A case of chocolate cyst rupture in a 14-year-old female

Tsutomu Takaki, Tomofumi Matsuoka, Amane Mitake, Airi Kuruma, Yoshiki Sakamoto
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2019 · vol. 35(1) , pp. 195–198 · doi:10.5180/jsgoe.35.1_195 · W3156968287
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This case report describes a 14-year-old female who presented with severe abdominal pain due to a ruptured ovarian endometriotic cyst, classified as stage IV.

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This paper reports a rare case of ovarian chocolate cyst rupture in a 14-year-old female who presented with severe abdominal pain. Using ultrasonography and computed tomography, the authors identified a cystic tumor of the right ovary, and laparoscopic surgery removed part of the right ovary including the ruptured cyst, with intraperitoneal adhesions also found. Pathology confirmed an endometriotic cyst, and the lesion was classified as 42 points (focal score for ovary 20, adhesion score 16, tube score 8) and stage IV under the revised American Society of Reproductive Medicine classification; the report notes the limitation of being a single case report. This paper is centrally about endometriosis — an adolescent ovarian “chocolate cyst” (ruptured endometriotic cyst) managed surgically and assessed with staging.

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Abstract

Here, we present a rare case of ovarian chocolate cyst rupture in an adolescent female. A 14-year-old female presented with severe abdominal pain. Imaging, including ultrasonography and computed tomography, detected a cystic tumor of the right ovary. Laparoscopic surgery removed part of the right ovary including the ruptured cyst, and identified several intraperitoneal adhesions. According to the revised American Society of Reproductive Medicine classification, it was graded 42 points (focal score: ovary 20; adhesion score: 16, tube 8) and stage IV. The pathological study after laparoscopic surgery revealed endometriotic cyst of the right ovary. The patient is presently doing well with a course of low-dose oral contraceptive medication. Although ovarian endometriotic cysts are frequently encountered in adults, it should be noted that these lesions also occasionally occur in adolescents.
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症例報告 14歳の若年女性に発症した卵巣チョコレート嚢胞破裂の1例 2019 年 35 巻 1 号 p. 195-198 詳細 抄録 Here, we present a rare case of ovarian chocolate cyst rupture in an adolescent female. A 14-year-old female presented with severe abdominal pain. Imaging, including ultrasonography and computed tomography, detected a cystic tumor of the right ovary. Laparoscopic surgery removed part of the right ovary including the ruptured cyst, and identified several intraperitoneal adhesions. According to the revised American Society of Reproductive Medicine classification, it was graded 42 points (focal score: ovary 20; adhesion score: 16, tube 8) and stage IV. The pathological study after laparoscopic surgery revealed endometriotic cyst of the right ovary. The patient is presently doing well with a course of low-dose oral contraceptive medication. Although ovarian endometriotic cysts are frequently encountered in adults, it should be noted that these lesions also occasionally occur in adolescents. © 2019 日本産科婦人科内視鏡学会

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