This is a case of an eighteen year old nulligravid with no h | Figure 1

KestrelMD

Obstetrics & Gynecology

This is a case of an eighteen year old nulligravid with no history of sexual contact, complaining of hypogastric and abdominal pain. Her condition started a month prior to consult. Her menstrual period was normal, regular. Transrectal ultrasound revealed that the right ovary was converted into a multiloculated cystic structure measuring 27 x 22 x 14cm with papillary projections and minimal color flow studies. She was requested for tumor markers and further work up however patient complained of persistent pain with painscale of 8/10. On intraop, the huge ovarian cyst right had one full twist on its pedicle. Salpingooophorectomy with peritoneal fluid cytology and peritoneal biopsy done. Cut section revealed the following pictures, with some tufts of hair, and solid excrescences. The left ovary was normal. We had to extend the incision site from above the pubis to below the xiphoid area as we didn't want to have spillage in the field. No ascites noted. Histopath revealed... Immature Teratoma, High Grade. PFC negative. This patient will now be referred to a gyne oncologist to start her VAC regimen.