The patient is a five-year old female who complained of abdominal pain. A ping pong ball-sized
mass on left lower quadrant of the abdomen was palpated six (6) months ago, which rapidly
grew in size and caused abdominal pain. Physical examination showed a 10 cm x 10 cm firm,
non-tender, smooth hypogastric mass with limited mobility. Primary impression was a mature
cystic teratoma and a differential diagnosis of a malignant ovarian mass was considered because
of the elevated tumor marker CA-125 and papillary excrescences on abdominal ultrasound. A
multidisciplinary team composed of pediatric anesthesiologist, pediatric hematology-oncology
expert, pediatric surgeon and the obstetrician gynecologist was formed to do thorough pre- and
post-op planning. The patient underwent exploratory laparotomy, peritoneal fluid cytology, left
oophorocystectomy, and frozen section under general anesthesia. Frozen section revealed
teratoma with mature components in three sections. Final histopathologic result was mature
cystic teratoma, 13.5 centimeters in greatest tumor dimension. She was discharged on the
tenth hospital day. Dilemmas in management were discussed.
mature cystic teratoma