Bilateral Ovarian Teratomas with Concurrent Ectopic Pregnancy at Diagnostic Laparoscopy

Background: Benign mature cystic teratoma accounts for approximately 33% of all benign ovarian neoplasms with the majority occurring between ages 10 and 30. Studies have shown that about 60% are asymptomatic at diagnosis and approximately 10% of cases are found during pregnancy with transvaginal ultrasound having a specificity of about 98% but there have only been a few documented cases of simultaneous occurrence of an ectopic pregnancy and an ovarian teratoma. Case Report: A 24 year-old multiparous lady with persistent pelvic pressure and pain of about month duration with a plateauing BHCG level and no evidence of intrauterine pregnancy had a diagnostic laparoscopy with findings of a ruptured right ectopic gestation and ovarian mass, which required a right salpingo-oophorectomy with a left ovarian cystectomy done for an incidental finding of a 6cm complex left ovarian mass. Pathology evaluation confirmed a right ruptured ectopic pregnancy and bilateral benign mature cystic teratoma. Conclusion: Due to the possibility of complications resulting from the presence of an enlarged ovarian teratoma, it might be necessary to proceed with an ovarian cystectomy at the time of surgery for other pathologies; ruptured ectopic pregnancy would be inclusive.