Minimal laparotomy management of a giant ovarian cystic teratoma in adolescence

Giant ovarian cysts in adolescents are very rare. Those treatment by laparotomy or laparoscopic surgery is discussed with gynecologists and pediatric surgeons because its limited working space and risk of rupture and malignancy. We present a case of minimal laparotomy management of a giant ovarian cystic teratoma in adolescent. A 13-year-old girl presented with abdominal pain and constipation. A CT scan showed a giant simple ovarian cystic tumor in her abdomen measuring 29 x 13 x 24 cm. We made a 3-cm Pfannenstiel incision and inserted an Alexis wound retractor XS. The cyst was completely aspirated without spillage in the intraperitoneal space. In total, 6L of murky brown fluid was aspirated from the cyst. There was no ovarian tissue visible on the cyst wall. The left tube and right ovary and tube were intact. The cyst wall and left ovary tube were dissected free by using a LigaSure. Postoperative recovery was uneventful. Pathological assessment revealed a mature cystic teratoma. The ovarian tissue was included in the part of the cyst wall. We were able to safely perform with minimal laparotomy. Therefore, we consider the for cases of giant ovarian tumors, minimal laparotomy surgery is useful from the safety and cosmetic perspective.