Torsion occurs most commonly with dermoid cysts and fibromas, but may occur with any mobile tumour of any size.
Torsion always produces severe lower abdominal pain, often originating in the iliac fossa and radiating to the flank - so called "reverse renal colic." Nausea and vomiting are common.
There may be a history of similar episodes representing partial twisting and untwisting of the pedicle. The mass may be extremely tender. Untreated, the tumour soon becomes necrotic.
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