IMAGE OF THE MONTH Accessory Ovary

A45-year-old asymptomatic woman was found on pel-vic sonography to have a 2.1 1.6 cm persistent right ovarian mass. After discussion and counselling, the woman decided to have the ovarian mass removed. At laparoscopy, the uterus and left ovary and fallopian tube were normal. There was a 2 cm structure resembling ovar-ian tissue located on the right side of the anterior cul-de-sac (Figure 1) connecting to the adjacent peritoneum and the right adnexa by two strands of ligamentous adhesions (Figure 2). The extra-ovarian mass was removed laparoscopically, and histological examination showed nor-mal ovarian tissue, confirming that it was an accessory ovary. Ectopic ovaries, either accessory or supernumerary, are rare gynaecological anomalies.1 An accessory ovary is defined as an ectopic ovarian structure located in the vicinity of a nor-mally placed ovary, with which it has a direct or ligamentous attachment, whereas a supernumerary ovary is located at some distance from, and not connected to, the normal ovary.2 Most women with ectopic ovary are asymptomatic but some may present with chronic pelvic pain and dyspareunia.3 Different types of ovarian tumour have been reported to develop in an ectopic ovary. 4 Approximately one third of women with an ectopic ovary have associated congenital gynaecological and renal anomalies.1 Consent to publish these images has been obtained from the patient. REFERENCES 1. Vendeland LL, Shehadeh L. Incidental finding of an accessory ovary in a 16-year-old at laparoscopy. A case report. J Reprod Med 2000;45:435–8. 2. Clement PB. Nonneoplastic lesions of the ovary. In: Kurman RJ, ed. Blaustein’s pathology of the female genital tract. 5th ed. New York: