Surreal illustration representing the diagnosis of ovarian torsion through laboratory markers.

Ovarian Torsion Alert: Can Clinical Markers Predict This Emergency?

Samir D’Costa in Health & Wellness July 2025 • 3 min read.

"New research combines age and lab results to spot mature cystic teratomas at risk of twisting, offering earlier intervention."

Mature cystic teratomas (MCTs), also known as dermoid cysts, are common ovarian tumors, accounting for about 20% of all ovarian tumors. While usually benign, these cysts can sometimes twist (torsion), leading to pain and potential complications. Prompt diagnosis is critical, but can be challenging.

Ovarian torsion occurs when the ovary twists on its supporting ligaments, cutting off blood supply. This can cause severe pain and, if not treated quickly, can lead to ovarian damage or necrosis. Diagnosing torsion can be difficult because symptoms can be similar to other conditions.

A new study published in Obstetrics & Gynecology Science explores whether a combination of clinical and laboratory findings can improve the accuracy of diagnosing torsion specifically in MCTs. The research aims to provide clinicians with better tools for identifying at-risk patients and intervening early.

Unlocking the Torsion Code: Key Markers Revealed

Surreal illustration representing the diagnosis of ovarian torsion through laboratory markers.

Researchers conducted a retrospective review of 384 patients who underwent surgery for histologically confirmed ovarian MCTs. They compared patients who experienced torsion with those who did not, looking for significant differences in clinical presentation, lab results, and surgical findings. The goal was to identify factors that could help predict torsion.

The study revealed several key markers that were significantly higher in the torsion group:

White blood cell (WBC) count
Neutrophil count
Neutrophil-to-lymphocyte (N/L) ratio
Tumor size

Interestingly, the age of patients in the torsion group was also significantly younger than those in the control group. Individually, each of these factors provided some diagnostic value. However, the real breakthrough came when they were combined.

A Combined Approach: The Power of Prediction

Using receiver operating characteristic (ROC) analysis, the researchers found that the combination of age, WBC count, neutrophil count, N/L ratio, and tumor size yielded an impressive area under the curve (AUC) of 0.898. This indicates a high level of accuracy in distinguishing between MCTs with and without torsion.

The researchers developed a prediction model equation, incorporating these five variables, to estimate the probability of torsion. This tool could potentially help clinicians make more informed decisions about patient management.

While further validation is needed, this study suggests that a combined assessment of clinical and laboratory characteristics may serve as a valuable diagnostic marker for torsion in mature cystic teratomas, leading to earlier intervention and improved outcomes for women.

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This article is based on research published under:

DOI-LINK: 10.5468/ogs.2018.61.3.386, Alternate LINK

Title: Combination Of Clinical And Laboratory Characteristics May Serve As A Potential Diagnostic Marker For Torsion On Mature Cystic Teratomas

Subject: Obstetrics and Gynecology

Journal: Obstetrics & Gynecology Science

Publisher: Korean Society of Obstetrics and Gynecology

Authors: Ji Yun Lee, Whan Shin, Jeong Sook Kim, Joo Hyun Park, Sihyun Cho

Published: 2018-01-01

Everything You Need To Know

What are mature cystic teratomas (MCTs), and why is it important to understand them in relation to ovarian torsion?

Mature cystic teratomas (MCTs), also known as dermoid cysts, are common ovarian tumors. They are usually benign but can sometimes twist, a condition known as ovarian torsion. This torsion cuts off the blood supply to the ovary, leading to pain and potential complications. Identifying MCTs at risk of torsion is crucial because prompt diagnosis allows for early intervention, which can prevent severe consequences such as ovarian damage or necrosis.

What exactly is ovarian torsion, and why is it a concern?

Ovarian torsion occurs when the ovary twists on its supporting ligaments, disrupting the blood supply. This can cause significant pain and, if left untreated, can result in serious complications such as ovarian damage or necrosis. The twisting can happen in mature cystic teratomas (MCTs), requiring prompt diagnosis and intervention.

What specific factors were found to be associated with ovarian torsion in the study?

The study identified key clinical and laboratory markers associated with torsion in mature cystic teratomas (MCTs). These markers include a higher White blood cell (WBC) count, Neutrophil count, Neutrophil-to-lymphocyte (N/L) ratio, and larger Tumor size. The age of the patient was also a factor, with patients in the torsion group being younger. These markers, when combined, provide a more accurate prediction of torsion.

How does combining multiple markers improve the prediction of ovarian torsion?

The combination of multiple markers significantly improves the ability to predict ovarian torsion in mature cystic teratomas (MCTs). Using receiver operating characteristic (ROC) analysis, researchers found that the combined approach of age, White blood cell (WBC) count, Neutrophil count, Neutrophil-to-lymphocyte (N/L) ratio, and tumor size yielded an impressive area under the curve (AUC) of 0.898. This demonstrates a high level of accuracy in distinguishing between MCTs with and without torsion. The more accurate the diagnosis, the more likely early intervention will prevent serious complications.

What are the practical implications of identifying these markers for patient care?

The identification of these markers has significant implications for patient care. By combining age and lab results, doctors can more effectively identify mature cystic teratomas (MCTs) at risk of torsion. This allows for earlier intervention, potentially preventing serious complications like ovarian damage or necrosis. Early diagnosis can lead to improved outcomes and reduced risk of complications. The study suggests these markers can serve as valuable tools for clinicians in diagnosing and managing patients with MCTs.