CASE REPORT   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 July-August;177(7-8):403-7

DOI: 10.23736/S0393-3660.17.03664-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Multiple bilateral ovarian teratoma in a young woman presenting with acute abdomen and ovarian torsion: lesson learned

Roberta VENTURELLA ¹ ✉, Sara PEDRI ¹, Pietro D’ALESSANDRO ¹, Alberto VAIARELLI ^{2, 3}, Fulvio ZULLO ¹, Costantino DI CARLO ¹

¹ Department of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, Catanzaro, Italy; ² GENERA, Center for Reproductive Medicine, Valle Giulia Clinic, Rome, Italy; ³ Department of Human Pathology, University of Messina, Messina, Italy

We report a rare case of multiple bilateral ovarian teratomas in a young nulliparous woman, admitted with acute abdomen and managed by emergency surgery to resolve the acute torsion of the left ovary and to excise the multiple contralateral teratomas. The patient had been previously diagnosed with a single dermoid cyst during her adolescence but was not counselled for an adequate follow-up. The emergency laparoscopy was performed assuring the preservation of as much healthy ovarian tissue as possible, according to fertility sparing intent. Ovarian torsion caused congestion of the left ovary that requested omolateral adnexectomy, while the absence of hemorrhagic infarction or necrosis on the right ovary allowed the contralateral multiple cystectomies, with healthy ovarian tissue preservation. Patient’s postoperative recovery was uncomplicated and she was discharged two days after surgery. Menstruation appeared three months after surgery, then the patient was submitted to an ovarian reserve evaluation through ultrasonographic and biochemical parameters that showed a significantly reduction in ovarian reserve. Carefully informed about the risks of future infertility, the patient, who had no immediate desire of pregnancy, asked for fertility preservation procedures and decided for oocyte freezing. According to this experience, to prevent ovarian torsion and subsequent adnexectomy, women with ovarian teratomas should be advised about the natural history of these tumors and managed appropriately to preserve their fertility.

KEY WORDS: Fertility preservation - Laparoscopy - Teratoma - Ovary - Ovarian reserve - Torsion abnormality