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Case of the Month 06/06

27 year old female presented to ED complaining of RLQ and midline lower abdominal pain x 6 days. One episode nausea/emesis the day before. No diarrhea, normal bowel movements.

Q: What is the circled structure?

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A benign cystic teratoma (also may be referred to as dermoid cyst or mature teratoma.) The calcification seen on xray is most likely from tooth tissue which is seen in 50% of dermoids.

Q: What is the most common complication of this growth?

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Torsion of the dermoid.

Q: What other serious complication needs to be considered in a patient with this finding and abdominal pain?

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Dermoids can perforate into the peritoneal cavity (this happens more commonly during pregnancy) causing an acute abdomen.