Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2023; 11(16): 3852-3857
Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3852
Ruptured teratoma mimicking a pelvic inflammatory disease and ovarian malignancy: A case report
Pei-Hsuan Lai, Dah-Ching Ding
Pei-Hsuan Lai, Dah-Ching Ding, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Tzu Chi University, Hualien 970, Taiwan
Author contributions: Ding DC and Lai PH contributed to conceptualization; Lai PH contributed to data curation; Ding DC and Lai PH wrote—original draft preparation; Ding DC and Lai PH wrote—review and editing.
Informed consent statement: Written informed consent was obtained from the patient (s) to publish this paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Dah-Ching Ding, MD, PhD, Chief Physician, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Tzu Chi University, No. 707, Chung-Yang Rd., Sec. 3, Hualien 970, Taiwan.
Received: February 16, 2023
Peer-review started: February 16, 2023
First decision: April 19, 2023
Revised: April 20, 2023
Accepted: May 6, 2023
Article in press: May 6, 2023
Published online: June 6, 2023

We report a case of ruptured ovarian teratoma mimicking pelvic inflammatory disease (PID) and ovarian malignancy. The case indicates the need for reviewing the information on ovarian teratomas, as the symptoms are vague, and, therefore, diagnosis and treatment had to be structured accordingly.


A 60-year-old woman was admitted to the emergency department with acute lower abdominal pain. She experienced weight loss and increased abdominal girth. Pelvic ultrasound and computed tomography revealed a 14-cm pelvic tumor. Laboratory examination revealed leukocytosis (white blood cell count: 12620/μL, segment: 87.7%) and high levels of C-reactive protein (18.2 mg/dL). Elevated levels of the tumor marker cancer antigen 19-9 (367.8 U/mL, normal value < 35 U/mL) were also noted. Due to the impression of a ruptured tubo-ovarian abscess or a tumor with malignancy, she immediately underwent an exploratory laparotomy. A ruptured ovarian tumor with fat balls, hair strands, cartilage, and yellowish fluid was observed on the right side. Right salpingo-oophorectomy was performed. A pathological examination revealed a mature cystic teratoma. The patient recovered after surgery and was discharged on post-operative day three. No antibiotics were administered.


This case illustrates the differential diagnosis of an ovarian tumor. Therefore, surgery is the mainstay for treating a ruptured teratoma.

Keywords: Teratoma, Ovarian cancer, Pelvic inflammatory disease, Ruptured, Peritonitis, Case report

Core Tip: We report a case of a ruptured ovarian teratoma mimicking pelvic inflammatory disease and malignancy. We updated the information on ovarian teratomas regarding symptoms, signs, diagnosis, and treatment. Because of the vague symptoms of ovarian teratoma, we provided a strategy to diagnose and treat this ovarian teratoma.