engleski

Laparoscopic approach of mature solid teratoma of Fallopian tube: Case report

Introduction: We report a laparoscopic resection of mature solid teratoma arising in the fallopian tube. The mass was noted on MSCT prior to surgery for a mature cystic teratoma. The incidence of a mature solid teratoma of the fallopian tube is extremely low. Case report: A 43-year-old nulligravida female, was seen at the emergency room because of worsening right lower quadrant abdominal pain, nausea and vomiting. The physical examination showed tenderness on palpation of the right lower abdominal quadrant with rebound tenderness and a freely movable mass in cecoascendens projection. Bowel sounds were hypoactive. Preoperative laboratory data showed mycrocytic anemia, serum concentration of cancer markers CA 19-9 were increased (79.6) and CA 125 (9.40) were within normal limits . No leukocytosis was noted. High resolution ultrasound examination was inconclusive. First MSCT revealed inhomogeneous tumor (size 9, 5 x11cm) with calcification and sharp border to surrounding structures on the right side of lower abdomen. Colonoscopy findings did not reveal any pathology. Repeated MSCT scan showed tumor on the opposite side. Preoperatively, we considered that these findings represented acute abdomen due to probable bowel obstruction caused by small intestine tumor. The patient was taken to surgery, and the abdominal cavity was laparoscopically explored. Laparoscopy demonstrated a solid-appearing mass, approximately 10 × 11 cm in diameter, located in the ampullary segment of the right fallopian tube. Teratoma was attached by a pedicle to the tubal mucosa. Laparoscopic excision was performed, and the mass of the right fallopian tube and right ovary were resected. Pathology revealed mature cystic teratoma of the fallopian tube. The patient improved and was discharged 2 days after surgery. Conclusion: Laparoscopic teratoma treatment in emergency condition combines two major advantages of laparoscopy: it is highly valuable in achieving the diagnosis when other diagnostic modalities don’ t give us clear picture in resolving the problem ; laparoscopy approach presents the last frontier in teratoma treatment and is more acceptable method in comparison with classical surgery.

teratoma of Fallopian tube

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