Mature Cystic Teratoma Of The Ovary Coexisting With Tubal Ectopic Pregnancy

Öz

Although mature cystic teratoma dermoid cyst of the ovary and ectopic pregnancy are common gynecologic disorders in women of reproductive age, the coexistence of these two pathologies is an unusual case. We present a 26-year-old nulligravid women with a history of pelvic pain and minimal vaginal bleeding. Detailed gynecologic examination and imaging studies revealed a simultaneous coexistence of mature cystic teratoma and ectopic tubal pregnancy in the same adnexa. She had undergone laparoscopic surgery. In the exploration, unruptured left tubal pregnancy 2x2 cm in the ampullary region and ipsilateral ovarian mature cystic teratoma measuring 9x7 cm were found. Salpingostomy and total cyst excision were performed. Pathological examination confirmed the diagnosis of ovarian dermoid cyst and ectopic pregnancy. Postoperative recovery was uncomplicated. The present report demonstrates the importance of considering the coexistence of different gynecologic pathologies in the same patient and clinical importance of an accurate diagnostic evaluation.

Anahtar Kelimeler

• Dermoid cyst,ectopic pregnancy,laparoscopy,ovary

Ovaryan Matür Kistik Teratom Ve Beraberinde Tubal Ektopik Gebelik

Öz

Matür kistik teratoma dermoid kist ve ektopik gebelik, reprodüktif dönemdeki kadınlarda sık görülen patolojiler olmakla birlikte, bu iki hastalığın aynı hastada görülmesi nadir rastlanan bir klinik durumdur. Bu olgu sunumunda, pelvik ağrı ve minimal vajinal kanama ile başvuran 26 yaşında nulligravid bir hastayı bildirmekteyiz. Detaylı jinekolojik değerlendirme ve görüntüleme tetkikleri sonucunda, aynı taraftaki adneksiyal bölgede tubal ektopik gebelik ve ovaryan dermoid kist tespit edildi. Ardından uygulanan laparoskopik cerrahide sol unrüptüre 2x2 cm tubal ektopik gebelik ve 9x7 cm ovaryan dermoid kist olduğu gözlendi. Salpingostomi ve total kistektomi yapıldı. Patolojik inceleme, ektopik gebelik ve dermoid kist tanılarını doğruladı. Cerrahi sonrası dönemde sorun saptanmadı. Bu vaka sunumunda, aynı hastada farklı jinekolojik patolojilerin bir arada bulunabileceğinin hatırda tutulması gerekliliği ve eksiksiz bir diagnostik incelemenin önemi vurgulanmaktadır.

Anahtar Kelimeler

• Dermoid kist,ektopik gebelik,laparoskopi,over

Kaynakça

1. Berek JS. Benign diseases of the female reproductive tract. In: Berek JS, eds. Berek & Novak’s Gynecology. 15th ed. Philadelphia: Lippincott Willi- ams & Wilkins, 2012: 374-437.
2. Chae H, Rheu C. Endometriosis coexisting with mature cystic teratoma in the same ovary and ectopic pregnancy of left fallopian tube: a rare coexistence. Clin Cas Rep 2015; 3:315-8.
3. Serafini G, Quadri PG, Gandolfo NG, Gandolfo N, Martinoli C, Derchi LE. Sonographic features of incidentally detected, small, nonpalpable ovari- an dermoids. J Clin Ultrasound 1999; 27:369-73.
4. Pepe F, Lo Monaco S, Rapisarda F, Raciti G, Genovese C, Pepe P. An unu- sual case of multiple and bilateral ovarian dermoid cysts. Case report. G Chir 2014; 35:75-7.
5. Togashi K, Nishimura K, Itoh K, Fujisawa I, Sago T, Minami S et al. Ovarian cystic teratomas: MR imaging. Radiology 1987; 162:669-73.
6. Hajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev 2007; (1):CD000324.
7. Jalencas G, González Bosquet E, Guirado L, Fernandez Arias M, Ruiz de Gauna B, Fiores L et al. Ovarian mature teratoma: a ten year experience in our institution. Clin Exp Obstet Gynecol 2015; 42:518-22.
8. Kuna K, Grbavac I, Vuković A, Bilić N, Kraljević Z, Butorac D.Coexistence of ruptured ectopic tubal pregnancy, dermoid and endometriotic cyst with tubo-ovarian abscess in the same adnexa: case report. Acta Clin Croat 2015; 54:103-6.

9. Alvarez PA, López AG, Mateu VS. Ectopic pregnancy. Review of 32 cases including right tubal rupture and dermoid cyst of the same ovary. Acta Obstet Ginecol Hisp Lusit 1979; 27:397-414.
10. Shetty MK. Adnexal Masses: Role of Supplemental Imaging With Magne- tic Resonance Imaging. Semin Ultrasound CT MR 2015;36:369-8.