Tek Taraflı Ovaryan Torsiyon ile Birlikte Diş ve Kemik İçeren Bilateral Dermoid Kist Olgusu

Akut batın ile başvuran tek taraflı over torsiyonunun eşlik ettiği bilateral dermoid kist vakası takdim edildi. 35 yaşında hasta acil servise akut batın ile başvurdu. Cerrahi sırasında sol over iki tam tur torsiyone ve bilateral dermoid kisti saptandı. Sol salfingooforektomi ve sağ kistektomi uygulandı. Kistektomi sırasında yağ dokusu ile beraber bir adet kesici diş, kemik benzeri yapı ve saç dokusu saptandı. Dermoidler germ hücrelerinden kaynaklanan matür teratomlardır, bu yüzden epiderm, saç, kalsifiye kemik, diş, yağ gibi her üç germ hücre tabakasından yapı içerebilir. Bilateralite, dermoidlerin sık rastlanan bir özelliği olduğundan, acil alınan tek taraflı torsiyon vakalarında dahi karşı over dermoid kist açısından incelenmeli, böylece gelecekte ortaya çıkabilecek mükerrer over torsiyonu vakaları da önlenebilir.

Case Report of Bilateral Dermoid Cyst Containing Tooth and Bone with Unilateral Ovarian Torsion

A case of bilateral dermoid cyst accompanied by unilateral over-torsion with acute abdomen was presented. A 35-year-old patient presented with acute abdomen in the emergency department. Two complete rounds of torsion and bilateral dermoid cysts were detected during the surgery. Left salpingoformectomy and right cystectomy were performed. During cystectomy, together with the hair one incisor tooth and bone like tissue was detected. Dermoids are mature teratomas arising from the germ cells, and therefore they can contain elements of all three germ cell layers such as epidermis, hair, calcified bone, teeth, fat and soft tissue like in our case. Since bilaterality is a common feature of dermoids, it should be examined in the opposite over dermoid cyst, even in cases of emergency unilateral torsion, so that future multiple torsion cases can be prevented.

___

  • 1. DiSaia PJ, Creasman WT. Germ cell, stromal, and other ovarian tumors. In: Gaertner R, Simpson D, editors. Clinical Gynecologic Oncology. 7. Philadelphia: Mosby Elsevier; 2007. pp. 369–395.
  • 2. Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A. Mature cystic teratomas of the ovary: case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol 2000; 88(2):153-157.
  • 3. Kahraman K, Cetinkaya SE, Kankaya D, Dunder I, Soylemez F. Squamous cell carcinoma arising from mature cystic teratoma of the ovary with synchronous endometrial adenocarcinoma. J Obstet Gynaecol Res 2011;37(2):146–150
  • 4. Chiang AJ, La V, Peng J, Yu KJ, Teng NN. Squamous cell carcinoma arising from mature cystic teratoma of the ovary. Int J Gynecol Cancer 2011;21(3):466–474
  • 5. Shariat Torbaghan S, Aleagha M, Sedighi S, Azadbakht F, Keshvari A, Hajarizadeh B, Rosai J. Squamous cell carcinoma arising in an ovarian mature cystic teratoma: a case report. Arch Iran Med 2009; 12(2):186–189
  • 6. Sah SP, Uprety D, Rani S. Germ cell tumors of the ovary: a clinicopathologic study of 121 cases from Nepal. J Obstet Gynaecol Res 2004;30(4):303– 308.
  • 7. Hackethal A, Brueggmann D, Bohlmann MK, et al. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. Lancet Oncol 2008; 9:1173-80.
  • 8. Outwater EK, Siegelman ES, Hunt JL. Ovarian teratomas: tumor types and imaging characteristics. Radiographics 2001;21(2):475-90.
  • 9. Ozgur T, Atik E, Silfeler DB, et al. Mature cystic teratomas in our series with review of the literature and retrospective analysis. Arch Gynecol Obstet 2012;285(4):1099-101.
  • 10. Lee YH, Kim SG, Choi SH, Kim IS, Kim SH. Ovarian mature cystic teratoma containing homunculus: a case report. Korean Med Sci 2003;18(6):905-7.