Abstract
Gynaecologists must be aware that in a teratoma, malignant change is possible within one of the mature cellular elements. Clinically, the tumour may present as an apparently benign cystic teratoma. However, when the mass is fixed, and when adhesions are found intraoperatively, the suspicion of malignant change in a dermoid should be entertained. Furthermore, the risk increases with time, and once a woman passes the age of 70 years, a dermoid cyst in her ovary has a 15 percent chance of containing malignant elements.11 The case described above illustrates that what appears immediately obvious, does not always represent the complete picture. Probing beneath the surface of what is immediately obvious will enable us to reach a deeper understanding of our patient and her disease.
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