Surgical Management of Bilateral Dermoid Cysts during Caesarean Section

A 27-year-old nulliparous woman presented with abdominal pain and was diagnosed on ultrasonography with bilateral ovarian dermoid cysts—one measuring 5.9×5.5×4.9 cm on the right ovary and three cysts on the left ovary measuring 7.8×7.4×8.3 cm, 7.2×8.0×6.4 cm, and 5.7×5.3×4.5 cm. She was initially scheduled for laparoscopic bilateral cystectomy; however, the procedure was postponed. Four months later, she returned with a positive pregnancy test and opted to continue the pregnancy.

Due to intermittent abdominal pain during gestation, close monitoring was undertaken. At 36 weeks, she developed persistent abdominal discomfort and oligohydramnios was detected on ultrasound. After corticosteroid administration, a lower segment caesarean section (LSCS) was performed, delivering a healthy female neonate weighing 3 kg.

Intraoperatively, torsion of the left ovary was observed. A bilateral ovarian cystectomy was carried out,one dermoid cyst was excised from the right ovary, and three from the left. All cysts were removed intact, preserving healthy ovarian tissue. Histological features were consistent with mature cystic teratomas. The postoperative course was uneventful, and both mother and baby were discharged on the fourth postoperative day.

This case highlights that large, bilateral dermoid cysts diagnosed pre-conceptionally can be safely managed surgically at the time of caesarean delivery. Careful monitoring during pregnancy and intact excision of the cysts can minimize complications such as torsion, preserve ovarian tissue, and support favorable maternal and fetal outcomes.

Source: View of removal of bilateral multiple dermoid cysts during caesarean section – a rare case. (n.d.). https://iog.org.in/journal/index.php/iog/article/view/600/423