Case Report: Rare Occurrence of Pediatric Ovarian Dermoid Cyst 

We present a 7-year-old premenarchal female admitted for investigation of acute onset right lower quadrant abdominal pain of twelve-hour duration. Past medical and family history was otherwise unremarkable. Upon physical exam, a mass approximately 8cm in diameter was appreciated. The patient had a left shift in her WBC but no other lab abnormalities. Tumor markers, including CA-125 and AFP, were negative. Ultrasound showed a large right ovarian cystic mass containing solid components, but imaging was unable to sonographically exclude ovarian torsion. CT abdomen pelvis with contrast showed a 7.2cm x 5.8cm mass consistent with an ovarian dermoid in the right pelvis along the uterine bladder. Due to the size and high suspicion for ovarian torsion, we proceeded with surgical treatment for this patient. An exploratory laparotomy, resection of right ovarian mass, and right salpingo-oophorectomy were performed. On post-op day one, the patient was discharged on pain medication prn and scheduled for follow-up. We compared our case and clinical workup to the literature and current ACOG guidelines for treatment in order to further explore alternative approaches to similar cases.