Authors : Dr. Krupa BM, Dr Divya TK, Ashwini Nayak U, KB Yuktha
DOI : 10.18231/j.ijmpo.2024.018
Volume : 10
Issue : 3
Year : 2024
Page No : 69-72
Ovarian dermoid cysts or mature cystic teratomas are benign ovarian germ cell tumours most seen in the 3rd and 4th decades of life. These tumours contain tissue from the ectoderm, mesoderm and endoderm. Haemorrhagic ovarian cysts occur when blood accumulates in a corpus luteum or follicular cyst. Ovarian torsion involves the twisting of an ovary on its ligamentous attachments reducing its blood supply. A 22-year-old unmarried nulligravida presented with sudden, severe right lower abdominal pain and vomiting. Ultrasound (USG) and other investigations were performed. Elevated CA 19-9 levels raised concerns about malignancy. Differential diagnoses included gastrointestinal cancers, appendicitis with secondary ovarian involvement, ruptured ovarian cyst and ovarian torsion with a cystic mass. USG showed a right ovarian dermoid cyst measuring 5.1 x 4.3cm with partial torsion and a left haemorrhagic cyst measuring 3.1 x 8cm. The patient underwent laparoscopic right oophorectomy and left cystectomy under spinal anaesthesia. Tumour markers (CA 125, AFP, β-hcg, LDH and CEA) were normal. Histopathology confirmed a benign ovarian dermoid cyst, ruling out malignancy. The occurrence of Ovarian dermoid cyst is less than 20%, ovarian torsion occurs in 15% of these cases. Haemorrhagic ovarian cysts occur in about 5-10% of ovarian cysts. Ca 19-9 is raised in GI malignancies and conditions. In ovarian pathologies, it is not well documented and relatively rare. This case underscores the importance of rapid diagnosis and multidisciplinary approach and intervention in rare ovarian conditions, especially in young women where fertility preservation is crucial.