Management of an acute hemorrhagic ovarian cyst in a female patient with hemophilia A

Purpose: This case report represents a description of a hemorrhagic ovarian cyst in a patient with hemophilia A. Patient: An 18-year-old female patient with severe factor VIII deficiency presented with the acute onset of a hemorrhagic ovarian cyst, meeting the standard indications for surgical intervention. Instead, because of the underlying coagulopathy, factor VIII therapy was instituted. Result: Within 1 day of starting the factor VIII therapy, the hemorrhage had clinically resolved and surgical intervention was avoided. Conclusions: Hemorrhagic ovarian cysts in the setting of hemophilia may respond to factor VIII replacement therapy without the need for surgical intervention. Because the incidence of functional ovarian cysts is high in the general population, female patients with hemophilia should be counseled regarding its possibility of occurrence. Moreover, if a female patient with hemophilia displays a propensity toward the development of ovarian cysts, the administration of prophylactic oral contraceptive pills should strongly be considered.