Presentation
The patient presented with sudden onset of severe right sided lower abdominal pain.
Patient Data
Bilateral adnexal cystic masses show predominant fat content with dense teeth-like structures (dentiform) and scattered soft-tissue attenuation. The largest one measures 9 x 7.5 x 8.5 cm in maximum orthogonal dimensions. Some lesions show intracystic high-density fluid attenuation suggestive hemorrhage.
Note the thick-wall tubular filled structure on the right attached to the largest lesion.
Small fluid density noted in the pelvis
Case Discussion
Features are consistent with multiple mature ovarian teratomas complicated with right tubo-ovarian torsion.
The patient underwent emergency laparotomy, where multiple bilateral ovarian teratomas with hemorrhagic changes were confirmed and removed. The right ovary and fallopian tube found to be twisted several times and non-salvagable.
Ovarian teratomas (dermoid) represent the most common ovarian germ cell neoplasm. The term teratoma and dermoid are commonly used interchangeably, although, are histologically different.
Resection is advised for teratomas more than 7 cm to avoid complications such as rupture or torsion.
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