Benign Cystic Ovarian Teratoma With a Fistula Into the Small and Large Bowel

von-Walter, Astrid R.; Nelken, Rebecca S.

doi:10.1097/aog.0b013e3182319185

Cited by 19 publications

(16 citation statements)

References 5 publications

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“…Colorectal involvement by a benign cystic ovarian teratoma has been reported with varied and unusual presentations. von-Walter and Nelken [4] reported a benign cystic ovarian teratoma with a fistula into the small and large bowel. Awareness of clinical and radiological findings in these cases is important to avoid further complications.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Presentation of Ovarian Teratoma: A Case Report

Khanna

Srivastava

Saroj

et al. 2012

Case Reports in Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

An Unusual Presentation of Ovarian Teratoma: A Case Report

Khanna

Srivastava

Saroj

et al. 2012

Case Reports in Emergency Medicine

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“…4 Although ovarian dermoids remains asymptomatic for quite long time yet rarely, serious complications occur that result in life-threatening events such as bowel perforation. 5 The most common complication associated with dermoid cysts is torsion. In contrast, rupture, infection and secondary malignant change are uncommon complications and dermoid cysts only very rarely present with bowel involvement.…”

Section: Introductionmentioning

confidence: 99%

Ovarian dermoid presenting as acute intestinal obstruction: a rare case report and review of literature

et al. 2015

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“…One small series reported a fistula in 9 of 195 patients (4.6%) treated with chemotherapy for recurrent disease 1 . Occurrence of a fistula has been described in patients with advanced ovarian epithelial tumours 11,12 and germ-cell tumours [8][9][10] . Recently, fistulae were described in patients receiving bevacizumab with chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Rare cases present with giant cystic air-filled masses 8,9 ; others, with bowel obstruction necessitating emergency surgical intervention 10 .…”

Section: Discussionmentioning

confidence: 99%

Conservative Management for an Entero-Adnexal Fistula at Initial Presentation of Advanced Ovarian Carcinoma

et al. 2013

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pelvis and lower abdomen. Transvaginal ultrasound revealed a multicystic mass originating from the left ovary, 14 cm in its largest dimension, with additional masses on the right ovary, peritoneum, and pelvic side walls. Computed tomography (ct) imaging showed two hypodense lesions in the spleen, retroperitoneal lymphadenopathy, and several lung nodules measuring up to 1.5 cm. The patient's white blood count was within the normal range, and cancer antigen 125 (CA125) was elevated at 1073 U/mL. Blood and urine cultures were sterile. With no concrete evidence of infection, the clinical presentation suggested that the high temperature was secondary to metastatic malignant disease and therefore nonsteroidal anti-inflammatories were prescribed as symptomatic treatment.Pathology assessment of a specimen from one of the peritoneal masses obtained by ct-guided biopsy was interpreted as adenocarcinoma, strongly positive for p53, cytokeratin 7, and CA125, suggesting serous ovarian carcinoma. Neoadjuvant treatment with intravenous carboplatin (area under the curve 6) and paclitaxel (175 mg/m 2 ) every 3 weeks was initiated. After the second course, the patient was admitted because of neutropenic fever and was treated with antibiotics and granulocyte colony-stimulating factor for 10 days. Prophylactic granulocyte colony-stimulating factor was administered with subsequent cycles.After 3 cycles of chemotherapy, the size of the pelvic mass was reduced on physical examination, and the CA125 level had declined to 283 U/mL. The patient's abdominal pain resolved, and she reported fever up to 37.5°C that started 10 days after each cycle of chemotherapy and normalized after the subsequent cycle. Imaging by ct performed after the 3rd cycle suggested a decrease in the size of the splenic, retroperitoneal, lung, and abdominal masses. In those images, a new air-fluid level within the multicystic pelvic mass was reported (Figure 1), but a clear fistula between the pelvic mass and the bowel was not visible on contrast imaging. ABSTRACTGastrointestinal fistulae can occur in ovarian cancer patients, usually in the setting of advanced relapsed disease. Treatment typically involves immediate surgery.Here, we describe a case of an abscess resulting from an intestinal fistula as the first manifestation of advanced epithelial ovarian cancer, and we review the current literature on this subject. The patient was successfully treated with a combination of chemotherapy, antibiotics, and delayed surgery. Optimal debulking was achieved without a need for bowel resection.This report is the first of conservative management of a fistula in an ovarian cancer patient in the chemotherapy-naïve setting.

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Benign Cystic Ovarian Teratoma With a Fistula Into the Small and Large Bowel

Abstract: This case illustrates the rare formation of a fistula between a dermoid cyst and the small and large bowel. Awareness of the clinical and radiologic findings in these cases is important to avoid further complications.

Cited by 19 publications

References 5 publications

An Unusual Presentation of Ovarian Teratoma: A Case Report

An Unusual Presentation of Ovarian Teratoma: A Case Report

Ovarian dermoid presenting as acute intestinal obstruction: a rare case report and review of literature

Conservative Management for an Entero-Adnexal Fistula at Initial Presentation of Advanced Ovarian Carcinoma

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