Obstet Gynecol Sci.  2018 Jul;61(4):529-532. 10.5468/ogs.2018.61.4.529.

An unusual presentation of ovarian dermoid cyst: a case report and review of literature

• Azami MA
• Elalami I
• Siati A
• Lamalmi N

• KMID: 2439728
• DOI: http://doi.org/10.5468/ogs.2018.61.4.529

Abstract

Dermoid cysts or mature cystic teratoma are the most common type of ovarian germ cell tumor. It may be complicated by torsion, rupture, chemical peritonitis and malignant change but is rarely complicated by infection. We present a case of an ovarian dermoid cyst with super-infection caused by Schistosoma haematobium (S. haematobium). We present here a case of incidental finding of S. haematobium eggs in an infected cystic teratoma of the ovary because of the rare occurrence of this lesion. A 45-year-old Moroccan woman admitted to the gynecological department because of abdominal pain and fever. Gynecological examination, ultrasonography, and abdominopelvic computed tomography scan revealed an ovarian mass thought to be a dermoid cyst. The pathological evaluation suggested infected ovarian dermoid cyst with the presence of adult worm in the tumor, contains same eggs of S. haematobium. Super-infection of an ovarian dermoid cyst is a rare event, and the association with S. haematobium is extremely rare in the literature.

Keyword

Dermoid cyst; Ovary; Infection; Schistosoma haematobium

MeSH Terms

Abdominal Pain
Adult
Dermoid Cyst*
Eggs
Female
Fever
Gynecological Examination
Humans
Incidental Findings
Middle Aged
Neoplasms, Germ Cell and Embryonal
Ovary
Ovum
Peritonitis
Rupture
Schistosoma haematobium
Teratoma
Ultrasonography

Figure

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  Fig. 1 Abdominal-pelvic computed tomography shows the presence of a triple component mass related to a right dermoid cyst with homolateral pyosalpinx.

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  Fig. 2 (A) Section showing ovarian mature cystic teratoma surrounded by a large polymorphic inflammatory reaction of altered and non-altered neutrophil polynuclear cells, lymphocytes, plasma cells, and macrophages. (B) High power view showing an adult worm with Schistosoma haematobium egg surrounded by granulomatous inflammatory infiltrate (hematoxylin and eosin 40×).

Reference

1. Colley DG, Bustinduy AL, Secor WE, King CH. Human schistosomiasis. Lancet. 2014; 383:2253–2264.

2. Christinet V, Lazdins-Helds JK, Stothard JR, Reinhard-Rupp J. Female genital schistosomiasis (FGS): from case reports to a call for concerted action against this neglected gynecological disease. Int J Parasitol. 2016; 46:395–404.

3. Abu Zikry AM, Fahmy K. Bilharziasis in a dermoid cyst of the ovary. J Obstet Gynaecol Br Commonw. 1963; 70:891–893.

4. Paradinas FJ. Schistosomiasis in a cystic teratoma of the ovary. J Pathol. 1972; 106:123–126.

5. Sunder-Raj S. Cystic teratoma of ovary associated with schistosomiasis. East Afr Med J. 1976; 53:111–114.

6. Melato M, Muuse MM, Hussein AM, Falconieri G. Schistosomiasis in a cystic teratoma of the ovary. Clin Exp Obstet Gynecol. 1987; 14:57–59.

7. Sarma NH, Agnihotri S, Jeebun N. Incidental schistosomiasis in a dermoid cyst of the ovary: a case report. Internet J Parasit Dis. 2007; 3.

8. Hasanzadeh M, Tabare S, Mirzaean S. Ovarian dermoid cyst. Prof Med J. 2010; 17:512–515.

9. Ayhan A, Bukulmez O, Genc C, Karamursel BS, Ayhan A. Mature cystic teratomas of the ovary: case series from one institution over 34 years. Eur J Obstet Gynecol Reprod Biol. 2000; 88:153–157.

10. Pradhan P, Thapa M. Dermoid cyst and its bizarre presentation. JNMA J Nepal Med Assoc. 2014; 52:837–844.

11. Chambô Filho A, Neves Ferreira R, Gusmão CB, Saade FT, Dalvi IR, Leo TC. Genital schistosomiasis: mucinous cystadenocarcinoma of the ovary containing schistosoma mansoni eggs. J Trop Med Parasitol. 2010; 33:36–40.

12. Jourdan PM, Roald B, Poggensee G, Gundersen SG, Kjetland EF. Increased vascularity in cervicovaginal mucosa with Schistosoma haematobium infection. PLoS Negl Trop Dis. 2011; 5:e1170.

13. Helling-Giese G, Sjaastad A, Poggensee G, Kjetland EF, Richter J, Chitsulo L, et al. Female genital schistosomiasis (FGS): relationship between gynecological and histopathological findings. Acta Trop. 1996; 62:257–267.