An Unusual Case of Bilateral Ovarian Dermoid Cyst in an Infertile Woman - A Case Report

Dermoid ovarian cysts or benign cystic teratomas are benign germ cell tumours which make up to 10 to 25 % of all ovarian tumours. These are usually found in women of reproductive age group with peak age between 25 and 45 years. Of all cystic tumours of the ovary, 5 to 10 % are dermoid cysts. These are bilateral in 12 to 15 % of cases. Mature cystic teratomas account for 10–20 % of all ovarian neoplasms and are the most common neoplasms in patients younger than 20 years of age. Mature teratomas are usually benign, but in 0.1-0.2 % of cases, they may undergo malignant transformation.[1] The word “teratoma,” initially coined by Virchow in 1863, originates from the Greek word teraton, meaning monster. The term “dermoid cyst” used much earlier for the same entity was coined by Leblanc, in 1831.[2] These are initially asymptomatic but can become symptomatic and present with symptoms like pain in the abdomen, anorexia, bloating, and an increase in size. Other complications are torsion, rupture, and infection. They are usually unilocular with smooth surfaces containing sebaceous material with hair, lined by squamous epithelium. Tissues like cartilage, bone, teeth, bronchial mucosa and thyroid tissue can be found in the wall. They have tissues from all three germ layers but ectodermal structures predominate. Diagnosis is usually made by ultrasound scan. Dermoid cysts have a characteristic appearance on ultrasound. Ultrasound findings include the presence of a Rokitansky nodule, fat fluid levels, dermoid mesh, and the “tip of the iceberg sign”.[3] CT scan and MRI can also be used. Management includes surgical excision by laparotomy or laparoscopy.