Bilateraldermoid ovarian cyst in an adolescent girl

A 19-year-old unmarried woman with regular menstrual cycles presented with symptoms of vague abdominal pain of 1 month duration. General condition fair. Per abdomen-a firm, non-tender mass corresponding to 26 weeks of gestation with smooth surface, upper and lateral borders well defined, lower border not palpable was observed. Ultrasonography: left ovarian tumour 28×19 cm with mixed echogenicity was seen in the pelvis extending superiorly into the abdominal cavity with fat, fluid contents, multiple septations. Right ovary measures 6×4 cm with 3.7 cm focal hyperechoic lesion. Uterus anteverted, normal size. No free fluid seen. CT confirmed the ultrasonography findings. Cancer antigen (CA) 125 was 52 IU/mL. Exploratory laparotomy followed by left ovariotomy and salpingectomy and right ovarian cystectomy was performed, leaving behind a significant amount of normal ovarian tissue. Cut section of the gross specimen of the left ovarian tumour-dermoid cyst-plenty of sebaceous fluid and a large tuft of hair. The right ovarian cystectomy revealed a dermoid cyst with hair and pellets of sebum. Histopathology showed bilateral dermoid ovarian cyst.