Rapid growth of dermoid ovarian cyst: case report

Abstract

Introduction. Dermoid cysts, or mature cystic teratomas, are the most common benign germ cell tumors in the ovaries, accounting for 10% to 20% of all ovarian tumors. Dermoid cysts are typically considered to grow very slowly, with an average increase of 1.8 mm per year in premenopausal women. Case description. A 33-year-old woman presented in February 2024 with severe right lower abdominal pain. Laparoscopy revealed ovarian and fallopian tube torsion. The adnexa were restore, and all uterine appendages were inspected. No complications were noted. In May, the patient returned to the emergency department with recurring abdominal pain. A gynecological examination was not performed, as the patient had undergone gynecological surgery a few months prior, and no gynecological pathology was suspected. On June, the patient consulted a gynecologist. Ultrasound showed normal ovarian structure, and 7-8 cm mass behind the uterus, resembling a dermoid cyst, was identified. Considering the patient’s recent laparoscopy, a differential diagnosis was conducted, including a pelvic ultrasound and MRI, which confirmed the findings. The mass was located behind the uterus, and with normal ovarian structure, it took time to confirm its origin. Multidisciplinary consultations were held, resulting in the scheduling of a planned laparoscopic surgery. On August, a cystectomy was performed, and histological examination confirmed a mature cystic teratoma. Summary. A 33-year-old woman presented with severe right lower abdominal pain in February 2024. Laparoscopy revealed a torsion of ovary and fallopian tube. In June, ultrasound and MRI identified a 7-8 cm mass behind the uterus, resembling a dermoid cyst. After multidisciplinary consultations, a laparoscopic cystectomy was performed. Histology confirmed a mature cystic teratoma, which was grown to 7 cm in 3 months. Conclusions. A benign mature cystic teratoma should remain a consideration when a new ovarian mass is found in a patient with previous imaging showing no ovarian abnormalities.