{Reference Type}: Journal Article
{Title}: Dermoid cyst management and outcomes: a review of over 1000 cases at a single institution.
{Author}: Tankou J;Foley OW;Liu CY;Melamed A;Schantz-Dunn J;
{Journal}: Am J Obstet Gynecol
{Volume}: 0
{Issue}: 0
{Year}: 2024 Apr 24
{Factor}: 10.693
{DOI}: 10.1016/j.ajog.2024.04.021
{Abstract}: <B>BACKGROUND: </B>Mature cystic teratomas represent nearly 60% of benign ovarian neoplasms across all age groups.<BR><B>OBJECTIVE: </B>This study aimed to update existing descriptive studies of ovarian teratomas, including the epidemiology, rate of torsion or malignancy, and treatment modalities in a large modern cohort of patients.<BR><B>METHODS: </B>This was a retrospective cross-sectional study of all pathology-confirmed cases of ovarian teratoma that underwent surgery at 1 tertiary care institution from 2004 to 2015. Patient demographics, ovarian cyst characteristics, surgical approach and timing, rate of spillage, and surgical complications were examined.<BR><B>RESULTS: </B>A total of 1054 cases of ovarian teratoma were identified during the study period. There were 113 cases (10.7%) of bilateral teratoma. The mean age at diagnosis was 38 years. The average cyst size was 6.26 cm. The overall rate of torsion was 5.6%, with a higher rate of torsion with increasing cyst size. More than 70% of cases were treated with minimally invasive surgery, which was associated with decreased perioperative complications but an increased risk of cyst spillage. Among 394 patients with cyst spillage, only 1 patient developed chemical peritonitis. The malignant transformation rate of mature cystic teratoma in this cohort was 1.1%. This cohort included 100 pregnant women with mature teratoma. Pregnant patients were more likely to have minimally invasive surgery in the first trimester of pregnancy and more likely to undergo laparotomy in the second or third trimester of pregnancy.<BR><B>CONCLUSIONS: </B>Similar rates of bilaterality, torsion, malignant transformation, and struma ovarii in ovarian teratomas were found in this large modern cohort compared with previous literature. Most cases of ovarian teratoma can be managed laparoscopically, which is associated with a lower surgical complication rate. Despite the increased risk of cyst spillage with a minimally invasive approach, chemical peritonitis is a rare complication.