A calcific pelvic mass in a woman with chronic spinal pain: a case of mature cystic teratoma

Martha A. Kaeser, Jennifer K. McDonald, Norman W. Kettner
In: Journal of Chiropractic Medicine · 2011 · vol. 10(4) , pp. 327–332 · doi:10.1016/j.jcm.2011.06.004 · PMID:22654694 · W2020318691
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Mature cystic teratoma was diagnosed in a woman with chronic spinal pain after calcific densities were incidentally found in the pelvis during a spinal radiographic examination.

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Abstract

ObjectiveThe purpose of this case is to describe findings of a mature cystic teratoma and to further provide differential diagnoses for ovarian pelvic masses and calcifications.Clinical featuresA 27-year-old woman presented to a chiropractic teaching clinic with a chief complaint of chronic multilevel spinal pain. During a full spine radiographic examination, radiopaque densities were incidentally identified in the pelvic bowl visualized through a gonad shield. Follow-up pelvic radiography revealed several radiopacities of uniform density localized in the pelvic bowl. INTERVENTION/OUTCOMES: Medical (gynecological) consultation led to ultrasonography of the pelvis that revealed a mature cystic teratoma. The patient underwent complete excision of the mass through a laparotomy procedure. The patient continued to receive chiropractic treatment of her original cervical and lumbar spine complaints, further suggesting that the pelvic mass was not a source of her musculoskeletal complaints.ConclusionThis case demonstrates the detection and proper referral of a patient with a calcific mass. The presence of a pelvic mass, suspected of arising from the ovary, requires additional diagnostic imaging and careful clinical correlation.

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