A 30-year-old woman presents to the emergency department reporting severe headache, nausea, vomiting, and ‘worst thing happened to my life’ lower abdominal pain. On further questioning, she reports last week she sideswiped a parked car in downtown. She explains that she never saw the car until after she hit it. She denies any trauma to herself and her headaches are not related to that incident because she has been having similar headaches every day for over two months. Her medical history is significant for polycystic ovarian syndrome. She denies alcohol, tobacco, and drug use. Her temperature is 99.8 F, heart rate is 108 beats/min, blood pressure is 148/94 mm Hg, respirations are 19 breaths/min, and oxygen saturation is 97% on room air. On examination, her cardiac examination is notable for tachycardia; abdominal examination is notable for bilateral, lower quadrant tenderness, and neurologic examination is notable for bitemporal hemianopia. MRI demonstrated a heterogeneously enhancing sellar and suprasellar mass, measuring 2.4 × 1.8 × 2.1 cm, with compression of the optic chiasm. Abdominal ultrasound revealed bilateral enlarged polycystic ovaries and ovarian torsion. Pathology revealed a large hemorrhagic follicular cyst and numerous smaller cysts lined by granulosa cells and a layer of luteinized thecal cells. She underwent right salpingo-oophorectomy for ovarian torsion. What is the most likely diagnosis in this patient?
