
Left ovary (figure 6)
Right ovary (figure 7)

Pathology:
1.Left salpingo-oophorectomy (figure 8,9):
Severe congestion, hemorrhage and ischemic necrosis form a bulging
hematoma, consistent with torsion, clinically. No malignancy.

2.right ovary biopsy:
Developing follicles evenly distributed among somewhat cellular or
focally aggregated fibrous stroma. Some luminated segments
inner-lined by granulosa cells. No malignancy.