Abstract Ref Number = APCP1270
A Rare Case of Ovarian Teratoma in A 2 Year Old Girl
Jessica Christy Limanjaya, Yuli Yafri Razak, Kemas Firman, Patricia M Widjaja
Background Ovarian teratoma is uncommon in children, with its peak occurrence found during reproductive years. Ultrasonography (USG) is the preferred test of choice in pediatric population, and combination with CT or MRI, could give valuable information and detect malignant transformation. Ovary-sparing surgery should be considered to maintain fertility of the child. Case discussion A 2 year old girl, with no significant past medical history, was presented with acute abdominal pain for 3 days, which was exacerbated with movement. She had no history of fever, nausea, vomiting, weight loss, changes in bowel pattern and urination. Tender abdominal mass was palpable on physical examination. Leukocytosis and increased CRP was found in laboratory examination. LDH examination showed 261 U/L and AFP <1 ng/ml. Abdominal USG revealed heterogeneous, solid density 7.5 x 4.4 x 5.9 cm mass, with no vascularization. Abdominal CT found a solid-cystic component of 10.6 x 6.3 x 8 cm mass, urged pressing the bladder and ureter, with absence of metastasis, suggested embryonic cell ovarian tumor. Cystectomy was performed and a solid-cystic mass of 10 x 8 x 5 cm with a firm limit in right ovary. Histopathology examination showed a solid-cystic tissue corresponding to mature teratoma. The patient was discharged in stable uncomplicated state. Discussion Mature ovarian teratoma is uncommon and contributes to 15% of ovarian neoplasm. Complaints could be unspecific, asymptomatic, and some could be found accidentally on imaging. Abdominal USG is the method of choice, while CT scan and MRI could give valuable information on the extent and nature of the mass. Assay of serum marker such as LDH, AFP, and beta-HCG could be used to raise concern to malignant neoplasm. Ovary-sparing surgery should be considered to preserve future reproductive function in children and annual evaluation could be done to detect any recurrence.
Keywords: mature ovarian teratoma, ultrasonography, abdominal pain
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