To investigate the diagnostic features of massive ovarian edema(MOE).

The clinical data of 4 patients with MOE were retrospectively analyzed, which were diagnosed by pathological diagnosis in the First People′s Hospital of Zaoyang from January 2017 to January 2022. The corresponding literatures were reviewed, simultaneously.

Four patients, 16 to 28 years old, had varying degrees of lower abdominal pelvic pain. All patients underwent ultrasound examination, and gynecological ultrasound showed hypoechoic mass in the annex area or lower abdominal pelvic cavity. Gynecological tumor markers were normal in 3 cases. Two cases underwent reproductive hormone testing, and 1 case was diagnosed with polycystic ovary syndrome. Four patients underwent laparoscopy or laparotomy procedure. The mass was seen as enlarged and swollen ovary with torsion during operation, and the color was porcelain white, pale red, or dark red, the ovary was tough and elastic, and edema fluid or bloody fluid exudation could be seen on the section. Benign lesions were found through intraoperative frozen section examination. Follicles at different developmental stages were found in the postoperative routine pathological examination, and blood vessels and lymphatic vessels were exposed in the edema area.

The patients with MOE are young and related to ovarian torsion. Combination of the medical history, preoperative examination, and intraoperative frozen section examination plays an important role in guiding the surgical procedure.