Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 442-447
DOI: https://doi.org/10.52403/ijrr.20261039
Ovarian Sparing Surgery for Torsion of a Giant Mucinous Cystadenoma with Coexisting Dermoid Cysts in Early Pregnancy: A Case Report
Amanda Gray1, Leatitia Samuel1, Latoya Young2
1Medical Registrar, Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana
2Senior Registrar, Department of Obstetrics and Gynaecology, Georgetown Public Hospital Corporation, Georgetown, Guyana
Corresponding Author: Dr. Amanda Gray
ABSTRACT
Background: Adnexal torsion is a time-sensitive gynecological emergency that may complicate pregnancy. Ovarian masses increase the risk of torsion, while operative management in early pregnancy requires balancing maternal safety, pregnancy preservation, and future ovarian function.
We present a 19-year-old primigravida at approximately 7 weeks and 3 days of gestation who was referred to Georgetown Public Hospital Corporation in February 2026 for further management of suspected right ovarian torsion. Operative exploration demonstrated a markedly enlarged right ovary torsed twice around its pedicle, with a large cystic lesion measuring approximately 20 × 12 cm and two dermoid-appearing cysts measuring approximately 3 × 4 cm and 4 × 5 cm. Approximately 3 L of clear fluid were drained from the large cyst. Detorsion, cystectomy and ovarian reconstruction with purse-string sutures were performed, preserving the ovary. Dermoid contents included hair and tooth-like material. Histopathological examination demonstrated a cystic cavity lined by mature squamous epithelium with sebaceous glands, with a component lined by mucinous epithelium. The final diagnosis was mature cystic teratoma with mucinous cystadenoma of the right ovary. Postoperative recovery was associated with appropriate pain and no reported surgical complications. The patient received appropriate routine antenatal care, with a final clinic visit at 37 weeks and 2 days. Gestational diabetes mellitus required metformin and subsequent induction of labour. Concerns regarding cephalopelvic disproportion led to emergency lower-segment caesarean section, with delivery of a neonate weighing 3,610 g.
Conclusion: This case demonstrates successful ovarian conservation following torsion associated with a large complex right ovarian mass in early pregnancy. Histopathology confirmed mature cystic teratoma with mucinous cystadenoma. Prompt detorsion, cystectomy and ovarian reconstruction preserved ovarian tissue and were followed by continuation of pregnancy to delivery.
Keywords: ovarian torsion; pregnancy; mature cystic teratoma; dermoid cyst; mucinous cystadenoma; ovarian cystectomy; ovarian preservation
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