Story of recurrent bilateral ovarian dermoid cyst in a young woman: a case discussion

Abstract

Mature cystic teratomas (MCTs), also known as dermoid cysts, are the most common benign ovarian germ cell tumors, typically affecting women of reproductive age. Although usually unilateral and slow-growing, MCTs can be bilateral and carry a risk of recurrence, particularly in younger patients with large tumors. We report the case of a 29-year-old second gravida woman, known case of right ovarian dermoid cyst complicated by torsion at 18 weeks of gestation, managed by right salpingo-oophorectomy. Histopathology revealed a collision tumor comprising a mature cystic teratoma and mucinous cystadenoma. Two years later, the patient presented with intermittent left lower abdominal pain. Imaging suggested a left ovarian dermoid cyst. Laparoscopic cystectomy was performed, and histopathology confirmed a mature cystic teratoma. The postoperative course was uneventful. The patient exhibited multiple risk factors for recurrence, including young age at diagnosis, initial tumor size >11 cm, and subsequent bilateral involvement. This case highlights the importance of identifying key risk factors for MCT recurrence-namely, young age, large tumor size, and bilateral presentation. While imaging and tumor markers such as CA 19-9 aid in diagnosis, surgical excision remains the definitive treatment. In reproductive-age women, laparoscopy offers a fertility-sparing approach. Long-term follow-up is essential in high-risk patients to monitor for recurrence.