Giant ovarian teratoma in premenarchal girl

Introduction: Ovarian torsion in children and adolescents is an acute gynecological condition that most often occurs in morphologically normal ovaries. It results from anatomical characteristics of the infundibulopelvic ligaments in children and is rarely associated with an adnexal mass. Ovarian tumors in children are most commonly of germ cell and sex cord-stromal cell origin, while epithelial and other tumors are much less frequent. Teratomas are the most common ovarian tumors and may be mature or immature, unilateral or bilateral, with variable size. They may be asymptomatic or become symptomatic in cases of torsion or rupture. Clear guidelines for the management of these conditions in children and adolescents are lacking. To prevent complications, surgical treatment is recommended, with laparoscopy as the preferred approach. This paper presents a case of a giant ovarian teratoma with torsion in an eight-year-old premenarchal girl. Case report: The patient was an eight-year-old girl who presented with abdominal pain and progressive abdominal enlargement, without nausea, vomiting, or fever. Following a complete clinical, laboratory, and imaging evaluation, a giant ovarian teratoma with torsion was suspected, and the child was referred, accompanied by her parents, to a tertiary care center for further diagnosis and treatment. Discussion and conclusion: Teratomas are the most common ovarian tumors in children and may present with symptoms or be detected incidentally. Diagnostic evaluation should determine whether the lesion is benign and whether torsion is present, using clinical examination, laboratory analyses, tumor markers, and imaging-primarily ultrasound and magnetic resonance imaging. Early diagnosis is essential to preserve ovarian function and to select an appropriate surgical approach that ensures fertility preservation.