Pepe F, Lo Monaco S, Rapisarda F, Raciti G, Genovese C, Pepe P
G Chir. 2014 Mar-Apr;35(3-4):75-7.
Multiple and bilateral ovarian dermoid cysts constitute a very unusual report. We report an rare case of a woman with three ovarian dermoid cyst, two localized in the same ovary, detected by US examination and removed by laparoscopy.
A patient aged 29 years, para 0, gravida 0, was referred to our hospital with pain of the right adnexal region. Gynaecological examination showed an antiverted uterus with normal volume; on the right side a mobile mass approximately 7 cms in diameter was palpable, moreover the left ovary was normal. Ultrasound examination showed a normal uterus. The right ovary presented two complex masses of 7 and 3 cm in diameter, respectively; moreover, the left ovary showed a hyperechogenic complex mass of 3 cm in diameter. The ultrasound pattern was compatible with bilateral ovarian dermoid cysts. On laparoscopy abdominal cavity and uterus were normal, while the right ovary presented two masses and the left ovary a small mass which were enucleated and removed. The patient had an uncomplicated postoperative recovery and was discharged two day after laparoscopy. Pathologic examination confirmed the diagnosis of ovarian dermoid cysts. A one year follow-up showed no evidence of recurrence.
The case reported shows that exceptionally multiple and bilateral dermoid cysts may be detected underlining the importance of an accurate preoperative diagnostic imaging. Some recurrence of ovarian dermoid cysts may be due to undiagnosed small dermoid cists during preoperative imaging and/or surgical exploration.
多发性双侧卵巢皮样囊肿的报道非常少见。我们报告一例罕见病例,一名女性经超声检查发现有三个卵巢皮样囊肿,其中两个位于同一卵巢,通过腹腔镜手术切除。
一名29岁未育未孕女性因右侧附件区疼痛转诊至我院。妇科检查显示子宫前倾,大小正常;右侧可触及一个直径约7厘米的活动肿块,左侧卵巢正常。超声检查显示子宫正常。右侧卵巢分别有两个直径为7厘米和3厘米的复杂肿块;此外,左侧卵巢有一个直径3厘米的高回声复杂肿块。超声表现符合双侧卵巢皮样囊肿。腹腔镜检查显示腹腔和子宫正常,右侧卵巢有两个肿块,左侧卵巢有一个小肿块,均被摘除。患者术后恢复顺利,腹腔镜检查两天后出院。病理检查确诊为卵巢皮样囊肿。一年随访未发现复发迹象。
所报告的病例表明,异常情况下可能会检测到多发性双侧皮样囊肿,强调了术前准确诊断性影像学检查的重要性。卵巢皮样囊肿的一些复发可能是由于术前影像学检查和/或手术探查时未诊断出的小皮样囊肿。