Incidental finding of an accessory ovary in a 16-year-old at laparoscopy. A case report.

BACKGROUND: Supernumerary and accessory ovaries are rare anomalies. The reported incidence of these conditions is 1:29,000-700,000 gynecologic admissions. Since 1864 there have been only six cases of accessory ovary reported in the literature. Additionally, there have been 26 reported cases of supernumerary ovaries. This case seems to be the seventh reported case of an accessory ovary in over 135 years. It is the third case in a woman under age 18. In 36% of reported cases, associated congenital anomalies have been identified. Defects have included accessory fallopian tube, bifid fallopian tubes, accessory tubal ostium, bicornuate and unicorunate uteri, septate uterus, agenesis of kidney or ureter, bladder diverticulum, accessory adrenal gland and lobulated liver. CASE: A 16-year-old nulligravida complained of persistent left lower quadrant abdominal pain. Abdominal ultrasound confirmed a left ovarian cyst, which was unresponsive to medical management with oral contraceptives. At laparoscopy, a normally placed, right ovary and eutopic left ovary were identified. In addition, an accessory ovary was identified on the posterior surface of the left broad ligament.
CONCLUSION: Since accessory ovaries are likely to be asymptomatic, they may be underreported. This condition is associated with a high risk of pelvic and renal anomalies and should lead to further evaluation to allow physicians to provide advice about future reproductive function and management of congenital anomalies.