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

Ovarian Torsion Alert: Can Clinical Markers Predict This Emergency?

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Samir D’Costa in Health & Wellness November 2026 • 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.

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Insufficient Medical Evidence

The listed sources describe the 2026-27 Los Angeles Lakers roster, coaching staff, player statistics, and team information rather than clinical approaches to ovarian torsion. ESPN identifies the roster's basketball positions, while NBA.com discusses the coaching staff and complete player statistics. These sources do not provide evidence about accepted diagnostic methods or their limitations for ovarian torsion.

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
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Inflammatory Markers and NLR

The neonatal ovarian tumor study reports that inflammatory markers such as WBC and CRP have been considered predictors of ovarian torsion, but it also notes that other scholars found no significant difference in inflammatory markers between torsion and control groups. A systematic review and meta-analysis specifically examined the predictive role of the neutrophil-to-lymphocyte ratio in adnexal torsion. Another study describes NLR as a valuable diagnostic marker and reports higher NLR values in patients with torsion of mature cystic teratomas. Together, these sources support interest in blood-based markers while also showing that their diagnostic value is not uniformly established.

Missed or Unclear Presentations

A study of torsion involving mature cystic teratomas reports one incidental case and three cases in which symptoms were too mild or unclear to predict torsion. It also describes three cases in which surgery was delayed because clinicians suspected that pain had weakened after detorsion. The Korean study source identifies a further limitation: the torsion group was too small compared with the control group. These findings show why clinical symptoms and study results may not reliably predict every case.

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.

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Unrelated Technology Sources

The listed sources concern Roblox communities and tools rather than ovarian torsion or healthcare delivery. ForgeGUI is described as an AI Roblox Studio plugin that generates, debugs, explains, and refactors Luau scripts. Other sources discuss Roblox communities and a pilot for publishing UGC Avatar Backgrounds on the Marketplace. These materials do not support conclusions about broader clinical, systemic, or healthcare challenges related to ovarian torsion.

Unrelated Story Archives

The listed sources describe online stories and archives rather than patient experiences or the real-world impact of ovarian torsion. Quotev presents stories inspired by the experiences of fifth-grade girls, including Charlotte, Kate, and Sarah. The other sources describe the Kristen Archives as a collection of reader-submitted stories and provide archive or site information. These materials do not provide evidence about patients' experiences, emergency care, or the human consequences of ovarian 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.

How much weight to give this MCT torsion study

Observational study (level 4 of 8)

This was a retrospective review of patients who had surgery and histologically verified ovarian MCTs, so it can identify associations in that surgical group but cannot establish that the markers cause torsion or predict it in other populations.[1]

The comparison included 24 torsion cases and 360 controls, making the torsion group much smaller than the comparison group.[1]

What keeps the result unsettled

  • Some torsion cases were incidental or had symptoms too mild or unclear to point to torsion; suspected detorsion also delayed operations in several cases.[2]
  • In cases thought to have detorsed, pain loss was later attributed to progressing tissue necrosis, complicating interpretation of symptom changes.[2]
  • The study did not find a statistically significant difference in CA19-9 between the torsion and control groups, despite elevated average levels in both.[2]

A retrospective review of surgically confirmed MCT torsion

Study designObservational study[1]
PopulationPatients who underwent surgery and had histologically verified ovarian MCTs[1]
Sample size384[1]
SettingSingle university hospital[1]
DurationJuly 2006 to May 2017[1]
ComparisonTorsion group (n=24) versus control group (n=360)[1]
Effect sizeCombined AUC of 0.898[1]
Confidence interval95% confidence interval, 0.833-0.962[1]
Times cited10[1]

How the findings relate to earlier diagnostic work

Earlier work cited in this paper found low positive predictive value for preoperative torsion diagnosis and limited CT or MRI sensitivity in that study, underscoring that the combined marker result addresses a difficult diagnostic setting rather than replacing certainty.[2]

What follow-up work would need to clarify

  • Would the combined marker performance hold in prospective, multi-hospital groups beyond patients selected for surgery and histologic confirmation?[1]
  • How reliably can the model distinguish torsion when symptoms are mild, unclear, or appear to ease despite worsening tissue injury?[2]
  • Would the same marker combination add useful separation when imaging signs such as the whirlpool sign are not clearly visible?[2]

Terms used in the study

Whirlpool sign
A twisted vascular pedicle seen on color Doppler imaging that can suggest torsion.[2]

Sources

  1. Combination of clinical and laboratory characteristics may serve as a potential diagnostic marker for torsion on mature cystic teratomas (Korean Society of Obstetrics and Gynecology, 2018)
  2. Combination of clinical and laboratory characteristics may serve as a potential diagnostic marker for torsion on mature cystic teratomas (Europe PMC, 2018)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

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

1

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.

2

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.

3

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.

4

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.

5

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.

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