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Abstract: This is a case of a 13-year-old girl who came to the hospital with occasional unexplained abdominal pain for 2 years, which worsened in the past 2 months, and a mass could be felt in the lower abdomen lying down. She was diagnosed as “teratoma” and was treated with laparoscopic ovarian mass debulking. After the operation, the abdominal pain and abnormal bleeding and fluid symptoms disappeared, and the child was advised to undergo regular review to avoid recurrence.
Basic information】Female, 13 years old
Type of disease】Benign mature teratoma
Hospital】Qilu Hospital of Shandong University
Date of consultation】April 2022
Treatment plan】Surgical treatment (laparoscopic ovarian mass removal) + medication (compound sodium chloride injection, glucose sodium chloride injection, cefuroxime sodium for injection)
Treatment period】7 days of inpatient treatment, 1 month of outpatient follow-up
Treatment effect】Good surgical effect, abdominal pain, bleeding and other symptoms disappeared
I. Initial consultation
The 13-year-old child came to the clinic accompanied by her mother. She reported that she had occasional mild lower abdominal pain in the past 2 years, which was obvious after sports activities. A gynecological ultrasound examination at a local hospital revealed a “large pelvic mass” and recommended surgery, so she came to our outpatient clinic. The gynecologic ultrasound showed that “a 14.7×10.6×10.1 cm cystic mass with poor intracapsular sound transmission and filled with dense light dots” was detected in the pelvis, and the diagnosis of teratoma was made.
II. Treatment history
After the child was admitted to the hospital, the relevant auxiliary examinations were completed and the blood tumor markers were within the normal range.
After excluding the contraindications to surgery, laparoscopic ovarian mass debulking was performed, and intraoperative rapid pathology reported “benign mature teratoma”. The operation went smoothly, and postoperative rehydration with compound sodium chloride injection and sodium chloride glucose injection, and anti-infection treatment with cefuroxime sodium for injection were given.
III. Treatment effect
On the 7th day of hospitalization, the child was in good general condition without fever, slight abdominal pain and distension, which was considered to be caused by gas residue from laparoscopic surgery. One month after discharge, the child was re-examined in the outpatient clinic. There was no dizziness and fatigue, no abdominal pain and bloating, no abnormal vaginal bleeding and fluid flow. The gynecological ultrasound showed “no significant abnormality in the uterus and bilateral adnexal areas”, and the abdominal incision healed well without redness, oozing and hard nodes, and the scar was not obvious. Now the child has resumed her daily study and life, and the treatment effect is satisfactory.
IV. Notes
I was happy to see the child’s recovery, and advised the child and her parents to pay attention to the following matters after discharge from the hospital.
1.Adjust living habits, don’t stay up late too often; pay attention to keeping warm, don’t get cold, postoperative immune system is prone to low, easy to catch a cold after getting cold, which affects the recovery of the body.
2, appropriate activities, can promote intestinal peristalsis, conducive to the recovery of gastrointestinal function, while preventing intestinal adhesions and lower limb venous thrombosis.
3, after the postoperative anal venting can eat a liquid diet, eat nutritious and easily digestible food, avoid eating cold, tobacco, alcohol and spicy stimulating food.
4. Pay attention to the cleanliness of the vulva, and go to the hospital promptly in case of abdominal pain, bleeding and other symptoms.
V. Personal insight
Teratoma is the most common ovarian germ cell tumor, there are two types of mature teratoma and immature teratoma, most of which are benign, that is, mature teratoma. Because early teratomas have no obvious symptoms, many patients do not feel them, but larger teratomas can cause abdominal pain and distention. For example, in this case, the child came to the clinic with abdominal pain, but fortunately, it was found in time and was a benign teratoma.