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Ovary tumor associated to pregnancy

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Introduction: Presence of uterine appendages tumors is rare during pregnancy. Many tumors are luteal cysts that disappear after six weeks of pregnancy, and 1 3 of those which still persist, are mainly dermoid cysts. Pregnancy and childbed increase the risk of torsion of the ovarian masses, and if these masses are represented by dermoid cysts, then the risk that they become torsioned is much more frequent- 15% of the cases. Material and method: We present in this paper the case of a pregnant woman aged 24 years, primigravid, primipara, of Caucasian race, who was seen by the specialist only in the last trimester of the pregnancy and who presented in the last five weeks of pregnancy two episodes of severe pelvic abdominal pains on the left side with the absence of intestinal transit pain 4-5 days. By initiation of the tocolitic and analgesic treatment, pain did not cease. Surgical consultation made during hospitalization did not show the necessity of performing the operation in emergency at that moment. At forty weeks of pregnancy, one decides to perform the delivery through cesarean section, the indication being an acute fetal bradycardia on the onset of labor. During intervention, at the examination of the peritoneal cavity the left ovary was transformed by the presence of a dermoid cyst of 9 7 cm, torsioned at 360 degrees with multiple adherences to the epiploon and the parietal peritoneum from the ovarian lodge. The left adnexectomy was performed with a favourable postoperative evolution of the patient and the absence of a painful symptomatology before the delivery.

Conclusions: The presence of the uterine appendages tumors is rare during pregnancy, an important percent being represented by the dermoid cysts, that, due to their consistency and size, more frequently lead to the torsion of these ones. When there are no complications, conservative management is indicated with the usual ultrasound evaluation. When torsion signs are obvious of the ovary tumoral masses, unresponsive to anti-inflammatory, antalgic treatment, one proceeds to the surgical intervention (through both laparotomy and laparoscopy).

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Gladys Cristina Al Jashi, Ana Nastas, Diana-Elena Comandasu and Isam Al Jashi

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