Intra-Peritoneal Rupture of a Benign Ovarian Teratoma - A Rare Complication of This Relatively Common Entity

Abstract

Mature cystic teratoma is a cystic tumor composed of welldifferentiated derivations from at least two of the three germ cell layers (ectoderm, mesoderm, and endoderm). These tumors are usually complicated by torsion, with rupture and malignant transformation to be relatively rare. Here we present a case of a 25-year-old woman with complaints of sudden onset generalized acute abdominal pain. Her ultrasound pelvis revealed a large anechoic lesion with internal chunky calcification as well as hyperechoic internal contents (like that of fat) in the pelvis and left adnexa, extending up to the midline. Mild to moderate loculated ascites, peri-hepatic and intraperitoneal nodularity were also seen, representing changes of peritonitis. On CECT abdomen and pelvis, focal discontinuity was seen within the pelvic cyst wall with evidence globular free fat contents within the peritoneal cavity. Findings related to peritonitis were corroborated on CT. The imaging findings were suggestive of underlying peritonitis, secondary to the intra-peritoneal rupture of dermoid and release of its internal fat and fluid contents.