Minimal Laparotomy Management of a Giant Asymptomatic Ovarian Teratoma in a Woman of Reproductive Age: A Case Report

Background: The majority of giant teratomas are symptomatic. The preoperative evaluation for possible malignancy is challengeable, as is the surgical approach. A consensus has not yet been drawn regarding the optimal treatment approach in cases of exceptionally large teratomas.

Case presentation: We report a rare case of minimal laparotomy management of a giant ovarian cystic teratoma in a 32-year-old asymptomatic multiparous woman. The patient was diagnosed while performing a fitness-to-work checkup where the physician noted a suspicious abdominal swelling. Subsequently, she was referred to us for further evaluation. Her CA125 level was raised, and an abdominal contrast computed tomography revealed a huge teratoma. After appropriate counselling, laparotomy and adenectomy were performed. Histopathological examination diagnosed a mature cystic teratoma with no malignant transformation. The patient had an uneventful recovery and was discharged on the third post-operative day.

Conclusions: We conclude that dermoid cysts can reach enormous sizes in the absence of serious symptoms or evidence of malignancy, although the size is a well-known risk factor for malignant transformation.

Keywords: Giant teratoma; Pelvic mass; Laparotomy; Computed tomography

Abbreviations: AFP: α-Fetoprotein; CEA: Carcino Embryonic Antigen; CT: Computed Tomography; SCC Ag: Squamous Cell Carcinoma Antigen