Dermoid Cyst Spillage Resulting in Chemical Peritonitis: A Case Report and Literature Review

Abstract

A dermoid cyst, also called a mature teratoma, is a benign tumor of the ovary derived from pluripotent germ cells. It is often asymptomatic; however, it can be expressed by several complications, including infection, adnexal torsion, and rupture. Rarely ovarian dermoid cysts can also transform into malignant degeneration. A ruptured teratoma is a rare and life-threatening complication and may arise spontaneously. However, cystic rupture is often secondary to surgical procedures such as ovarian cystectomy, leading to acute peritonitis and surgical emergency. Herein, we report a case of acute peritonitis in a female resulting from ovarian dermoid cyst spillage. Her clinical picture and radiological imaging were consistent with a ruptured ovarian cyst leading to chemical peritonitis, and a histopathological examination confirmed an ovarian dermoid cyst.

Keywords: acute peritonitis; benign mature cystic teratoma; chemical peritonitis; ovarian cyst; ovarian dermoid cyst.

Figure 1. Pelvic ultrasonography showing right-sided ovarian cystic cavity with multiple small hyperechoic dots without internal flow (blue arrows).

Figure 2. CT of the abdomen and pelvis showing the presence of three heterogenous rounded masses (a) and smooth enhancement of the peritoneal wall with free fluid in the abdominal cavity (b).

CT, computed tomography

Figure 3. Histopathology demonstrating a complex cystic mass lined by epidermal cells containing hair follicles (a), fat cells, and glial cells (b).