John Lugata

Ovarian torsion of a large mature cystic teratoma complicating early pregnancy: a rare case report

Introduction and Importance: Adnexal torsion complicating early pregnancy is rare but should be suspected in pregnant women presenting with acute lower abdominal pain. Mature cystic teratomas (MCTs) are common benign ovarian tumors in women of reproductive age, but their occurrence during pregnancy complicated by torsion is rare. MCTs comprise 20% of all ovarian neoplasms and are commonly encountered in patients between 20 and 40 years of age. Early diagnosis is challenging due to overlapping symptoms with common pregnancy-related conditions, yet prompt recognition and intervention are crucial to preserve maternal and fetal outcomes. This case report aims to highlight the diagnostic and management challenges of adnexal torsion complicating early pregnancy. Case Presentation: We report the case of a 21-year-old primigravida from Northern Tanzania who presented at gestational age of 11 weeks and 4 days of gestation with a sudden-onset history of left lower abdominal pain for 6 h that progressively worsened over time. Abdominal ultrasonography revealed a large left adnexal cystic mass with internal echoes, thickened walls, and posterior acoustic enhancement, measuring 14.0 × 10.4 × 9.3 cm, consistent with a complex ovarian cyst. The uterus was enlarged and contained a viable intrauterine pregnancy with a crown–rump length of 48.6 mm, corresponding to 11 weeks and 4 days of gestation with active cardiac activity. The patient underwent an emergency laparotomy, which confirmed a viable intrauterine pregnancy alongside a large, twisted left ovarian cystic mass measuring 19.0 × 14.0 × 10.0 cm, with torsion of its pedicle around the mesovarium. Detorsion and left salpingo-oophorectomy were performed successfully. Histopathological examination confirmed the diagnosis of a MCT. Postoperative recovery was uneventful, and follow-up at 23 weeks showed a viable ongoing pregnancy. Clinical Discussion: MCTs are prone to torsion due to their size and mobility. Early surgical management is critical to prevent ischemic necrosis and ensure optimal maternal and fetal outcomes. In this case, a timely laparotomy and removal of the affected adnexa resulted in a favorable recovery and continuation of pregnancy. Conclusion: Ovarian torsion due to a MCT in early pregnancy is a rare but important differential diagnosis for acute abdominal pain. Prompt recognition and surgical intervention are vital to preserving maternal health and supporting pregnancy continuation.

Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa

Management challenges of ovarian adult-type granulosa cell tumors at a tertiary facility in resource-limited setting: A case series of three patients and review of the current literature

Management of a Borderline Brenner Tumor of the Ovary in a Premenopausal Woman in Northern Tanzania. A Rare Case Report and Review of the Current Literature

ABSTRACTBrenner tumors are rare ovarian neoplasms that are typically small and unilateral. Most cases are benign; less than 5% of all Brenner tumors are borderline or proliferative. Brenner tumors originate from the follicular epithelium and consist of ovarian transitional cells surrounded by fibrous tissue. Here we present a case of a 49‐year‐old premenopausal woman from Northern Tanzania. This patient presented to our facility with acute abdominal pain. She also reported abdominal distention which was first noticed 12 months prior to presentation. Magnetic resonance imaging (MRI) identified a 21 × 17 × 5 cm complex cyst with a thickened wall on the right ovary. The radiological findings were suggestive of an ovarian cystadenoma; multiple intramural and subserosal uterine leiomyomas were also noted. A total abdominal hysterectomy (TAH) and bilateral salpingo‐oophorectomy (BSO) was performed. Histopathological findings identified an atypical proliferative borderline Brenner tumor of the right ovary. Postoperative recovery was uneventful, the patient was discharged and managed conservatively postoperatively.

A Rare Case of Large Ovarian Thecoma Diagnosed Histopathologically Following Surgical Management in a Premenopausal Woman: A Case Report and Review of the Current Literature

ABSTRACT Ovarian thecomas are rare sex cord‐stromal tumors of the ovary. These tumors are estimated to account for 1% of all ovarian neoplasms. Thecomas are primarily composed of cells that resemble theca cells, which are involved in estrogen production. While thecomas are more frequently observed in postmenopausal women, they can also occur in premenopausal women. This report presents a rare case of an ovarian thecoma in a premenopausal woman and reviews the current literature on the topic. Herein we endeavor to contribute to the current body of knowledge and provide guidance to clinicians managing similar cases. Our patient is 43 years old and was diagnosed with an ovarian thecoma after she presented to our facility complaining of abdominal pain and abdominal distension. She underwent a total abdominal hysterectomy and unilateral salpingo‐oophorectomy. Histopathological examination confirmed a benign thecoma. We demonstrate that it is crucial to consider this benign condition when evaluating solid ovarian tumors in premenopausal women.