Ectopic ovary: A case of autoamputated ovary with mature cystic teratoma into the cul‐de‐sac

Abstract

An ovary with a mature cystic teratoma which was autoamputated into the cul-de-sac and confirmed by laparoscopy is described. A 24-year-old woman with a history of chronic pelvic pain for 5 years presented with left abdominal pain. Magnetic resonance imaging revealed a left ovarian mass of 5 cm in diameter. The pain was relieved spontaneously after a few weeks. Laparoscopy was performed 5 months later. The mass was identified in the cul-de-sac partly enveloped in the omentum without any ligamentous or direct connection with the pelvic organs. There was no left ovary in its proper anatomical location. Histopathologic study revealed a mature cystic teratoma with viable ovarian tissue. These findings suggested autoamputation of the ovary either by inflammation or torsion, which is one of the mechanisms for the formation of an ectopic ovary.

Torsion, Autoamputation, and Reimplantation of Viable Ovarian Dermoid Cyst

“…The sigmoid colon located on the left side is thought to be protective of the twisting of the left adnexum, making right adnexal torsion more common. 1,2,4,6 When the blood supply to the dermoid is cut off as a result of torsion, the tumor can undergo necrosis and actually undergo autoamputation as a result. The dermoid may reimplant in neighboring structures and develop a new blood supply.…”

“…2 She was not operated on until several months later, showing a dermoid with viable ovarian stroma in the posterior cul-de-sac. As in the cesarean case report, the omentum was encasing and vascularizing the ovary.…”

“…1 Extremely rare is the case in which a viable ovary is found in the posterior cul-de-sac in an adult. [1][2][3] This case involves a woman with a history of abdominal pain for 1 year who was found on diagnostic laparoscopy to have a mature cystic teratoma that had undergone autoamputation with viable ovarian tissue adherent to the posterior cul-de-sac, attached to a viable fimbriated portion of the fallopian tube.…”

Two cases of ectopic ovary and one case of potential ectopic ovary

“…Therefore, a dermoid cyst may have an inherent potential to develop into an ectopic ovary. According to the literature [1,5,11,12], the omentum is one of the common sites for an ectopic ovary. In this case, the mass may have received a blood supply from other tissue after autoamputation of the dermoid cyst.…”

Ectopic ovary autotransplanted over rectosigmoid colon: a case report

“…The synonymous terms are accessory ovary, parasitic ovary, and ovarian implant syndrome (1). The etiology of this situation is not well known yet, and there are some congenital and acquired mechanisms proposed (1). The most common cause of acquired ectopic ovary is autoamputation of the large mass due to torsion and reimplantation to a different location.…”