ABSTRACT
Background: Tubo-ovarian abscess (TOA) is a documented and severe complication of untreated pelvic inflammatory disease. It is a life threatening infection that involves the ovaries, the fallopian tubes, and or any other adjacent tissue with a significant risk of infertility and pelvic adhesions. It is most commonly unilateral.
Case summary: This report presents a rare and unusual presentation of a huge bilateral tubo-ovarian abscess in a young woman, who presented with recurrent abdominal pain with no clear signs of infection. Clinical and
laboratory findings were suggestive of a complex ovarian mass with elevated CA-125. She had exploratory laparotomy with bilateral ovarian salpingectomy and bilateral ovarian cystectomy based on intraoperative findings.
Conclusion: The management of this case underscores the need for having a high index of suspicion for unusual presentations of pelvic masses.
Keywords: Bilateral Tubo-ovarian abscess, Ovarian cyst, Pelvic inflammatory disease, Tubo-ovarian mass