Identical twins with twisted benign cystic teratoma of the ovary

Abstract

Case reports Case 1. T. L., a 24-year-old, Lumbee Indian, nulliparous woman, presented with a 2 week history of lower abdominal pain. She had been treated elsewhere for pelvic inflammatory disease with antibiotics and no improvement. Surgery had been recommended for her “infection.” When initially seen, she was afebrile. Physical findings were limited to the abdomen and pelvis. The abdomen was slightly protuberant with normal peristalsis and minimal spasm and guarding. There was some low abdominal tenderness without rebound. The uterus was of normal size. A left adnexal, irregular cystic mass extended from the anterior surface of the uterus to the left pelvic side wall. A right adnexal, exquisitely tender mass extended posteriorly to the uterus and into the cul-de-sac. Outpatient therapy of suspected pelvic inflammatory disease was continued with tetracycline. One week later, she was essentially asymptomatic and had been afebrile throughout the past week. Examination revealed the left adnexal mass to be mobile. The right mass was less tender but was fixed. One week subsequent to this, the left mass was interpreted as being completely mobile and cystic. Pelvic laparotomy for pelvic inflammatory disease or twisted ovarian cyst was performed on November 25, 1964, and revealed a twisted, infarcted, hemorrhagic, 12 cm, benign cystic teratoma of the right ovary. The left ovary was quite large and contained five separate benign cystic teratomas measuring from 1 to 8 cm in diameter. The right adnexa were removed, and multiple cystectomies were performed on the left ovary