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Pilimiction, a Rare Presentation of Ovarian Teratoma: A Case Report
Feysel Hassen Issack1, Seid Mohammed Hassen1, Ferid Ousman Mummed1
1Department of Surgery, Urology Unit, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Background:
Adnexal teratoma involving the urinary bladder is a very rare condition. Presentation is variable ranging from irritative LUTS (lower urinary tract symptoms) to pilimiction or trichiuria (passage of hair in the urine).
Case Presentation:
We report a case of a 42-year-old woman who presented with pilimiction and lower abdominal pain. Contrast-enhanced computed tomography scan (CECT) and cystoscopy were used for the diagnosis. Tumor markers were negative. Right side salpingo-oophorectomy and partial bladder wall excision were performed. Histopathology of the specimen showed features consistent with mature teratoma. The patient reported improvement of symptoms in the subsequent follow-up visits.
Conclusion:
Pilimiction is a pathognomonic sign of bladder teratomas. This case represents a rare complication of ovarian teratoma. Therefore, a high index of suspicion is required in patients with ovarian teratoma presenting with urinary complaints. Transurethral resection is associated with a high recurrence rate and is not recommended for secondary bladder teratomas.
