Torsion of dermoid cyst in a perimenopausal woman: a case report

Mature cystic teratoma comprise 20-30% of all ovarian tumours. They are mostly seen in patients between 20 and 40 years of age and are mostly asymptomatic. Incidence of malignancy is high in perimenopausal and postmenopausal group. Here, authors report a case of torsion of dermoid cyst presenting unusually in a 45-year-old perimenopausal woman with acute abdomen. A 45-year-old perimenopausal woman presented with lower abdominal pain of 8 hours duration and 3-4 episodes of vomiting. Abdominal examination revealed a regular, firm to cystic, tender abdomino-pelvic mass corresponding to the size of 28 weeks gravid uterus by palpation. Abdominal ultrasonography revealed the presence of right ovarian cyst measuring 12.9x12.8x10.1 cm. Total abdominal hysterectomy with bilateral salpingo oopherectomy was done. Histopathological examination confirmed mature cystic teratoma. Although mature cystic teratoma is rare after 40 years age, especially in perimenopausal women and are usually malignant in that age group, it can have an unusual age presentation at 45 years with benign nature as in present case