Mature teratoma with secondary infection: case report

Mature teratoma (dermoid cyst) is a common disorder in women of reproductive age. Sometimes the tumor is complicated by torsion, rupture, and malignant change. However, it rarely presents with fever. We present a 38-year-old woman with an intermittent fever for 30 days, who received occasional medical treatment without improvement. She was to our clinic for evaluation and treatment; however, fever persisted for three days without clinical improvement. No definite infection source could be identified except the presence of a huge pelvic tumor. The patient underwent exploratory laparotomy and an ovarian dermoid cyst with infection was noted. Pathology review revealed mature teratoma with superimposed infection by Escherichia coli. Fever impressively subsided on the fifth postoperative day. Although the majority of patients suffering from fever initially search for medical treatment at primary clinics, rare conditions such as persistent fever should be consulted by specialists to make differential diagnosis. Mature teratoma is rarely superimposed by infection and rarely causes fever. Furthermore, the possibility of fever caused by tubo-ovarian abscess (TOA) is often missed in patients with history of tubal ligation since there is a lower incidence of TOA in these unique patients. However, based on this case report, we should be alert whenever long-term fever is noted. Prompt surgical treatment for extirpation and an appropriate antibiotic treatment would be the choice of treatment in such cases.