RUPTURED IMMATURE TERATOMA OF OVARY, AN UNUSUAL PRESENTATION; A CASE REPORT.

Teratomas are a histological subgroup of germ cell tumors, originating from primordial germ cell. Ovarian teratomas represent 15% to 20% of ovarian germ cell tumors. Mature cystic teratomas account for 10?20% of all ovarian neoplasms and are the most common in patients younger than 20 years of age, but malignant version is an uncommon tumor comprising less than 1% of teratomas of the ovary. The immature form was first described in 1960 by Th?rlbeck and Scully, and can be pure or mixed with a mature component1. Spontaneous rupture of the teratoma is rare and has been occasionally reported. We report a case of a five year old female child who presented with 4 days history of abdominal pain with few episodes of vomiting and constipation. Patient was initially managed conservatively as worm colic, but was later decided to undergo laparotomy in view of non resolution of symptoms and development of tachycardia and fever. In a planned laparotomy, hemoperitoneum was noted and a fleshy ruptured mass studded with lot of clots was seen arising from right ovary. The opposite ovary, peritoneum, bowel surface and other visceras where grossly normal. The cyst was excised by transfixing and dividing its broad stalk and sent for histopathology. Hemoperitoneum washed and abdomen was closed back after putting in a drain. Intestinal ascariasis though common in endemic areas often adds to the diagnostic dilemma but is not always responsible for most cases of acute abdomen.