Abstract
Background
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.
Case report
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 × 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.
Conclusion
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.
Similar content being viewed by others
References
Shiels WE, Dueno F, Hernandez E (1986) Ovarian dermoid cyst complicated by an entero-ovarian fistula. Radiology 160:443–444
Sanghera P, El Modir A, Simon J (2006) Malignant transformation within a dermoid cyst: a case report and literature review. Arch Gynecol Obstet 274:178–180
Lee YC, Abulafia O, Montalto N, Holcomb K, Matthews R, Golub RW (1999) Malignant transformation of an ovarian mature cystic teratoma presenting as a rectal mass. Gynecol Oncol 75:499–503
Okada S, Ohaki Y, Inoue K, Nakajo H, Kawamata H, Kumazaki T (2005) A case of dermoid cyst of the ovary with malignant transformation complicated with small intestinal fistula formation. Radiat Med 23:443–446
Kim SJ, Kimoto Y, Nakamura H, Taguchi T, Tanji Y, Izukura M, Shiba E, Takai S (1999) Ovarian carcinoma with fistula formation to the sigmoid colon and ileum: report of a case. Surg Today 29:449–452
Stern JL, Buscema J, Rosenshein NB, Woodruff JD (1981) Spontaneous rupture of benign cystic teratomas. Obstet Gynecol 57:363–366
Livesey SA, Conn PC, Dunn DC (1989) Benign cystic teratoma of the ovary rupturing into the rectum: a rare problem. Br J Clin Pract 43:77–79
Stern JL, Buscema J, Rosenshein NB, Woodruff JD (1981) Spontaneous rupture of benign cystic teratomas. Obstet Gynecol 57:363–366
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cebesoy, F.B., Baskonus, I., Mete, A. et al. Benign ovarian dermoid cyst complicated with rectal fistula formation: an unusual case. Arch Gynecol Obstet 279, 179–181 (2009). https://doi.org/10.1007/s00404-008-0659-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-008-0659-7