Twisted benign ovarian teratoma presenting with pain and generalized pruritus: a case report

INTRODUCTION Cystic ovarian teratomas comprise 20% of all ovarian neoplasms, and are commonly encountered in patients between 20 and 40 years of age. Although these cysts are usually asymptomatic, we present the case of a patient whose cyst resulted in pruritus and abdominal pain. Based on a MEDLINE search of the literature, we believe this is the first case report of a twisted ovarian cyst presenting with generalized pruritus. CASE PRESENTATION A 35-year-old Sri Lankan woman presented with lower abdominal pain of one day's duration with vomiting and generalized pruritus. She had no history of allergies and was not on medication. Upon a physical examination, our patient was found to have an acute abdomen, localized peritonism in her lower abdomen and tachycardia of 100 beats per minute. Computed tomography showed that the cyst, which contained calcified structures, originated from her left ovary. After laparoscopy-assisted removal of the twisted ovarian cyst, her symptoms resolved completely. Histological examination confirmed a benign ovarian teratoma. CONCLUSIONS An unusual case of torsion of an ovarian teratoma presenting with abdominal pain and generalized pruritus, believed to be due to an antibody-mediated response, was resolved after surgical removal of the cyst.