Cebesoy Fatma Bahar, Baskonus Ilyas, Mete Ahmet, Kutlar Irfan, Aybasti Necdet
Obstetric and Gynecology Department, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
Arch Gynecol Obstet. 2009 Feb;279(2):179-81. doi: 10.1007/s00404-008-0659-7. Epub 2008 May 1.
Fistulation in benign cystic teratomas has not been commonly reported in the literature. We present a case of a benign ovarian dermoid cyst complicated with a recto-ovarian fistula.
A 30-year-old nonpregnant woman admitted to the gynecological outpatient clinic because of lower abdominal pain and purulent diarrhea. Gynecological examination and ultrasonography revealed a 10-cm heterogeneous cystic mass in the left ovary. Abdominopelvic CT scan revealed a left ovarian mass (10 x 9 cm) thought to be a dermoid cyst, which was seen to penetrate the proximal part of the rectum. Left adnexectomy and low anterior rectum resection were performed. The pathological evaluation suggested benign ovarian dermoid tumor penetrating the rectum wall.
Fistula formation by a dermoid ovarian cyst is not always related to malignant transformation of the cyst. In addition to factors such as torsion, infection, trauma, and chronic pressure during labor, spontaneous rupture of the dermoid cyst resulting in leakage of fluid could be the cause of fistula formation.
良性囊性畸胎瘤形成瘘管在文献中尚未有常见报道。我们报告一例良性卵巢皮样囊肿并发直肠 - 卵巢瘘的病例。
一名30岁未孕女性因下腹痛和脓性腹泻入住妇科门诊。妇科检查及超声检查发现左卵巢有一个10厘米的异质性囊性肿物。腹盆腔CT扫描显示左卵巢肿物（10×9厘米），考虑为皮样囊肿，可见其穿透直肠近端。行左侧附件切除术及直肠低位前切除术。病理评估提示良性卵巢皮样瘤穿透直肠壁。
卵巢皮样囊肿形成瘘管并不总是与囊肿恶变相关。除了扭转、感染、创伤及分娩时的慢性压迫等因素外，皮样囊肿自发破裂导致液体渗漏可能是瘘管形成的原因。
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