Ovarian Torsion Secondary to a Dermoid Cyst in a Child: A Case Report

TL;DR

A young girl with a dermoid cyst experienced ovarian torsion, requiring surgery to remove the affected ovary and fallopian tube.

Contribution

This case highlights the rare occurrence of ovarian torsion due to a dermoid cyst in a child and emphasizes the need for prompt surgical intervention.

Findings

A 4-year-old girl presented with symptoms leading to the diagnosis of a necrotic ovarian torsion secondary to a dermoid cyst.

Laparoscopic surgery confirmed the torsion and necessitated a left salpingo-oophorectomy due to nonviable tissue.

The child recovered well post-surgery, emphasizing the importance of early recognition and treatment in preserving fertility.

Abstract

A four-year-old girl presented with a two-day history of progressively worsening right lower abdominal pain, accompanied by anorexia and nausea. The initial assessment revealed lower abdominal tenderness with guarding and rebound tenderness, raising concern for an acute surgical abdomen. Ultrasonography demonstrated mild ascites and an enlarged left ovary with absent Doppler flow, suggestive of torsion. Emergent laparoscopic exploration revealed a 6×7 cm necrotic left adnexal mass with complete torsion of the ovary and fallopian tube. Detorsion was attempted, but the ovary remained nonviable, necessitating a left salpingo-oophorectomy. Gross examination revealed hair within the mass, and histopathology confirmed an infarcted ovarian dermoid cyst. The child had an uneventful recovery and was well at both the one- and three-month follow-ups. This case underscores the importance of the early recognition and prompt surgical management of pediatric ovarian torsion to prevent irreversible adnexal damage and preserve future fertility whenever possible.

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