Dermoid Cyst With Adnexal Torsion Presenting as Acute Appendicitis in a Young Premenstrual Patient

Adnexal masses are relatively frequent in adults but also present in prepubertal females. Mature ovarian teratomas, also called dermoid cysts, are slowly growing disorders that could result in adnexal torsion (AT), rupture, or hemorrhage. In these cases, low abdominal pain or acute abdomen are the commonest symptoms, leading the patient to the medical emergency unit. In adolescence, early diagnosis of this pathology is not uncommon since it can be disclosed in a routine gynecological examination. Unfortunately, in young premenarchal females, routine examination or a screening program for dermoid cysts does not exist. In cases of abdominal pain due to AT, early attendance to the hospital, prompt diagnosis, and timely surgical intervention are of paramount importance, increasing the possibility of minimal surgery and preservation of the ovary. Concomitant inflammation of the neighboring organs, such as the appendix, should also be considered.