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Abstract: Malignant teratoma is a common ovarian tumor. The patient suddenly experienced severe pain in the right abdomen during rope skipping at home, with no relief after rest and nausea and vomiting, and went to the hospital for ultrasound suggesting that the right ovarian mass was about 5×6.5 cm. The pathological examination result was reported as immature teratoma. The condition was controlled through surgery, chemotherapy and anti-inflammatory treatment, and she recovered well after surgery.
Basic information】Female, 16 years old
Type of disease】Malignant teratoma
Hospital】Jiangbin Hospital of Guangxi Zhuang Autonomous Region
Date of consultation】August 2021
Treatment plan】Surgical treatment (surgical removal of the affected ovary) + chemotherapy (etoposide injection, cisplatin for injection, bleomycin hydrochloride for injection) + anti-inflammatory drugs (ceftriaxone sodium for injection, metronidazole injection)
Treatment period】12 days of hospitalization
Treatment effect] The disease was controlled and the patient recovered well after surgery
I. Initial consultation
Patient’s self-report: In order to fitness often jump rope exercise, today school holiday as usual at home to jump rope, more than 9 o’clock to start jumping rope, about 10 minutes after jumping rope, suddenly felt severe pain on the right side of the abdomen, no relief after rest, and nausea and vomiting, then accompanied by family members, 16:00 to the hospital. The outpatient doctor was informed that the patient had just had her menstrual period for 5 days and had no history of sexual intercourse.
(Patient’s outpatient medical record)
II. Treatment history
We explained to the patient and her family that a tumor existed on her ovary before, but due to its small size, she had not experienced any symptoms, but today, after strenuous exercise, the ovarian tumor rotated in the abdominal cavity, resulting in sudden onset of severe abdominal pain. Because of the prolonged ovarian torsion, it would lead to ischemia and necrosis of the torsioned ovary and loss of ovarian function, so emergency surgery was necessary. Moreover, in order to clarify the benign and malignant nature of the ovarian tumor, the tumor needed to be sent for pathological examination, and the patient and her family agreed to the surgery after understanding her condition. The patient was sent to the operating room at 18:00 for laparoscopic exploration under general anesthesia after perfecting the preoperative examination and preoperative preparation, and was seen to have a right ovary twisted 3 times and in a state of complete ischemia. After the surgery, the patient was given intravenous anti-inflammatory treatment with ceftriaxone sodium for injection and metronidazole injection. The pathological examination results were later reported as immature teratoma, and since it was a malignant teratoma, chemotherapy was given after surgery, specifically etoposide injection, cisplatin for injection, and bleomycin hydrochloride for injection.
III. Treatment results
The patient recovered well after surgery. Although the immature teratoma was a malignant teratoma, the patient was young, so she was given to preserve her fertility and did not expand the surgery.
IV. Notes
We are glad that the patient’s condition is under control after treatment. Since the patient is a malignant teratoma, he needs 4 cycles of chemotherapy, and it is recommended to follow the doctor’s advice to return to the hospital regularly for chemotherapy, and after chemotherapy, to review the blood routine and liver and kidney function regularly to understand the side effects of chemotherapy. After the surgery, we suggest that patients should eat light and nutritious food, more fresh vegetables, fruits, eggs, lean meat, etc., and less spicy and stimulating food. Pay attention to relieve psychological pressure and develop good living habits. As this disease has the possibility of recurrence, it must be reviewed regularly. Surgery and chemotherapy will lead to a decrease in the patient’s body resistance and immunity, so patients need to pay attention to personal hygiene, prevent infection and avoid going to crowded places.
V. Personal insight
For young women who are generally in good health, most of them do not undergo routine medical checkups, thus leading to some asymptomatic diseases that are easily overlooked, such as ovarian tumors. Malignant teratoma is usually found only after certain symptoms appear. This disease requires a comprehensive treatment plan based on the patient’s age, fertility requirements, cancer invasion, etc. For young women with malignant teratoma, fertility is usually preserved, so the scope of surgery is minimized, but chemotherapy must be administered after surgery, and attention should be paid to the side effects of chemotherapy drugs.