卵巣と索状に連続した大網成熟嚢胞性奇形腫の一症例

抄録

Background: Ovarian teratomas are commonly observed in women of reproductive age; however, omental teratomas are extremely rare. Omental teratomas are usually asymptomatic or can produce compressive symptoms. Here we report a case of a patient with omental teratoma treated with laparoscopic surgery.

Case presentation: A 74-year-old woman had 3 months' history of intermittent leg numbness. She visited an orthopedic hospital. Computed tomography (CT) was performed, and mass lesions were defined in her abdomen and pelvis; therefore, she was referred to our institution. Magnetic resonance imaging and contrast-enhanced CT was performed, and we considered these lesions to be a right ovarian cyst and an omental cyst. Laparoscopic surgery was performed. Intraoperatively, a right ovarian cyst of 8 cm and an omental cyst were diagnosed. Although her left ovary was normal in appearance, it was connected to the omental cyst with its pedicle. Those cysts adhered to the around tissue, small intestine, greater omentum, and abdominal wall. Bilateral salpingo-oophorectomy was performed. The cyst wall of the omental cyst was thick and calcified, mimicking an egg shell. The pathological diagnoses were right ovarian mature cystic teratoma (MCT) and greater omental MCT arising from the left ovary.

Conclusion: Although extragonadal teratomas in the abdominal cavity are extremely rare, gynecologists should be aware of them. The possibility of an autoamputated ovarian teratoma should be considered, and careful observations of intraperitoneal conditions should be made during surgery.