Dermoid Cyst Co-Existing with Ectopic Pregnancy - A Case Report

Abstract

Mature cystic teratoma is a common benign ovarian germ cell tumour, whereas ectopic pregnancy is a potentially life-threatening obstetric condition Their coexistence is rare, with definitive diagnosis dependent on histopathological evaluation. We report a case of a 33-year-old female with 7 weeks of gestation who presented for routine antenatal check-up without any clinical complaints, in whom laboratory investigations were within normal limits, except for elevated serum β-hCG levels, and ultrasonography suggested a right tubal ectopic pregnancy. A salpingo-oophorectomy was performed, and the specimen was submitted for pathological examination. Gross examination of the ovary revealed a cystic lesion containing yellowish-white cheesy material with tufts of hair. Microscopic examination showed a cyst wall lined by keratinizing stratified squamous epithelium with underlying sebaceous glands, hair shafts and mature adipose tissue, consistent with mature cystic teratoma, with no evidence of immature elements or malignancy. Sections from the fallopian tube demonstrated chorionic villi lined by cytotrophoblast and syncytiotrophoblast, accompanied by haemorrhage and acute inflammatory infiltrate, confirming tubal ectopic pregnancy. This case underscores the importance of meticulous gross examination and thorough histopathological examination in identifying concurrent adnexal pathologies and highlights the central role of pathology in establishing definitive dual diagnoses in gynaecologic specimens.